to iud or not?

December 17, 2006 4:50 PM

Tell me about your IUD experience?

I've never been pregnant, had children, or stayed on hormonal birth control for over two days. [yasmin. it made me really weird.] I am considering getting an IUD.

Has anyone who had bad experiences ever tried the Mirena hormonal IUD? While it sounds less painful than the Paraguard, I am worried that the hormones will affect me as badly as Yasmin did and I was not and am not willing to be depressed and vomiting for a month to "get used to it."

In your experience did the Paraguard IUD make periods significantly more painful and heavy? [I would prefer responses on this one from people who did not go from hormonal birth control to the IUD because obviously going off of hormonal birth control would change periods anyway]

Are there different brands of IUD that I can't find in America that would be better choices? Will Blue Cross/Blue Shield cover it? Is there anything else I should know?

posted by mustcatchmooseandsquirrel to health & fitness (19 comments total)

Definitely check out past threads on it. I think most of my IUD wisdom's been posted already. :)

To sum up, though: Yes, I'd recommend it.
posted by occhiblu at 5:06 PM on December 17, 2006

I've been on the Paraguard for almost a year. I got it while I was still breastfeeding, so I don't have the clearest memory of my non-hormone influenced periods.

I think the changes have been very slight. I have a small amount of cramping now, I don't remember having any previously. And my period seems to last a little longer. I don't think the "volume" has changed, but I do have one day that is practically a flood. And spotting seems to continue for an extra day at the end of my period.

Neither of those changes are enough to give me second thoughts. Love my IUD.
posted by saffry at 5:08 PM on December 17, 2006

Only Mirena and Paragard are available in the USA. I went from Yasmin to the Paragard a few months ago and have been very satisfied. I picked the Paragard because, like you, I was worried about the hormones in the Mirena. Heaviness is about equal to my pre-Pill teenage years, although it lasts a couple of days longer. Pain is actually less. My BC/BS insurance reimbursed me for the IUD and the installation appointments, which I had done at Planned Parenthood. Take the day off when you get it put in and take at least a couple of Advil beforehand.
posted by amber_dale at 5:20 PM on December 17, 2006

I've posted in previous IUD threads. I'm also a nullip with bad reactions to hormones (although mine started suddenly, which is why I went off them.)

I had a three month gap between pills and the IUD but I charted since before I was on the pill as well. If you have crampy periods already, Paragard's possibly going to make it worse. I never had really crampy periods, and the first three or four cycles I had to take an NSAID, but nothing since then. The heaviness is about on par with pre-Pill periods, but I definitely feel more anemic than I did in high school. I've had it in for almost three years now and I love it so much it was worth the few months of crampiness and the insertion-day cramps.

There's an LJ group which is pretty active here, but a lot of the posts are people who have newly gotten them. You don't hear too much from long-term users since once the cramping goes away, generally there aren't problems. There are also some Brits in the community who can answer for some of the European variants.

As for insurance, BC/BS (in CT) covered mine in 2003. I think I had a regular co-pay only, and I think I may have had to drop $60 for my labs.
posted by cobaltnine at 5:21 PM on December 17, 2006

For some reason the comment I remember making about Paraguard and heavy periods doesn't seem to be showing up in those links. So:

I got a Paraguard after not being on hormonal birth control for about 10 years (I don't like the way it fucks with my body). Before getting the IUD, as long as I exercised regularly and ate reasonably well, my periods were pretty light and I had very little cramping. I figured I could handle upping both of those without seriously upsetting my life.

The first period with the IUD was hell. I spent three days curled up with a heating pad (which REALLY helped). My gynecologist inserted it while I was bleeding, so it was a combo of reasons for uterine unhappiness, but man was it unpleasant.

The next few months were iffy. Cramping wasn't bad -- I'd have one really bad day which could be staved off with Midol or heating pads -- but the heavier flow was starting to bother me. It was often ridiculously heavy compared to what it had been in the past, and there would be days when I was scared to leave the house because of it. More frustrating, it was like being a 14-year-old again, like I had no experience with my body and how it would react, because each month would be different. It was *really* psychologically frustrating and actually sapped a fair amount of my confidence for a while.

But they tell you it can take 4-6 months for things to settle, so I stuck it out. When nothing had changed after six months, I was on the verge of calling my doctor and having her take it out, but thought that I should try to do some research to see if I could make things more bearable first.

Various sites recommend various things for heavy flow and cramps, and I tried a bunch that I won't go into here (if you do need to find that sort of info in the future, I found the most helpful keyword was "flooding," which seems to be the common British term for heavy flow, and for some reason the most helpful sites I found were all British and Australian).

The most helpful advice I found: Advil, or other non-steroidal anti-inflammatory drugs. The site I found this on said the heavier flow is not really because of menstruation, but because your uterus is inflamed and trying to get the foreign body out of it. I started taking 2 advil every eight hours the week before and the week of my period, and all problems quite literally disappeared. The blood flow problems just stopped, within like 30 minutes of taking the first couple advil.

The site recommended continuing on the advil for a few days after your period, as well, otherwise you may start bleeding again.

So that discovery made it all good, and then suddenly a year to the day after I got the IUD inserted, my period got a lot lighter. Now, as long as I remember the advil, it's actually lighter than it was before I got the IUD.

(I mentioned all this to my doctor at my last appointment, and she said, "Yeah, Advil! It's great." I have *no* idea why *she* didn't tell me about it when she inserted the IUD, rather than making me hunt around for months on my own. Sigh.)

So: I liked the Paraguard IUD before, I love it now. Definitely check with your doctor to make sure that taking 1200mg of Advil or another NSAID is ok for you, but as long as it is, I think it's definitely worth trying the Paraguard. (And, from my experience, I'd definitely highlight that it may take a bit longer than the 3-6 months they claim for things to settle down.)
posted by occhiblu at 5:24 PM on December 17, 2006

I've posted in previous IUD threads, but just to reiterate: I have a Paraguard and I love it. I did have heavier periods (but no flooding) for the first few months, and there was some cramping, but I discovered the Advil trick, too.

After nine months, though, I found I didn't need the Advil anymore (and 600mg worked for me). The best thing overall for the cramps, though, was ThermaCare pads. I found I could reduce my Advil to 200-400mg (or none at all) with the pads. It's gotten to the point now that I forget I have it at all.

I really love the copper IUD and have become a bit of an evangelist on the subject. I was on hormonal birth control years ago, and had a stroke when I was 27 (ten years ago).
posted by astruc at 5:44 PM on December 17, 2006

I'va had a copper IUD for 10 years and love it - no thinking in advance, no extra hormones messing with my moods. The first few months were annoying in that not only was flow heavier, but it would come up all in one swoosh - making me sure I was in sight of a bathroom and with a change of clothes at all time. After that, I was just like a regular woman - periods every 4 weeks like clockwork, a bit heavier than I would hav liked, but nothing to think about or deal with. Really, the least worst form of birth control of tried (and for me that's high praise).

I'm going to have to go off it soon since it's been 10 years and I'm not sure what to do next. I'm guessing I've got about 5 years of fertility left and I've got no desire to be the world's oldest single mother.

The only tip I would have is - when you go to get it, have someone drive you home. That's the only time the cramping was really bad for me and like an idiot, I thought I was only going to get measured for the IUD and not actually getting it that day. I was hurting pretty bad and the drive home was not one of my fonder memories. Also, if you feel like it, stay in bed and let people pamper you the rest of the day. You won't feel on top of your game and you might as well milk that for all it's worth.
posted by katyjack at 6:02 PM on December 17, 2006

I've also been thinking about an IUD. Multiple OB-GYN and Planned Parenthood people have mentioned it may be difficult because I haven't had a kid, but they also say the hormonal effects of Mirena should be minimal unless you're really sensitive. The hormones are released locally, like with the NuvaRing, so they don't get out into your bloodstream to fuck up your head and weight. As such, I've been considering Mirena--it also is not supposed to have the cramping and heavy-period side effects of the copper IUD. The doc told me my period might even be shorter and lighter.
posted by schroedinger at 7:26 PM on December 17, 2006

when you go to get it, have someone drive you home

YES. Most enthusiastically yes, do not try to drive yourself home. I couldn't sit up straight.
Also wear loose pants, or a non-constricting skirt or dress, or pajamas. Bring a pad.

I have the Mirena. I chose it because I was told the copper one was larger, I think? but I might have made that up; and that it tended to increase cramping and flow. I hadn't been off hormonal since I was 19, so had no idea what my unmedicated adult cycle was like, but did not want to take the chance given that I had a significantly heavy and long period while on hormonal.
I had some minor issues with hormonal BC -- some weight gain, breast size increase, some mood stuff -- that may or may not have been attributable, as I'd been on it since I was a teenager and in college, etc. I also had trouble changing pills -- OrthoTriCyclen to OTC Lo to the generic of OTC; had mood swings and spotting for three months each time I changed.

For the first few months I would get random cramping unassociated with periods. My periods are now unpredictable but they are very, very light so it doesn't matter if I'm caught without my Diva Cup (which one can still use, I was told, as long as one breaks the suction before removing; the suction could potentially pull on the IUD. Apparently I was the first person to have asked). I did not have mood swings on switching. I also did not lose weight, but that's OK.

The thing that definitely did get better when I switched off the pill and onto the hormonal IUD was that the yeast infection I had had for approximately three years disappeared and hasn't been back since (it's been a year). That alone is worth the pain of the insertion. Which hurts. Like a bitch. So much.
(But then, I have never had a broken bone nor a baby nor a kidney stone or similar, so no idea how it compares. But I was pretty miserable.)

My doctor said they do the insertion while you are still bleeding on purpose (cervix more open, nearly-absolute certainty of non-pregnancy), so be prepared for that. I was on what was supposed to be the last day of my period, and it went for about four more painful days after insertion.

I got permission to take 4 Advil at a time (where 1 == 200 milligrams) for the few days afterwards. I also found the ThermaCare pads and long hot showers to be beneficial.

The only thing that worried me was that the procedure was involved enough, and costly enough, that it would really suck if it didn't work. It was hard to justify as an experimental "let's see if this fixes my yeast infection finally" sort of thing, like I could do with switching pills. As I'm also nulliparous, there were enough things in the Pros column and the only one in the Cons column was "I might not like it."

I love it now. I recommend it to anyone I can without being creepy.
posted by librarina at 7:51 PM on December 17, 2006

I've posted about having an IUD before (and asked about it before, too). I have the Mirena. No kids for me, ever. Hormonal BC started making me feel funny, too -- not the violent reaction you are talking about, but just "not right" and probably bitchy. The Mirena is awesome - I haven't HAD a period the whole time I've had it, which is not a guaranteed side-effect, but a common one. More painful or heavier periods were not an option for me, so the Mirena is basically BC nirvana for me.

You should talk with your GYN about this. I was afraid I'd have trouble with mine, but she asked me about plans for kids (none, and certainly none in the next five years) and a few other things, and then she said she would be happy to try, with the caveat that it's harder for someone who hasn't had kids. I had to take a pill on the night before I went - I don't remember what it was called, but it was to help dilation of the cervix to make insertion easier. I won't kid you, insertion hurt, but not necessarily any worse than a colposcopy, if you've had one. I sat on the couch for the rest of the day with a heating pad and then ate advil like candy for a week afterward. But it's been 100% worth it.
posted by Medieval Maven at 7:58 PM on December 17, 2006

... without being creepy.

Which goal, on seeing the number of paragraphs I just wrote about it, I suppose I missed.
posted by librarina at 8:02 PM on December 17, 2006

I have a paraguard. I have never had a baby, so I found the insertion to be incredibly painful, and the pain that day bad enough to take some percoset I had lying around. At first I had some sort of cramps every day, then every couple of days, and now only associated with my period. I always had bad cramps with my period when not on the pill, and it's slightly worse now. Alleve has worked the best for me, two at a time, twice a day. That being said, I think reliable non-hormonal birth control is worth it, discomfort aside. I wouldn't want all the pain of the insertion/cramping to get the Mirena, I'd rather just take the pill.
posted by jules1651 at 8:03 PM on December 17, 2006

Regarding the pain on insertion issue-- I have never had a baby, and due to bad timing, I did not have my period during insertion. It did hurt, but it was over in less than a minute, and was not the worst pain I ever felt. So don't be terrified!
posted by astruc at 9:29 PM on December 17, 2006

I have a Paraguard and it's not working out for me. I wasn't on hormonal birth control prior and had light periods and no cramping. Post insertion I have heavy bleeding (ridiculously, insanely, can't do anything heavy for at least 3 days a month) and horrible cramps and more regular bleeding for 7 to 10 days a month. As I can't take the pill I'm going to try the Mirena. My doctor and I expect this to work a lot better, the reason I didn't try it the first time was a) I wanted to avoid hormones and b) cost, my insurance doesn't cover it.

I really think that the insertion is key. Find someone who is really good at it and does it a lot.
posted by fshgrl at 9:57 PM on December 17, 2006

I've had my Mirena for amost 3 years, and it's great. I had been on the pill on and off over the years from the late 80's until the 90s and then for a few months about 4 or 5 years ago. I don't recall many problems with the pill apart from my last stint, which *really* exacerbated the depression I was suffering at the time (and taking Effexor XR for). Stopping the Pill stopped me from constantly bursting into tears. I briefly used Implanon, but ended up with frequent spotting and then bleeding that lasted for weeks. I know other women that use Implanon and don't bleed/spot AT ALL. So unfair. Implanon had no impact on the depression.
Mirena has been a wonderful "set & forget" contraceptive for me. My period is regular and very light, with none of the usual cramping and heavy flow, but it does last a bit longer than it did when my cycle was left to it's own devices. The hormones don't drive me nuts, in fact my mood is more stable now than it has been for years and I've been off the anti-depressants for 18 months (should have been much longer, but it took forgetting to take my meds on a week long interstate trip to force me through the horrendous withdrawl syndrome).
I was mildly crampy after the insertion, but it was nothing compared to what my period used to by like. I have had one child.
I highly recommend Mirena (and Implanon, even after my own negative experience with it, I think it's well worth trying).
posted by goshling at 3:41 AM on December 18, 2006

Does the Mirena remove a lot of natural lubrication?
posted by mustcatchmooseandsquirrel at 10:28 AM on December 18, 2006

I've not had any problems with natural lubrication, libido or anything else I can think of.
posted by goshling at 12:27 PM on December 18, 2006

I had both. I started with the copper one, 6 weeks after I had my daughter. While I was very happy with it because of the care free intimate life I could have, my periods increased in heaviness, as well as length (from 5 days to 9 days) over the next 3 years.

That 3rd year, my flow had increased so much, I had to take off work and go to the OBG (think 1 whole pad package in less than 3 hours, and huge blood clots).

He (doctor) took it off the following week, after doing some quick blood tests: my Iron was dangerously low.

A couple of years later, I had an ectopic pregnancy (while I was without the IUD), and was told I could never use an IUD again, because that would not prevent ectopic pregnancies.

A year later my doctor called me and told me about Mirena, and how it was safe for me to use it if I wanted. I've had it for 6 years now, and it's the best thing I ever did.

My periods are 3 days only, very light, and no pain. I did gain 10 pounds after I first had it inserted, but that wasn't a concern for me.

I hope this helps you make your decision.
posted by adriana at 2:46 PM on December 31, 2006

Got a Mirena (hormonal one). So far, so good.
posted by mustcatchmooseandsquirrel at 6:35 AM on October 23, 2007