Want an IUD...but which one?
October 25, 2010 10:57 AM   Subscribe

Have you used either of the IUD forms of birth control? Great! Help me out!

After quite some time without using birth control (just condoms when needed), I am now needing to look at a more permanent birth control option. For several reasons, I don't want to go back on the pill (migranes, naseau, sex drive problems, etc.) and that also makes me very hesitant about using other hormonal options.

It looks like an IUD would be a great option. But until today, I didn't realize there were two different kinds of IUD: the Mirena kind and the copper kind. It looks like the copper kind is less expensive, is hormone free, but has the same effectiveness (is it magic? how does it work without some kind of hormone?). The no-hormone thing sounds perfect. But...it looks like the trade-off is the possibility of some really messed-up periods.

So, I would like to know about side effects and hive preference between the two IUD options. What kind of discomfort have you had with these? I'm not too worried about the pain during insertion, but what about feeling it afterwards? Does it interfere with sex? How about your sex drive? How long did the spotting/ headache/ backache crap really last that they cite as the common side effects? If you have had similar problems/concerns with hormonal birth control, have you found that the hormone used with the Mirena kind is low enough that it didn't bother you? If I knew that wouldn't be a problem, it sounds like Mirena would be optimal because it doesn't have the period problems that the copper kind has. But, it's a pretty expensive option to just try and find out- I don't want to risk it not agreeing with me because of the damn hormones.
(Please, no "I heard about a friend of a friend that had an IUD go through her uterus and now she's infertile"- I know that most of the problems with IUDs were with a brand in the 70s, so I don't want to rehash outmoded scare stories.)

I've read the previoius Ask Me-fi's (like this one) and I'm checking out the IUD Divas site. But getting answers to my specific questions above would help out a lot! Thanks in advance.
posted by Eicats to Health & Fitness (44 answers total) 9 users marked this as a favorite
I had a copper IUD for a year about 10 years ago. I have always had very painful periods, and the IUD definitely made it worse. I didn't find that it interfered with sex at all. However, the pain was so bad that I finally had it removed. If I had to do it over again, I would have done the Mirena in a heartbeat, even with my dislike for hormonal birth control.
posted by Zophi at 11:06 AM on October 25, 2010

I have the Mirena IUD and I love, love, love it. I recommend it to everyone. The hormones seem to stay put (no weird mood swings like with BC pills or the NuvaRing) and I haven't had a real period in like, a year. However, I still get some spotting, but it's much less than a period and I don't miss them one bit.

In terms of pain, I never feel it and it doesn't hurt, ever. I don't ever get headaches or backaches, either.

You also have to consider time length - Mirena is good for 5 years verses 10 for the regular copper one. But it's worth it to me to get the Mirena.
posted by amicamentis at 11:09 AM on October 25, 2010 [1 favorite]

I have a copper IUD and LOOOOVEE it. Apparently the copper changes the ph of the "environment" enough to account for the birth control. I love it because it's good for 10 years, no hormones, no monthly cost, is more effective than the pill...the list goes on. I'm a single 30-year old female, no kids, and had no issues with my doctor inserting it. Apparently, some OB/GYNs will not implant in women who have never had kids due to the IUD not being effective at warding off the horrors of STDs, so make sure that your doctor is willing to do it. I even had it fully covered by insurance!

I had mine inserted in an hour appointment and went back to work the same day. It was a little uncomfortable but other than that, I was fine. My periods have been normal and nothing crazy has happened. The only maintenance is to check at least monthly to make sure you can still feel the strings. My doctor kept my strings long and I haven't had any complaints from partners, even the most *ahem* well-endowed.
posted by floweredfish at 11:09 AM on October 25, 2010

I've had a Mirena since 2006, and I absolutely love it. I'm really sensitive to hormonal treatments in general (had to get the Mirena because estrogen-containing BC gave me wicked migraines, and progestin-only BC had diverse nasty effects on me, and I'm allergic to most metals so Paragard was right out). But the only side effect I've had with the Mirena has been to lose my period, which doesn't really bother me anyway :) Based on anecdotal evidence, most women have decreased flow and/or less-frequent periods, and at least 20% completely lose their period for the duration of having the IUD. I would highly recommend it. A coworker has the Paragard, and she likes it okay, although her period has gotten pretty horrible (with dire cramping) after she had it inserted, so now she has to go home early from work a couple days a week every month.

In terms of feeling it afterwards, I felt like I could feel it for a few weeks after it was inserted -- like if I turned over weirdly in bed, or if I was doing yoga or something. But eventually that sensation went away and now I don't really notice that it's there. I didn't have any headache or backache, although I had random spotting for a month or two.

It doesn't interfere with sex at all, once you're allowed to have sex again (I think I had to abstain for a couple weeks after having it inserted). I haven't really noticed any side effects (other than the afore-mentioned losing of my period). I think I would go with a Mirena again over a Paragard, even if I was able to choose between the two. I used to have pretty horrid periods to begin with, and I shudder to imagine what it would be like to have cramps so bad I had to go home from work every month.
posted by kataclysm at 11:15 AM on October 25, 2010

I would marry my copper IUD if I could. I'm going on three very happy years and counting, and my only regret is that I didn't get it put in ten years ago.

I had terrible headaches on hormonal BC and so wasn't willing to risk the Mirena. Insertion was a snap, haven't had any of the side effects described above, can't feel the strings during sex, and my periods are pretty much the same as they've always been (no overt heaviness, no cramping or backaches, etc.).
posted by anderjen at 11:16 AM on October 25, 2010

Love the Mirena. I couldn't do the pill because the hormones messed me up really bad, but the hormones in the Mirena did not bother me at all. Got my first one when I was 27, replaced it with the second one at 32. The insertion kind of sucks, but it's over very quickly. Aside from some cramping for a few hours after insertion, no pain whatsoever. And, after a short breaking-in period, my periods stopped completely, which was a total bonus -- loved never having to deal with periods. Honestly, you don't notice it at all. You need to check the string occasionally to make sure it's still in place, but otherwise it's completely maintenance-free for five years.

When I was 35, I decided to have a baby, so I got it removed, and got pregnant the very first month after removal. So it's really the best of both worlds, IMO. I'm due in four weeks, and am planning on getting another Mirena put in as soon as I can after the baby's born.
posted by rabbitrabbit at 11:16 AM on October 25, 2010

I'm not too worried about the pain during insertion, but what about feeling it afterwards?

I noticed an ache (like cramping, but more dull and persistent) for about a day afterwards. Having said that, I walked out of the appointment and wandered the city for a few hours, so it was by no means debilitating. I didn't use tampons for my first period after insertion, but using them was fine after that.

Does it interfere with sex?

You will be able to feel the strings in your vagina (they are stiff and pointy at first, but soften within a few days) so you will probably want to warn your partner(s) about that. Assuming they don't pull on the strings (I'm wincing just typing that) I wouldn't worry too much.

How long did the spotting/ headache/ backache crap really last that they cite as the common side effects?

My first period after insertion was 3 weeks of spotting. The next 2 periods were spotting plus a light flow at the appropriate time. Every period after that has been very light and regular and I haven't seen much spotting at all. I haven't had any headaches, cramping or backaches, which I did have when I wasn't on any BC.

If you have had similar problems/concerns with hormonal birth control, have you found that the hormone used with the Mirena kind is low enough that it didn't bother you?

The main side effect for me with the Tricyclen 28-day pill was near daily headaches. I haven't had any since getting the Mirena.
posted by cranberrymonger at 11:17 AM on October 25, 2010

I've only had it a month or so but I can answer this question: What kind of discomfort have you had with these? I'm not too worried about the pain during insertion, but what about feeling it afterwards?

I know you said you aren't worried about the pain during insertion but I have to say this was not trivial for me. It hurt worse than I imagined. Afterwards, I was crampy and took off the next two days from work.
posted by gyroscope at 11:20 AM on October 25, 2010 [1 favorite]

I'm pretty sure I posted about my experience to a prior thread, but I will reiterate in case it is useful. I had a Mirena IUD for about a year.

-Discomfort: I had occasional twinges of uterine cramping when I had it in. They would only last a few seconds but were painful. If this was my only issue with it, I would have kept it longer.
- My sex drive was just fine. It did not interfere at all.
- I did not get any headache or backache. I did have some spotting/irregular periods, but I had that already, so that was not really an issue.
- I never had hormonal problems with oral contraceptive pills, but I did with the Mirena. I'm not sure why that would be, given the hormones are localized and low dose, but I think it was the fact that Mirena has progestins with no estrogens and most of the HBCs I'd had before were the type with ethinyl estradiol in them. With the Mirena, I had a small amount of weight gain, no big deal, it was maybe 5 or 10 pounds. I thought this was a small price to pay for never having to remember or pay for birth control, as I got the Mirena nearly free with my insurance and was otherwise enjoying it. However, I've always had pretty good/clear skin, and with the Mirena, I'd get breakouts of a pimple or two every few weeks. It was vain, but it bothered me. Not only that but I had a little bit of excess hair growth, and that bothered me even more. I had it removed so that I could have clear skin for my wedding, and have not gone back.

I will be interested in going back to an IUD at some point but would try the copper IUD to avoid the hormonal side effects. That being said, I think Mirena is a great method of birth control in a lot of ways and would not discourage others from using it simply because it didn't work out for me. Free, effective birth control that lasts many years is a beautiful thing.
posted by treehorn+bunny at 11:20 AM on October 25, 2010

That was with copper.
posted by gyroscope at 11:21 AM on October 25, 2010

I have the Mirena IUD and I have not had children and am in my mid 20's. Insertion was painful, but the worst pain was short. I spent a day on the couch (insertion happened in the morning) eating jelly beans and watching movies/TV while having what I consider moderate to heavy cramping. Heat definitely helped and it wasn't anything unbearable but not exactly fun times (and definitely worth taking a day off from work if you can do that). I had another day of mild cramping and that was really it. I had light periods for several months and I'm now (a year and 8 months later) to the point where I don't bleed at all or have one or two tiny spots. In the first several months, I felt like my cramps were worse than they were pre-IUD but the bleeding was lighter. I never had headaches or backaches.

It has never interfered with sex or my sex drive. My doctor left my strings long (standard practice I believe) and told me to come back to get them shortened if I wanted, but I never did. The tail curled up around my cervix and is out of the way. It can be felt with fingers but I don't think my male partner feels it during PIV. I've found it to have less sexual side effects than other hormonal birth control (even the Nuvaring, which I was on before).

I love it and I think IUDs in general are a really great form of birth control!

One of the big differences (besides composition) between the two IUD types is that Paragard is effective for up to 10 years, while Mirena is only effective for up to 5. Paragard works by releasing copper into your uterus and that apparently affects the ability of the sperm to join up with the egg and for the egg to implant if it does get fertilized. Also just having something in your uterus is thought to be enough to prevent pregnancy (though obviously not entirely since people can and do get preggers with and IUD inserted).
posted by radioaction at 11:23 AM on October 25, 2010

Nthing Mirena love - I too reacted badly to oral HBC, but the low, localized doses in the Mirena (which I understand are for the express purpose of regulating periods) are fine. It's amazing to not have to think about BC at all, ever.

I was pretty unhappy the evening I got mine inserted - bad cramps - but I was fine the next day.

My period has *not* stabilized, a year and a half after having it inserted - I still get completely unpredictable weeks-long periods of spotting and light bleeding. This is apparently within the range of normal for Mirena users, though you don't hear about it as often as the omg my period is gone! benefit. That's no fun, but it's still the best form of BC I've ever used.
posted by peachfuzz at 11:23 AM on October 25, 2010 [1 favorite]

I have had the copper IUD for about 18 months and I love it so much. (34 years old, no kids, married.) I wanted to get off hormones despite my love for the Nuva Ring because it was affecting my sex drive. I had pain on the day of insertion that required bed rest, advil, and a heating pad but none since then. My periods, if anything, are lighter than they were on hormonal BC. My doctor said that her theory is a lot of the reports of heavier periods is because most women go from hormonal BC to the IUD and don't remember what their non-hormonally-augmented periods are like. Not to say that no one has truly heavier periods, of course.

My only weirdness was after insertion I had 3 or 4 normal periods and then didn't have one for 4 months, which led to much freaking out and several home pregnancy tests. But then everything went back to normal. Plus that happened to be an extremely stressful time in my life so it may have been related to that and not the IUD.

I love my copper IUD and am so glad I have it - I only wish I had gotten it sooner.
posted by misskaz at 11:23 AM on October 25, 2010 [1 favorite]

I do not have an IUD. One of my closest friends had a copper IUD for YEARS -- almost a decade, I believe. (I think the copper itself interferes with implantation, is the deal.) She had no pain or sensation of "feeling" the IUD after insertion. It never interfered with sex or her sex drive. She did not have headaches or backaches; spotting was just intermittent and a pantiliner was plenty.

She had her IUD removed last December to start trying to conceive and was pregnant within three months (she's 32). She actually intends to get a new one between this child and eventual child #2.

In short, she was entirely delighted with the entire IUD experience and never intends to use any other birth control. I don't know if she tried or considered Mirena, and I don't know if there's a way to know in advance which is "better" for you. But her experience has been extremely positive. (And if it interferes with sex, I think there's something wrong with the IUD's placement, I don't think that's supposed to happen.)
posted by Eyebrows McGee at 11:28 AM on October 25, 2010

Oh, and regardless of copper or Mirena: prior to insertion make sure to take some Advil, and afterwards have someone give you a ride home and take the day off work. I had to get off the subway way early because of nausea that hit all of a sudden. When I got home I took a nice long hot shower and napped. After I woke up I felt a hundred times better.
posted by amicamentis at 11:30 AM on October 25, 2010

You can search my posting history for "IUD" and find stuff I've previously written. I was a huge proponent, and really, I still am. I had mine for 5 years.

I hate hormonal BC. It is EVIL (for me). I wasn't willing to even try Mirena. Insertion was no big deal (although I'm comparing it to some awful cervical checks while pregnant - it's definitely worse than a pap). My periods were generally a bit longer than normal, but no heavier than normal as my periods had ALWAYS been very heavy and awful, starting at age 12.

But. Then my periods started to be 8 days long, then 9, then months and years passed and suddenly I realized I was basically bleeding (or having slimy brown discharge) for 14 days every month. It interferred with my sex life and I discovered (DUH) that I was pretty severely anemic.

So I had it removed. And everything was instantly better. So don't be afraid to give it a try. Even based on my eventually negative experience, I would still recommend it. I really loved not having to think about birth control for 5 years. If I'm not mistaken, the copper IUD is actually more effective than tubal ligation. You really can't beat that.
posted by peep at 11:31 AM on October 25, 2010

I've had a Paragard copper-T IUD for *counts on fingers* almost five years now and I LOVE it. In another five years, when this one reaches its replacement date, I intend to have my doc replace it immediately with another one.

Hormonal contraception makes me suicidally depressed, so I wasn't willing to even consider the Mirena. (The doc tried, briefly, to persuade me to try the Mirena. "Have you ever been suicidal, doc? No? Then I'm not listening to your opinion about whether my becoming suicidal again is a risk worth taking.") Like many women, my periods became markedly heavier for several months after it was inserted, but after that they went back to lighter than they had been before. (This is apparently something where YMMVwildly.)

Because I've never been pregnant, the first time they tried inserting the IUD they had a bit of trouble getting it positioned correctly. It became dislodged within two days and I had to go back in to have it removed. A month later we tried again, this time using the ultrasound machine to check the positioning (ah, so that's what my uterus looks like — fascinating) and had no problems.
posted by Lexica at 11:33 AM on October 25, 2010

I have bad reactions to hormones so I went for the copper IUD about a year ago. My periods were already painful and the pain did increase with the copper IUD. However, I find that with a menstrual cup, the pain goes away COMPLETELY as long as I have the cup in, and my periods seldom last more than 3 days so this is very manageable.

It has never interfered with sex and my sex drive increased dramatically once I went off the hormones.
posted by Lobster Garden at 11:33 AM on October 25, 2010

All my answers apply to the Mirena, which I had in between the birth of my first child and the decision to try for a second, and which I loved.

What kind of discomfort have you had with these? I'm not too worried about the pain during insertion, but what about feeling it afterwards?

None. Insertion was not a cakewalk, exactly; it was like an exceptionally long and unpleasant pap smear. I did have some cramping later, on a par with menstrual cramps. They didn't stop me from performing that night as part of the chorale to a major symphony orchestra.

Does it interfere with sex? How about your sex drive?

Not at all, for either of these. It was completely not an issue whatsoever.

How long did the spotting/ headache/ backache crap really last that they cite as the common side effects?

I had none of this at all. Two of my good friends had irregular spotting that lasted several months. I was also exclusively breastfeeding at the time, though, so that could have been a factor.

If you have had similar problems/concerns with hormonal birth control, have you found that the hormone used with the Mirena kind is low enough that it didn't bother you?

I had been on triphasic BCP for 12 years; the effect of the Mirena hormones was RADICALLY different. So much less. My skin cleared up, and I had this neat little "pseudo-cycle," where I would get cervical mucus that was LIKE fertile CM but thicker at around day 13-14, then a very slight ovarian twinge, and then light spotting (like one pantiliner's worth) on day 29. Again, though, I was exclusively breastfeeding. When my daughter was about 17 months old, I started getting much more regular periods, though they were still really light.

I have plans to get another Mirena put in at my six-week post-partum appointment after this baby is born. That's how much I love it. I have a friend who just had hers replaced after 5 years, even though her husband has had a vasectomy, because she loves the easy periods so much.
posted by KathrynT at 11:33 AM on October 25, 2010

OK so it seems it's the Mirena that's more effective than a tubal. But that's good to know, too.
posted by peep at 11:34 AM on October 25, 2010

I've had the Paragard (the copper IUD) for three years now, paid in full by my insurance. I have mixed feelings about it.

The insertion was a little painful, though I think that was because I couldn't take ibuprofen prior to it as recommended, due to my aspirin allergy.

From fairly mild periods before the IUD I got very heavy ones in the first year, resulting in mild anemia. They were accompanied by mild cramping which never bothered me much.

While the periods have now stabilized, I still can't seem to help staining my clothing one day a month because my period suddenly gets heavy without warning and then tapers off.

I also had a fairly constant clear jelly-like discharge for the first six months.

I can feel the little string if I look for it - it feels like fishing line with a slightly sharp tip, possibly from being snipped at an angle, but it hasn't been in the way, IYKWIM.

It's nice that I don't have to worry about birth control for ten years and that I'm not exposing myself to unnecessary hormones, but I'm wondering if it wouldn't be nicer to just be done with these heavy days. If it weren't for the risk of weight gain I would probably switch to the Mirena.
posted by Dragonness at 11:35 AM on October 25, 2010

I have a copper IUD, and though I am very much a fan of IUDs my experience has been somewhat mixed. My only real symptom is that now I have very bad cramps. I didn't have very bad ones before, but for the first 18 months or so my cramps were absolutely debilitating for about a week straight each month. Advil and heat pads helped a lot with that, though, and I never had any of the headaches or backaches you mention. Now that I'm in year three, I get bad cramps twice a month: once for about 4-5 hours the week or so before my period, and then during the first 6 hours or so once I actually start. However, I've never had kids, and I'm fairly young and small, so my uterus was apparently just barely big enough to fit an IUD. If your doctor doesn't hem and haw about your uterus size then you'll probably be fine.

On the plus side, it hasn't interfered at all with sex or sex drive, and it's basically maintenance-free. And that's pretty awesome.

If money's not an issue for you, I would try for the Mirena. I wish I could have had it because I think it could have lessened my symptoms, but I can't do hormonal BC so oh well.
posted by lilac girl at 11:37 AM on October 25, 2010

No one knows exactly how the copper IUD works. Likely, eggs do not implant in a uterus that is being very slightly "irritated" by the presence of a foreign object. This is theoretical.

Everyone I know who has one loves it. I have never, ever heard of them interfering with sex in any way. The painful periods and spotting improve after a few cycles for most women, although that does not mean they will in your particular case.
posted by serazin at 11:44 AM on October 25, 2010

My insertion was painful but its so short that its not that big of a deal. I felt unwell for the first 2 days then was riding my bike on day 3. I paid out of pocket (no insurance) for a Paragard and managed to find a way, through low cost health clinics, to get it at considerably less cost than even Planned Parenthood.

Longer and heavier periods do suck and the first 3 months they were bad. I was used to no cramps and 3 days periods on no BC and then had 7+ day periods with some days in which I was afraid to leave the house for fear of a sneak attack deluge of blood. Now at 5 months in everything is much more manageable. It last 1-2 days longer than before, is heavier (but not epic) and I get a few cramps here and there. But, for me, those crazy horrible cramps only happened during the first 2 months.

When I was deciding between the two I did consider Mirena. The downsides were that it was more expensive and there was the possibility of hormone side effects. I haven't had horrible hormone side effects before but after so long on the pill I loved the hormone-free me so I decided it wasn't worth the risk.
posted by Bunglegirl at 11:52 AM on October 25, 2010

Paragard user here. Awful insertion, horrible few first weeks, but MUCH, MUCH better than any hormonal BC that I've been on.

I have longer periods now (12 days rather than 7), but I'm thrilled with it.
posted by roomthreeseventeen at 11:54 AM on October 25, 2010

I've had a Mirena for two years, and I also love it. I was 26 when I got it put in and have never had children. When I brought up my interest in an IUD, my ob-gyn suggested the Mirena over the copper IUD (citing heavy periods, cramping, more difficulty with insertion in childless women I think). I had never really settled on a pill, but I don't know that I'm particularly sensitive to hormones. I certainly can't tell any difference in my sex drive or my moods from pre-Mirena (without any hormones) and with Mirena.

The insertion was not pleasant, but mine was luckily brief. I felt an intense cramping, and then it was in. I went back to work for the rest of the afternoon, and out to a bar that evening, so in my case, it was certainly bearable. I had spotting, sometimes heavily, for 6 weeks or so, and then regularly spaced (though, my cycle is long, so regular by my standards and not by the 28 day pill standards) for several months which were somewhat heavier, but much shorter, than they used to be. After 9 months or a year, the periods got even shorter and for the last year or so, I have a period that lasts less than a day (though, with a different consistency than pre-Mirena, if that's not TMI), every 6 weeks or so. No headaches or backaches, though some cramping for the first month or two, which was a change for me because I had maybe had cramps 4 times in my life before that. If the cramping lasted for more than two months, I don't remember it and I haven't had any cramps within at least the last 18 months.

I can feel the strings if I go looking for them, but I've had partners who don't know that I have the Mirena and they have never commented or appeared to have felt them. My sex drive hasn't changed that I've noticed either.

When this Mirena has to be removed at the five year mark, I intend on getting a new one (unless there is a better form of birth control on the market by that point). Feel free to Mefi Mail me with any questions.
posted by Caz721 at 11:57 AM on October 25, 2010

I have a Mirena. I love it! Don't be wary of hormones; I had crazy mood swings and crying fits on pills (Ortho Tri-cyclen primarily) that I don't experience anymore with my IUD. The hormones are localized. I'm one of the lucky ones who had no cycle after the first few months. And even those months weren't heavy, just spotty. I've had it for about two years now. Sex drive has been stable. Mood is MUCH more stable compared to pills. I've had three individual days where I had some pretty bad abdominal pain that was probably IUD-related. I assumed it was shifting slightly. This comes with slight spotting. Ibuprofen and a nap has been my remedy thus far; it's never been severe enough to cause me to miss work or anything.

I've never had kids, so I was worried at first about finding a place to do it, but Planned Parenthood didn't give me any trouble.

Post-insertion, you want a heating pad, ibuprofen, and someone to bring you water. It wasn't pleasant by any stretch, but I had it done in the evening and was fine for work the next day. I do intend to get another one when this one is due for removal, even if I have to pay full cost. The way I see it, I would be paying as much or more over time for monthly pill refills, and it's worth it for the convenience and lack of a cycle.
posted by almostmanda at 11:59 AM on October 25, 2010

Logged in as my sock puppet 'cause this is all a bit TMI. If you like, MeMail me and I might reveal my true identity.

YES, your partner may feel your IUD. I've had two partners with them, and I have felt them during sex, usually when the woman has been on top. It would vary between a vague sense that something is there to a very noticeable and painful poking in the head of my penis, usually right near the point of orgasm, when I really didn't want to be poked there. Both partners spoke to their gynecologists, who initially scoffed at the possibility, then (claimed to) trim the strings. Didn't help.

I don't think I'm being overly modest when I say I'm of, um, average size. Perhaps I'm more vigorous than average, though? The "cowgirl" position did seem to be the only one that involved the poking, but it was bad enough that I had a vasectomy to avoid it (OK, I had a vasectomy for other reasons too, of course, but this was on the list). Now that the IUD is out, I'm noticing (well, we are, really) that I can penetrate considerably more deeply, which is, you know, nice.
posted by pupsocket at 12:23 PM on October 25, 2010

I have a Mirena IUD, and my experience is almost exactly the same as almostmanda's, without the uncomfortable feeling she had. I used to get migraines with the pill; the localized hormones in the Mirena absolutely do not give me migraines.

I love my Mirena. LOVE it. I'm getting another one in two years as soon as this one expires.

Unlike pupsocket, I've had a few partners since getting the IUD and none of them have ever felt it, nor the strings.
posted by saveyoursanity at 1:40 PM on October 25, 2010

I had a copper one and it was great except for the poky string that had to be trimmed by the doctor several times and once even er...spiked something. Even after trimming I sometimes had to reposition the string because it was poking me places. It was a while ago so maybe there have been new advances though.
posted by meepmeow at 1:52 PM on October 25, 2010

Response by poster: Thanks so much for all the answers! And at least one from the male perspective, too- that is also helpful, thank you. I really can't mark any as "best" because they are all giving me just the information I needed.

It sounds like a change in cycle is a legitimate concern with the copper variety...if I had to choose right this instant, I would say the risk of hormone problems with Mirena seems lower than the risk of period problems with Paragard, so I think I'm leaning towards trying the Mirena. But feel free to add to this thread, I'm still deciding and it will no doubt help others that are considering the same thing.
posted by Eicats at 2:10 PM on October 25, 2010

Another male perspective - my gfriend loves the copper IUD. So do I.

I have never, ever "felt" it when doing it; I have felt the string with my hand. I don't believe that it ever "pokes" anyone, so I wouldn't worry about that.
posted by RajahKing at 2:48 PM on October 25, 2010

My cycle didn't really change much on Paragard; though there was one weird month where my period just skipped. While my periods were oh so bloody and painful the first year, after 14 months the pain just.. disappeared. Now I don't have to take a sick day every month like I used to (even before getting the IUD)!
posted by The Biggest Dreamer at 3:19 PM on October 25, 2010

I'm a guy, and know next to nothing about IUDs, but since no one's brought this up so far, I'll chime in:

Make sure you and your doctor discuss the possibility of copper poisoning with the copper IUD. My sister and my girlfriend's sister both experienced it pretty much immediately after getting the copper IUD. My sister's doctor was aware of the risk going in, and informed her of the potential side effects, so she knew enough to nip it in the bud when the symptoms started showing up. My girlfriend's sister's doctor, however, didn't discuss any of that with her. She got pretty sick, and started losing her hair, and had no no idea what was going on.

Obviously this doesn't happen with the majority of women who use a copper IUD, but it's worth discussing up front.
posted by hootenatty at 3:28 PM on October 25, 2010

I love my Paragard (never pregnant, was in early 30s when I got it, have high blood pressure so no hormonal BC for me). Unfortunately, it's going to be ten next summer so I'm getting ready to have it taken out. I won't replace it right away because I'm not currently having sex, but when I get back into a committed tested-for-STD relationship with a guy, I'll get another Paragard*.

I had never been a cramper until I got the IUD, but that settled down after a while. The only thing that's lasted has been me being much more aware of mittelschmerz. My ex-husband noticed the strings for the first couple of months; I noticed that my cervix was getting bumped during missionary penetration. This may be because I'm built small or because I just didn't notice it until I had the IUD in, but changing positions helped.

* Like peep, I've noticed some changes in my cycle lately. I don't think it's IUD-related since I may very well be going into perimenopause at 43, but I'm going to take it out soon anyway.

The thing I said in the other thread still holds true: when you get it done, get someone to drive you. You don't know how your body will react; although I have a high pain threshold, I was so glad to have a ride so I could stare out the window until I could get home and lie down.
posted by catlet at 3:33 PM on October 25, 2010

I had a copper IUD inserted a year ago and it was a very quick, but for me, extremely painful procedure. But the pain only lasted 15 seconds. I cramped and bled for a few days but after that never spotted again.
My periods used to be 3 days long and extremely light with barely a cramp. Now, my periods are 5 days and more medium to heavy flow and the cramps are pretty bad the first two days. But for me, it is worth it because I don't want to be on hormonal birth control. I can also feel myself ovulating now and I have cramping mid-cycle due to that.
For me, the IUD has been a good choice despite the heavier periods and cramps (which have lessened as the year has progressed). I expect that it will keep getting better as time goes by.
posted by cescadarling at 4:49 PM on October 25, 2010

Count me as another very happy Mirena user. I don't think the Paragard was available at the Planned Parenthood clinic where I got my IUD but I would have chosen the Mirena anyway, mainly due to the rave reviews I read on AskMetafilter and other sites.

To be honest, insertion was very painful for me (a nulliparous 31-year-old at the time). The worst pain was, however, very brief. I felt very crampy (like medium-bad period cramps) for the rest of the day and had some intermittent, milder crampiness in succeeding days.

The only way the Mirena interferes with sex is that there's one particular angle / variation on the missionary position where (I hypothesize) my partner's penis pushes against my cervix in such a way that the Mirena gets pushed against the back wall of my uterus . . . maybe?? . . . and it's very uncomfortable. It's easy to avoid that angle, though. Otherwise, no problems. And the Mirena does not seem to affect my sex drive one way or another.

I can't remember headaches or backaches after insertion. Spotting, I'm not sure, maybe intermittently for 2-3 months but it wasn't a big problem.

I've never used hormonal birth control (other than the Mirena) so I can't really compare it.

One of my favorite side effects of the Mirena is a near-complete cessation of menstrual periods. I do a lot of outdoor sports and just never having to even THINK about whether I'll have to change tampons in the middle of the woods or after a swim is so liberating. I still get very, very rare spotting (like, tiny amounts of blood a few times a year) and sometimes I get a "ghost period" where I feel bloated, unsexy, and grouchy for a couple days but even the ghost periods don't seem to be as frequent as a regular period.
posted by LBS at 6:15 PM on October 25, 2010

I was on the pill for a while and experienced some side effects, mostly a serious decrease in sex drive. I got the Mirena IUD after my son was born, and it's been great. The way my midwife explained it is that the hormones in the IUD are localized, so they don't have to go through your whole body, the way they do with the pill. I've had no side effects with Mirena (though my husband has complained about the wire being a little uncomfortable, but I imagine that would happen with the copper IUD as well). I don't have periods, which is nice. The only thing I don't like about it is that my insurance didn't cover the whole cost, so I ended up with having to pay a rather large amount out of pocket.

I also have a friend who has the copper IUD and she loves it. She says she hasn't had any side effects, and her periods didn't get heavier or more painful.
posted by lexicakes at 9:10 PM on October 25, 2010

Depo Provera made me very nauseous, but the hormone dose from the Mirena was fine. I loved the Mirena when I had it, but the last year of it, I started to get bad side effects - constant tiredness, falling asleep uncontrollably, tremors, etc. I don't know yet if it was the Mirena, but after removing it at a doctor's suggestion, about 70% of my symptoms vanished. I wouldn't risk going back on it again, but I would still recommend it because from what I understand, the side effects are really low and I was just unlucky.

There's the arm implants which do pretty much the same thing, if you're worried about the insertion. That's to the skill of the doctor - I had one hellish insertion and one super easy insertion.

You do need to be realistic about STDs and UTIs. If you get either frequently, an IUD is not a great idea.

The other alternative is the patch. If I were to go back on contraception again, I would pick that because it's once a month, a low dose and non-invasive. Maybe try that for a couple of months and see how the hormonal dose works for you?
posted by viggorlijah at 3:09 AM on October 26, 2010

I have a copper IUD. I used to take Depo-Provera, and when I was in a long-term relationship again wanted something that worked without the hormones as Depo cased a lot of weight-gain and depression.

It's great because: don't need to think about it once it's in, no hormones, effective, lasts forever.

It's not because: it makes my periods very painful (I feel like I'm being winded) and heavy (as in, I frequently bleed through clothing and have to change towels a lot). This is inconvenient to say the least. It was also very painful to get inserted, but this was only a few hours' discomfort.

I've also had some skin issues down there which may or may not be connected which
means I will have to have it out earlier than planned. If it wasn't for these (and I stress it may not be) I would be more than happy with it.
posted by mippy at 8:17 AM on October 26, 2010

Oh - I haven't had kids, I believe the pain is less if the cervix has been opened.
posted by mippy at 8:51 AM on October 26, 2010

If you think you'll be able to switch easily (good insurance, eg), I would start with the copper IUD. That's what I did. I loved it but my periods got heavier and never got lighter again (for some women it's a temporary effect that eventually goes away). I finally got sick of all the bleeding and tried a mirena. I love the mirena and that my periods are almost gone, but I have gotten more acne since I've had it. So for me, it's bleeding vs. acne and so far I'd rather have the acne (it's not terrible), but if I could have had the copper without all the increased bleeding (which friends of mine have had), that would have been the best.

That said, if it will be more onerous for you to switch then it may be better to start with the mirena if that's how you personally weigh out the potential side effects).
posted by Salamandrous at 8:16 AM on October 27, 2010

I was having my first Mirena inserted as you were posting this! All I can say is that I love it so far, it was not NEARLY as painful as anticipated and, if possible, have a midwife insert it. I had normal period-strength cramping the day of insertion and now, a few days later, I have no symptoms whatsoever. My midwife tucked my string up near my cervix and guaranteed my partner wouldn't feel them. And he hasn't.

Also, insurance covered the Mirena 100%. Didn't even pay a copay.

I considered the Paragard because I wanted my libido back but my bff has it and is on the rag 3 weeks out of the month. I'm athletic and have very light periods even when off birth control. My midwife told me I'd likely have much heavier periods on the Paragard. No thanks.

I'm coming off the nuvaring and anticipated some ... ugh feelings with the transition from estrogen to progestin but nada. And my libido is kinda coming back full force which is the reason I decided to switch to a non-estorgen form of BC. I got pregnant twice on BC; once on the pill (the pill made me crazy) and once on nuvaring (I wasn't so good at remembering when I put it in pre Period Tracker app on my iphone) - so the libido thing may be due in part to reduced stress at getting knocked up.

Good luck and if you're in NYC, send me mail and I'll give you the name of my midwife.
posted by Siena at 5:42 PM on October 28, 2010

Re: STDs, there is no evidence that having STDs when you have an IUD increases incidence of pelvic infection or pelvic inflammatory disease (or any other complication of STDs). The danger is only if you have an STD or other vaginal/cervical infection during insertion.
posted by serazin at 7:58 PM on October 29, 2010

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