the question is, how *much* will the IUD hurt my cervix this time?
October 17, 2011 2:10 PM   Subscribe

Tell me how IUD replacement compares with first-time insertion of an IUD.

Mirena, more specifically. I had a Mirena placed in 2006, so I'm due for a new one now. I'm 28 and have never given birth. The insertion of my IUD was the single most painful event in a life that has been filled with accidents, broken limbs, and other unpleasant occurrences. Needless to say, I am anticipating that next week's date with destiny is going to be un-fun.

So, when this thing is yanked out of my uterus and Mirena v.2.0 gets shoved up in there immediately thereafter, is it going to suck as much, less, or way way more than when the first one was inflicted on my unsuspecting uterus? I'm already taking the next day off from work and trying to get my hands on as many sedatives and painkillers as possible; I'd just like to know what to expect and if there are any brilliant uterus-painkilling suggestions.
posted by kataclysm to Health & Fitness (21 answers total) 4 users marked this as a favorite
Mirena lasts 5-10 years, depending. You might not have to replace it until 2016.
posted by roomthreeseventeen at 2:16 PM on October 17, 2011

I had mine replaced this year. Last year? Recently-ish.

It seemed worse to me this time. I don't remember the first time as quite so bad, but I needed a local - she gave me lidocaine in the old cervix. Which made my ears ring, which was really, really trippy.

Take a snack. A Clif bar or something. FWIW the aftermath - how long I was uncomfortable and so forth - was a lot less.
posted by Medieval Maven at 2:19 PM on October 17, 2011

Did you take plenty of ibuprofen before the insertion last time? I remember being told to take 600mg (3 pills from a standard drugstore bottle), and yeah, it still hurt like crazy, but I'm sure it was better than having no painkillers on board. My doc also told me that removal is a cakewalk compared to insertion, so at least that part of it shouldn't feel too bad. I can't imagine that putting a new one in will feel much different than the first time, though. It's not like the procedure permanently stretches out your cervix the way having a baby does, so having had an IUD previously probably won't influence how it feels to get another one put in. Good luck!
posted by vytae at 2:20 PM on October 17, 2011

My first insertion was mildly to moderately painful. I literally did not feel my replacement- the ol one was out and the new one was in before I even knew what was happening. I felt almost nothing. It was so easy that I literally asked, "Wait, really, it's done?" of course, YMMV.
posted by samthemander at 2:24 PM on October 17, 2011

The most important thing I learned the second time around is that you can request a local anesthetic. Which makes it painless!

I have no idea why they don't do this for everyone, but my doctor suggested it after I explained that the first time had been so difficult (I passed out). Well worth bringing up, at the very least.
posted by susanvance at 2:44 PM on October 17, 2011

I've heard tell it also hurts less if you get it done during your period (many doctors will have you purposely schedule IUD insertion to make this timing work out).
posted by Go Banana at 2:53 PM on October 17, 2011

My first one, five years ago, was moderately painful during insertion (like one big "OW" and then it was better) and then turned into a solid afternoon of pain. I'd taken OTC painkillers, didn't have other anesthetic, and hadn't ever been pregnant.

The removal and re-insertion last month hurt about the same amount during the procedure but was easier to deal with afterwards, just some mild cramping and bleeding. I had local anesthetic this time, but it didn't seem to make a difference. This was a different doctor.

I asked the re-insertion doctor what the status is re: Mirenas being okay for more than 5 years. She said they haven't been approved/shown to be good for more than 5 years and didn't recommend waiting. (I didn't press the issue, I'm happy to be conservative when it comes to birth control, but she did seem well-informed.)

Hope it goes well for you. I tend to just repeat to myself, "I'm sure childbirth hurts WAY more than this."
posted by orangejenny at 2:57 PM on October 17, 2011

In reply to previous posters: last time around I took 800mg ibuprofen and ate some food. I will look into getting a local anaesthetic -- sounds like a good idea to me :)

And I can't schedule the replacement based on my period, because I haven't had one since 2007, which is another reason that I love my IUD :)
posted by kataclysm at 3:00 PM on October 17, 2011

The local anaesthetic is great (I didn't realize they did them without! yikes!), but it won't make the whole thing painless. My insertion itself didn't hurt that much, but my innards were sore for the rest of the afternoon. Taking the day off work still seems like a good idea. This, btw, was for the first time around-- reading above it sounds like that might be lessened the second time.

Importantly, though, if you are at all not into needles, I do not recommend looking down while they are giving you the anaesthetic. Because watching someone insert a needle into your vagina is just straight up creepy.
posted by dizziest at 3:08 PM on October 17, 2011

Another anecdatapoint: my second hurt about the same as the first one did, maybe slightly less.
posted by rabbitrabbit at 3:13 PM on October 17, 2011

Just throwing in my two cents: my second (Paragard) insertion was much easier than my first, and the removal was not much worse than a cervical menstrual cramp (if you've ever had that). My practitioner was more skilled the second time around so the overall process was much faster, which I think had a lot to do with it being less painful. I also took Tylenol and ibuprofen before hand.

You can also ask about getting misoprostol (a cervical softener) that you can either administer orally or vaginally. I had it my first time and not my second, so I'm not sure how much it helped.
posted by SugarAndSass at 3:38 PM on October 17, 2011

It hurt less than the first (bigger, copper IUD).
The only thing that sucked, is that I was considerably freaked out (eyes watering - not crying! Ok, ok, crying. :P ).
I thought I was doing well, with the gritting my teeth and telling them to 'just do it!', but then they told me I had to relax so they could get it in. WTF?!

That seemed unfair, but hey, I managed it, and it hurt way less, so I just felt like a bit of a sook (wuss).

And, isn't it worth it? Yes it is!
posted by Elysum at 3:42 PM on October 17, 2011

My second hurt waaay less than the first one. For whatever reason, there was another nurse/doctor in the room with me the second time. She insisted I squeeze her hand while the other nurse did her thing. Hand-holding nurse also kept asking me questions, which I thought was rather annoying, but it actually helped. And I think it all wasn't as bad as I'd anticipated because I'd worked it up in my head as The Worst Pain Imaginable. Plus, see the small print...

The second time didn't actually entail removing the old one first, because I had the rather fun luck of having the IUD accidentally dislodged a few months first trip to the ER in foreign country, and on a holiday to boot, whee! So anyways, couldn't tell you what it would be like to have the thing removed and then immediately replaced. Having it go awol, though...worse than both times, let me tell ya.

At any rate, good luck! Oh, also, spend a moment being amazed at the rush of endorphins that steps in 3 seconds after the pain. You can literally feel the wash of brain chemistry doing its magic. The body-mind is an amazing system.
posted by iamkimiam at 3:45 PM on October 17, 2011

Not to be a bummer, but my second hurt just as much as the first. They were both just really painful for me, enough that the second time I kept thinking "Godammit this better be worth it! Wait, I know this is worth it! Oh god, this better be worth it!"

Both times I had quite a bit of pain the first thirty to forty-five minutes afterwards, and then the pain eased off remarkably.

I don't know how your brain works, but I just tell myself it'll be as bad as possible so I'll be pleasantly surprised. Regardless, the Mirena is so totally worth it.
posted by put another sock in it at 5:27 PM on October 17, 2011

Removal of my first IUD hurt a lot, but only momentarily, I was fine after. I didn't get my second IUD until a couple years later, but insertion was about the same as the first go-round - I probably could have gone back to work, but was glad I took the afternoon off.

I've heard from other folks that the replacement was horrible, and worse than getting the first one, so planning for a day off isn't a bad idea.
posted by momus_window at 6:29 PM on October 17, 2011

I had a copper pulled and immediately replaced with a larger mirena.

I think the pain of the actual insertion was comparable to the previous time (but then my friends have accused me of under reporting the pain. The thing is it's over so fast). What was amazing and wonderful and awesome was that my body loved it right away. This time around, no weeks of spotting and crampiness. I literally walked out to the subway and went about my day.
posted by Salamandrous at 6:45 PM on October 17, 2011

Update: For me, removal wasn't bad at all. Reinsertion hurt so unbearably much that I couldn't deal with it immediately after removal. I actually had to reschedule the appointment, preload myself with as many painkillers and anti-anxiety meds as possible, and come back (I was quite literally staggering and drooling on my way into the waiting room). It still hurt like a bitch, definitely even more painful than the first time and now I'm super-worried about having kids someday because if anything hurts more than that, I think it will drive me insane or maybe make me die.

However, on the bright side for anyone else who is reading this later, it took the replacement IUD no time at all to settle in, unlike the six weeks of spotting and crampiness I had with the first one.
posted by kataclysm at 11:07 AM on December 5, 2011

kataclysm - I ran across this post doing some research and just wanted to assure you that, as a person who has given birth vaginally and a person who has an IUD, getting the IUD placed was MUCH more painful than childbirth. Way.

I will probably have another baby - I will not be getting another IUD.
posted by bdowngold at 12:53 PM on July 19, 2012

bdowngold: OUCH!
I say this in all seriousness - I strongly recommend you find someone else to put in an IUD if you ever do it again, and am wondering what on earth your Doctor was doing! That's utterly ridiculous, and unecessary pain.

For all that I was a wuss about the getting it placed, it was in no way comparable to childbirth, or even falling over and banging my knee on concrete. I just got a lot more anxious about it, and hated the 'having to relax' bit.
And, this is pre-partum, and I have a small to medium uterus, so it's not like it was easy.

Seriously, two full magnitudes of pain below childbirth, at least.
Well below teeth extraction, below bruising my knee on a concrete step, and probably only a bit worse than getting a pap smear, tetanus vaccination etc (I hate needles).

Wow, I can't imagine how much they must have screwed that up!
Definitely go somewhere like FPA, where the doctors have placed hundreds of IUDs, rather than any Dr who has not had that much experience.
posted by Elysum at 4:29 PM on July 19, 2012

I will probably have another baby - I will not be getting another IUD.

Agreeing with Elysum, and also noting that if you do have another baby, your ob/gyn can place the IUD immediately, when your cervix is all wide open anyway. (Also agreeing with Elysum that it should be an ob/gyn who's experienced in it). Though if your original IUD placement was before childbirth, you might find it significantly less painful later no matter what. Although the thinking that IUDs are more suited for women who'd already given birth than for nulliparous women has not held up to scrutiny, as far as I know pretty much everyone agrees that insertion is less painful for parous than for nulliparous women.

Also, OP, hadn't seen your update. I'm so glad it ended up working out well though it sounds like it was hellish at the time. Sympathies!
posted by Salamandrous at 5:12 PM on July 19, 2012

Just chiming in here to say: I had two Mirenas inserted before childbirth, and one inserted two months after my son was born. The first two, while not really any huge deal, were at least painful enough to be memorable, probably on the scale of spraining one's ankle though the pain only lasts a few seconds.

I honestly cannot even remember the third (postpartum) one being inserted. I mean, I remember the appointment, but don't remember any pain at all with the insertion. (I was more focused on getting out of there so I could go pump or nurse, because I hadn't been away from my baby or a pump for that long before and my breasts were more uncomfortable than the IUD was!)
posted by rabbitrabbit at 8:21 AM on July 20, 2012

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