IUD freakout
August 3, 2013 5:56 PM   Subscribe

I've read the other questions about IUDs, but I'd like to ask some questions about my snowflake situation before I get one put in.

My boyfriend hates condoms and I can't use hormones (mood issues, weight gain), so we've settled on the copper IUD (Paraguard) as a possible solution. I have a few questions that don't seem to be addressed by previous Askmes...

- I have a VERY sensitive cervix. I hate gynecological exams, don't use tampons, and just feel everything very strongly down there. Will this be a problem with the IUD? Will I feel it all the time?

- I have wonderful, almost cramp-free short periods. I hear that they get worse with a copper IUD. But how much worse?

- I love deep thrusting in sex -- probably because of my sensitive cervix. Will this still be possible? Will sex hurt?

- Anything else I should know before I get it put in?

I'm going to get local anesthetic to put it in, and I think I'll be okay the day of, but I'm more concerned about how it will feel in the long term. They say that things will settle down over a few months, but if I can always "feel it", I don't know if I'll be happy with it.
posted by carolinaherrera to Health & Fitness (22 answers total) 1 user marked this as a favorite
Response by poster: After posting this, I started reading about Nexplanon. I can handle progestin-only pills (the mini-pill) but NOT the Nuvaring and I can't figure out whether or not that means I'll do well on Nexplanon or not.
posted by carolinaherrera at 6:09 PM on August 3, 2013

If you or your partner is really sensitive, the IUD might not be a great fit. Just from an anecdotal perspective (surfing on reddit.com/twoxchromosomes and IUD divas, most people feel like their cervix is MORE sensitive with an IUD. I have a Mirena (can't tolerate HBC by pill and hated the copper IUD) and haven't noticed any more or less sensitivity, myself.
posted by roomthreeseventeen at 6:57 PM on August 3, 2013

Also, local anesthetic is the way to go. It was wonderful.
posted by roomthreeseventeen at 6:58 PM on August 3, 2013 [1 favorite]

I could have written this question 13+ years ago. I only had the copper IUD for a few months. It hurt like a mofo going in, periods were longer and messier, and I had to get the string cut because my boyfriend could feel it. When I got it removed, I had to go on birth control pills for a few days to stop the bleeding.

YMMV, and indeed, there are lots of women who love their IUD's.

As for the Nexplanon, it appears to have the same type of hormone as Nuvaring does. Was the issue with the Nuvaring the device or the hormones?
posted by luckynerd at 7:05 PM on August 3, 2013

Response by poster: Thanks, luckynerd. The issue with the Nuvaring was the hormones -- they made me weepy, suicidal, depressed, and unable to focus. I think it was the estradiol, though not the etonorgestrel as I'm okay on the mini-pill (levonorgestrel) mood-wise, but I gained a lot of weight.
posted by carolinaherrera at 7:07 PM on August 3, 2013

I have've had inr for several years. Insertion was horrible and I felt an odd poking for a couple days post insertion despite thr clInic checking it was in the right place. My periods were lighting and cramp free pre UID and are heavier, bleeding wise but not duration, and I get minor cramps. The cramps last an hour or two an I don't usually take anything for them.

One ex could feel the string and its feelable with fingers but otherwise hasn't effected sex. If you have any other questions feel free to menial me.
posted by SpaceWarp13 at 7:16 PM on August 3, 2013

I have a paraguard, and I've noticed very little difference in periods. The first few are heavier, and there is a bit of cramping, but it's been a year and they've gone back to a few days, tops, and cramping manageable by NSAIDs. You can feel the strings, but they can also be trimmed. Local anesthetic would be the way to go, as without it the insertion can be unpleasant. Not nearly as bad as I was expecting after reading about it, though. A few seconds of wicked cramping, and then it's over. It felt weird for a week or so, and then I just got used to it.
posted by awesomelyglorious at 8:24 PM on August 3, 2013

I had a Mirena and loved it (although I had serious problems with other hormonal birth control including the pill and NuvaRing).

I didn't have an anesthetic, but I did get a shot in the cervix that was supposed to help, and I literally saw stars when it was inserted. I cramped and spotted for a day or so, and spotted for about 6 months before losing my period entirely.

My husband could feel the strings, and I had them cut short, which led to me not being able to check that it was still there. Earlier this year, I found out I had fibroids and started having heavy bleeding, and my doctor recommended we take it out. He couldn't find it, and eventually I had an ultrasound and an x-ray and we found out it wasn't there anymore. We have no idea how long its been gone (although we suspect it was around the time the heavy bleeding started) and now I'm back on the pill (mini).

If you are concerned about your periods, I wouldn't rule out the Mirena even if you have had trouble with other hormonal birth control, but don't get the strings cut so short you can't check, especially if your boyfriend won't wear condoms, and getting pregnant would be a huge issue.
posted by hrj at 8:33 PM on August 3, 2013

I got a Mirena IUD in February and had a rough first couple months. When everyone talks about the "strings," I thought it would be like a tampon string. NOPE. It was like fucking metal guitar strings poking the sides of my vagina. Hell, the first day they were poking my underwear because they were sticking out of my vagina. Bit of advice: don't get an IUD placed on a Friday afternoon. I had to call the after hours doctor line because there was no way in hell I was going to make it all weekend with guitar strings poking inside and outside of me. I ended up going to the labor and delivery unit on Friday night and getting the strings trimmed while perched on a hospital bed (which was very ironic given my actual labor and delivery experience two months prior, but I'll spare you that story).

So when my doctor told me that the strings would eventually soften and curl up around my cervix instead of hanging down in prime poking locations, I was beyond skeptical. But she told me to give it a couple more months, and I did. And what do you know, she was right. I honestly don't feel it anymore. My husband said he never felt the strings during sex, even toward the beginning, which I found hard to believe but whatever.
posted by Maarika at 8:40 PM on August 3, 2013

I think that it's great that you are taking charge of your fertility, but your question reads to me as if your boyfriend could be pressuring you about this. It's just a feeling I have. That is the first thing you should ask yourself. This is your body. That said, an IUD is wonderful because it is "set it and forget it" birth control and it is extremely effective.

To answer your questions:
1. I have never felt my iud inside me even though I too have a sensitive cervix. I hate vaginal exams and have a hard time with them. The iud insertion was really not that bad - I took Xanax and ibuprofin beforehand, which was very helpful. But you will not know it is is there once it is in. You can't feel it.

2. This varies. 30% of women experience heavier periods - up to 50% heavier. My periods were short and sweet and easy before my paraguard. Now they are longer (5 or 6 days instead of 3-4) and I have one or two days where I need to change my tampon 3 or 4 times. I also now need to wear a tampon or pad while I sleep, which never used to be necessary. I also have worse cramps, but they were very rare before I got the iud; now, I am always uncomfortable the day before and the first day of my period.

3. Yes, I love deep thrusting. My partner could feel my strings and they bothered him even with shallower thrusts so I had the strings clipped back. This made it worse. My gyn clipped them into the opening of the cervix so now it is not possible to feel them at all. This makes it so that I can't check if it is still in, but I am ok with that. If I expel the iud I may not know, but this is a risk I am willing to take.

4. This is your choice. You should use the birth control you are most comfortable with. I suggest you make an appointment to talk about your options with your gyn. That might be very helpful. I would also gently suggest that you start thinking of this as "my" decision and not "our" decision.
posted by sockermom at 10:13 PM on August 3, 2013 [1 favorite]

I really thInk you should try the Mirena first. I've had both kinds (no kids) and started with the Paraguad since I, like you, am crazy sensitive to hormones. The Paraguad did not work for me: 1) extremely painful cramps and bleeding. Like the kind where you don't leave the house for a couple of days and are living on Vicodin. 2) I could feel it inside me in the form of a dull ache for at least 2 weeks of my cycle; and 3) my boyfriend could feel it. (He did not feel the Mirena, I don't know why...)

Obviously everyone's MMV but given your situation and preferences I'd at least try the Mirena.
posted by hapax_legomenon at 10:30 PM on August 3, 2013

I'll echo hapaxlegomenon....

he hates condoms HOW much?
Condoms are not an unreasonable request or solution if it turns out an IUD isn't the answer. You could also look into a diaphragm or cervical cap!

posted by jrobin276 at 10:46 PM on August 3, 2013 [1 favorite]

I had what I'd rate as mild to moderate bleeding prior to my Paragard insertion. After the Paragard insertion, I was calling my physician husband every month asking if I needed to go to urgent care because I was bleeding so much. Unfortunately there's no way of knowing beforehand if you're going to become a heavy bleeder.
posted by emkelley at 10:48 PM on August 3, 2013

In terms of hormones, I used Implanon for over 10 years and loved it. I only had it removed because, after 10 years of continuous usage, I started to get some hair loss, but I think I'm very much a marginal case. I tried Nuvaring for one cycle prior to starting Implanon and it made me feel INSANE. Not sure if Implanon is the same as Nexplanon, but Implanon is definitely progestin only.

I've considered trying an IUD but I am way too chicken for the procedure. For some reason I find the quick, painless incision to the arm that comes with an implant much easier to deal with than a gynaecological procedure.
posted by nerdfish at 2:27 AM on August 4, 2013

Shoot just lost long post so abbreviated version:
- With paraguard, long heavy, frequent, painful periods. For 7 months, until I had it removed.
- Sex? What sex? I was (almost) always bleeding and/or in pain.
- I didn't realize it at the time but I had a smoldering case of endometriosis. The IUD pours gasoline on it, and planted a few C4 charges as well.
- I could feel it, but my body was trying to push it out and made it to my cervix before I had it removed.
- I got very sick with Chronic Fatigue Syndrome, beginning about a month after the IUD. Could be coincidence but I was very very sick for four years, and have only been feeling well again since the end of my recent pregnancy. Possibly unrelated, but the hormonal connection is interesting.
- I'm also another one who has had some bad reactions to hbc (nuvaring, hisss) but has also had some which seem fine. I don't know why some work for me and some don't though.

Good luck!
posted by pennypiper at 7:59 AM on August 4, 2013

Seconding the Mirena if you have had good experiences with the progesterone only pills. On the copper IUD my periods went from easy to very annoying. I held out for three years. I was wary of hormones on principle but I can't say how much I love my Mirena.

I do have some friends who, after a few months adjustment, ended up with periods they liked better with the paragard. But my recommendation would be to start with the Mirena. Also switching/replacing the IUD was much easier than getting it in the first place (no adjustment time).

That said, personally I also hate using condoms and I really like knowing I have a super effective and completely in my power form of birth control going on all the time. If that's not the case for you, and you're really doing it just and all for your boyfriend, that's really different. Him disliking condoms and your disliking all other forms of birth control really is a form of sexual incompatibility, and it might make more sense to find someone with whom you're more sexually compatible.
posted by Salamandrous at 8:35 AM on August 4, 2013

I have a Mirena and it is pretty great for me. I had a lot of weight gain on other birth control, less but some on the Mirena. And my periods have totally stopped.

That said, I have a pretty sensitive cervix and found insertion crazy intense. It's totally worth it, and look into the numbing shot others have mentioned, but definitely be prepared for an intense experience. That said, mine was over in two minutes, with some cramping for a day or so, for five awesome years of birth control. So I think it's really worth the effort.

Finally, regarding poking strings and all that, I think that it's most important to go to a doctor that has implanted lots of IUDs. I'm lucky to live near some big city women's health clinics. Be sure to ask your doctor how they handle followups like hanging strings -- you want them to be responsive.

As others have said, don't let anyone pressure you! But if you do make the choice for an IUD, in my opinion it's totally worth the effort of insertion and getting the strings right. Years of no hassle birth control, years.
posted by put another sock in it at 8:37 AM on August 4, 2013

If you're thinking Implanon, I can weigh in a bit. I got mine inserted at the beginning of May. It was basically painless. Now, the guy I went to had inserted about 500 of them, and said 5-10% of his patients get them removed.This mostly seemed to be because of periods— he explained that some women just start bleeding a lot, for weeks at a time. He said most women get their periods 15 days out of 90 days, but the implant can make that all happen at once, sometimes, and that there's no way to predict which ones will have that experience. He also said some women stop bleeding along the way, and some have mostly normal periods. As the first three months are especially fraught with period issues, he refuses to remove them before 90 days, to let women get used to the sudden rush of hormones that seems to accompany long-term birth control. He said if he were a woman, he'd use the NuvaRing.

I agreed that the NuvaRing had been awesome, but decided to get the stick anyway. I can't tell if it made me more emotional or made me gain weight, but it has played havoc on my cycle. I had my period for almost three weeks, and now seem to spot a lot.

I didn't go with an IUD because in college, I tried to get one from the local PP and they said my cervix was too short to insert one, which was heartbreaking.

Incidentally, my sister went on the copper IUD because most birth control made her crazy, to use the vernacular, but had to get it removed because her periods were unbearable. She's gone through half her options, I swear, but is currently on the pill, I believe.
posted by jenlovesponies at 2:25 PM on August 4, 2013

I've had the Mirena for almost a year, and I love it. I think I'll buy it flowers and chocolate for our anniversary.

I chose it because I wanted minimal hormones in my body and more spontaneous sex.

Insertion did hurt, but not more than getting your teeth numbed with that giant needle at the dentist's. Even though I've had a number of dental surgeries, I still wouldn't consider myself to have a high pain threshold. I just kind of resign myself to the pain and bear it then treat myself to a sweet beverage after.

As far as deep thrusting, my boyfriend rarely (like, 1 out of 50 times) will feel the strings as he goes in, but as he keeps thrusting, they are pushed out of the way again, and everything's fine. A few days after insertion, they are supposed to soften and then curl up around your cervix, so even if your guy feels them, he's not feeling the pokey ends, but the sides of it. Oh also, DO NOT trim the strings too short in an effort to prevent any poking. Your guy will probably still feel them, but instead of feeling the sides, he'll be poked by the ends. If the strings really are too long (like they're almost hanging out of you at certain times during your cycle when your cervix moves), then you can go back to the gyno and trim it a little. But start out medium length and go from there. You can always go shorter, but you can't go longer.

Oh, and the wonderful non-periods is just magic in the shape of a T. Probably the best part of the Mirena. Guy or no guy, sex or no sex, I love my body that much more because it no longer reduces me a to a crampy, bloody, immobile lump on my bed 2 days every month.
posted by shipsthatburn at 2:26 PM on August 4, 2013

He hates condoms but he's OK with you having a semi-permanent foreign object inserted into your uterus, even though you're "freaking out" over the prospect of this.

He could, maybe, get used to condoms. Aren't they sort of a fact of life now for a great many people? Why are you the one making the big sacrifice?

Right now it sounds like you're incredibly lucky to have short pain-free periods. No one can predict how that might change with an IUD. Personally I would not risk fixing something that ain't broken because my boyfriend "hates condoms".

You sound really scared about this. You don't HAVE to do it.
posted by Kangaroo at 4:08 PM on August 4, 2013 [3 favorites]

I've had a Paragard for three-ish years. It did hurt to insert, and periods were much worse for about 6 months. But it was still better than hormones, imho. I've never felt it poke and neither has my husband. I wish I'd gotten one 20 years ago--being off hormonal bc is that much better for me.

Keep in mind that people don't usually go online to talk about something that works--if you go looking for horror stories, you will find them. If an IUD sounds like a good fit, you are just going to have to accept that there is a small chance it won't work out. I think the chances are smaller than you perceive, but they are real. The key is to listen to your body, talk to your doctor and don't be afraid to go to them with questions or concerns afterward. If you are a good candidate for one, the odds are quite good that it will be fine.
posted by elizeh at 7:53 PM on August 4, 2013 [1 favorite]

Also chiming in with love for my Mirena. Insertion was a breeze (although the doctor was surprised by my lack of reaction since I'm nulliparous) and I have had no complications in the last two years since getting it done. I have heard that it's not as easy for many women though, so you are right to be cautious.

I hemmed and hawed about Mirena vs. Paragard for a while. I was really worried that I'd have a bad reaction to the Mirena hormones (I was on Tri-Cyclen Lo for a couple of years and it turned me into a mess) and I have enjoyed light, short periods for years, even before I was on any kind of hormonal birth control. Although I did have spotting for about six months after the Mirena insertion (perfectly normal) my periods are now nonexistent.

elizeh is right. I had myself worked into a bit of a tizzy by reading horror stories online, but my experience has been completely positive. Yes, there is always a chance the insertion won't work or it has to be removed for some reason. And it's a few hundred dollars down the toilet if it doesn't work. In my case, it was one of the best decisions I have ever made and my only regret is that I didn't get one years earlier. I can't feel it inside me and neither can my partner.
posted by futureisunwritten at 6:30 AM on August 5, 2013

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