To IUD or not to IUD (again)?

March 29, 2017 7:32 AM

It’s been about five years since I last thought about birth control, as that is when I had my first IUD put in. It’s been great not having to think about it at all, but all good things must come to an end in August. Before getting another one inserted, I thought I'd check and see what other methods people use and like.

So I originally picked the Mirena IUD for the lack of periods and the localized hormones. The main trouble I had with it was in the first couple of months, where it caused some difficulties for my husband and he felt like he kept getting jabbed by the strings. I did go back and have them tuck the strings up further, but he still felt like he was getting jabbed, just in a less pinchy way. I think what it really took was just time for the strings to soften and then it’s been fine for 4.5 years. The insertion was also really painful and I’m already dreading the removal. But if it’s once every 5 years, I guess I can deal with it.

So, really, I have no complaints about it and would be happy to just get another one inserted, but I was just curious what other people are using these days. Thanks!

posted by madonna of the unloved to Health & Fitness (31 answers total)

I had a really bad experience trying to get an IUD in once (and I didn't even get an IUD to show for it at the end!). I was on the pill for awhile, but I really wanted something longer acting and less dependent on my memory.

So I got the Nexplanon implant about a year and a half ago, and I really like it! The most painful part of getting it put in was the Novocaine injection, haha. When I get it replaced in another year and a half, I'll probably take some ibuprofen or something before going in to make that bit more pleasant. My arm was a little tender for a few days (like post-tetanus shot tender) and then it was fine, and now I don't even notice it's there unless I'm feeling around for it.

The chief drawback appears to be unpredictable periods/spotting. It's gotten better over time, but every so often it'll be like, "Huh, look at that." For me, it's not a deal breaker, but it could be a bummer for someone else. Also, your more squeamish friends probably won't want to talk/think about/look at it ever. :)
posted by helloimjennsco at 7:57 AM on March 29, 2017 [1 favorite]

The Skyla and Kyleena are available now, which are smaller and lower dosage devices (Skyla is 3 year, Kyleena 5 year). Insertion is supposedly easier and less painful - I don't personally have one, but I know several people who jumped to get the Kyleena due to concerns about future birth control coverage and they rave about it. Around my neck of the woods you can get either from your local Planned Parenthood, though YMMV depending on location.
posted by givennamesurname at 8:11 AM on March 29, 2017 [1 favorite]

I went from Mirena to Paragard last year because I wanted to lower (even more) the amount of added hormones in my body. I regret this and am actually thinking about switching back simply because I forgot how much having my period sucks. I had the same issue with Mirena where my boyfriend felt like he "hit" the strings, but after a few months this was fine. I didn't have that issue with the Paragard after insertion, but after not having a period for nearly 5 years and then having to remember how expensive tampons are... I'm not thrilled. In general, I still recommend an IUD to anyone looking for a really reliable, no worries type of birth control.
posted by thefang at 8:16 AM on March 29, 2017

For what it's worth, my insertion was painful and my removal was basically painless. Don't sweat the removal too much!
posted by olinerd at 8:24 AM on March 29, 2017 [5 favorites]

I'm in the same boat as you, although I had a (horrible) Paragard before I had the Mirena, which I love. I'm getting a second one this summer. My OB/Gyn does a local anesthetic shot in my cervix so I don't feel anything.
posted by roomthreeseventeen at 8:27 AM on March 29, 2017 [1 favorite]

Just a note that I agree on the removal -- you hardly feel it, it's nothing like the insertion
posted by neematoad at 8:27 AM on March 29, 2017

Chiming in as another person for whom IUD insertion was a nightmare and removal was a breeze! I had a Mirena that didn't work out, and I had it swapped out in favor of Nexplanon after about a year. Nexplanon has been great thus far (about 3 months in), and I enjoy having a weird, X-Files implant that can be seen/felt.
posted by quatsch at 8:32 AM on March 29, 2017

I use and like nuvaring. Yes, you have to think about it more often than an IUD, but I can also pick when I have a period, and that's fantastic.
posted by Ms Vegetable at 8:36 AM on March 29, 2017

Paragard for me, needed non-hormonal and liked the twelve year protection. Cramps were somewhat worse for the first year or so, but now I don't have any, and my periods are also shorter. Normal hormonal/aging changes probably, but it's nice. I use a DivaCup.
No reports of poking from strings, though I think they were trimmed pretty short to begin with.
posted by notquitemaryann at 8:47 AM on March 29, 2017

Going on year 8 of my Paragard. Insertion was no big deal but I was postpartum my second vaginal birth so nothing was a big deal, relatively speaking. I use a cup for periods.
posted by cocoagirl at 8:56 AM on March 29, 2017

I recently got my Mirena replaced and am glad I did. I considered the Skyla and Kyleena, but decided to stick with Mirena since I already knew it worked well for me.

My first Mirena insertion was terrible -- it took over an hour before I could even stand enough to walk out of the clinic, and I was completely out of commission for over a day. The second one went much more smoothly for me. I had some cramping during the removal and insertion of the new IUD, but nothing at all like the first insertion.
posted by thrungva at 8:57 AM on March 29, 2017 [1 favorite]

I'm on my second Mirena, removal was quick, but blindingly painful. Insertion was about the same the second go-round as the first time - painful but over reasonably quickly. Talk to your doc about pain management if you're worried, I've had friends who got a script for a Vicodin to take beforehand.

I didn't have them trim the strings at all, the bad stories I've heard were strings trimmed too short so they couldn't be tucked away.

I also previously had a Paraguard, and my periods were horrible on it. Cramps so bad I had to sit down on the curb, made me slightly anemic I was bleeding so much.
posted by momus_window at 9:00 AM on March 29, 2017

I'm on Mirena #3. I do not ever want to pay into the period industrial complex ever again. It's never great having the removal/insertion done, but it's also over fast. It's certainly less challenging physically for me than getting tattooed. YMMV.
posted by Medieval Maven at 9:20 AM on March 29, 2017 [4 favorites]

I am on Mirena #2 and will continue replacements until BC is no longer needed. It is painful, but quick and manageable with a local anaesthetic and paracetamol. I can't believe I spent so many years without it.
posted by Carravanquelo at 9:28 AM on March 29, 2017

I'm on Mirena #2. Removal of Mirena #1 was uncomfortable/pinchy, but it only took a few seconds. Insertion of Mirena #2 was pinchy and painful, in the range of severe cramps. It only took a few minutes and my very nice doctor explained every step and told me when to breathe in and out, which helped me keep calm. I had some light cramping for the rest of the day after insertion #2. Insertion of Mirena #1 was no more painful than #2 and went similarly smoothly, but I had nasty cramps for days after insertion #1. I have not had any complaints about stabby strings and to me the lack of periods is worth the temporary discomfort--no regrets!
posted by esoterrica at 9:32 AM on March 29, 2017

You haven't said what your birth control goals are. Are you thinking of having in a relatively soon time frame? A longer time frame? Never? That would be helpful to know when answering.
posted by vignettist at 9:36 AM on March 29, 2017 [1 favorite]

Just to chime in for others who might reading this, I have an IUD and didn't find insertion painful. Not saying that it won't be, but it isn't for everyone.
posted by caoimhe at 9:46 AM on March 29, 2017

I'm on Mirena 2 as well. It hurt coming out and it hurt going in but it was over quickly, and it's nothing compared to all the pain I missed out on due to having it! My gynecologist said that I could come back and have the strings trimmed shorter if I needed to, by the way.
posted by wintersweet at 9:49 AM on March 29, 2017 [1 favorite]

I'm on Mirena #2 as well and still love it. I was way more nervous than I needed to be about the removal/reinsertion. My doc recommended taking 800 mg of ibuprofen 30 minutes before, and that was great.
posted by donajo at 9:59 AM on March 29, 2017

Year 8 of my Paraguard and still love it. However, my doc couldn't find the strings at my last gyno appointment and did an ultrasound to make sure it was still there. It is, so I'm fine, but removal might end up being really awful if the strings have retracted and I'm not looking forward to it. IDK how common that is but I have heard from someone else who had that happen and said removal was just as awful as you'd imagine in this scenario. I just try not to think about it for now.
posted by misskaz at 10:26 AM on March 29, 2017

Chiming in another vote for another mirena. My insertion was very painful and my removal was literally painless. Im trying to get pregnant now but if I werent I'd get another mirena in a heartbeat.


Also I think that 6 months of poky sex for your husband is well worth the 5 years of no periods and peace of mind for you.
posted by pintapicasso at 11:00 AM on March 29, 2017

I've had the Paragard IUD for about 6 years now and love it! Never have to think about it and I like that it has no hormones and a really high effectiveness with preventing pregnancy. My significant other at the time did complain about being poked but they can cut the strings or move them up if needed. I don't know if I would ever go back to birth control pills at this point, since Paragard makes things so easy and I've never been good at remembering to take pills!

I do miss not having acne which was a nice pro to taking hormonal BC.
posted by koolaidnovel at 12:50 PM on March 29, 2017

Bout to get Mirena #3 in a couple weeks. Having #1 taken out and #2 inserted was *nothing* like having #1 inserted. It was sooooo much easier.

Given the potential fuckery with healthcare, I'd totally get another one and at least be covered for another 5 years. (and for what it is worth, in Europe you can leave them in for 7 years.)
posted by CoffeeHikeNapWine at 1:14 PM on March 29, 2017

(First time Mirena user- just wanted to say thank you for asking this question as I was concerned about the poking; I'm getting married next week and haven't had sex yet. It's so good to know that the strings soften over time. Got my Mirena in 2015 so it should be fine! )
posted by freethefeet at 1:28 PM on March 29, 2017

Lesbianism. But before that, I loved my Mirena and miss some of the advantages (lighter periods, less intense cramps).
posted by sugarbomb at 1:30 PM on March 29, 2017

Anecdata: removal for me was a nightmare. They broke the strings trying to get it out and after another visit to the hospital where they even used ultrasound and forecep-type things to get it and THAT didn't work (think: scene from a horror film), I had to go under a general to have it surgically removed. So, things CAN go wrong at the removal stage. Saying that, if I had to use birth control again (husband has since had a vasectomy), I would choose the IUD.
posted by Halo in reverse at 1:54 PM on March 29, 2017

Looks like other folks covered your questions, but I wanted to chime in -- good evidence suggests that the Mirena has enough hormone to prevent pregnancy for 7 years. I'm planning to keep mine for 7. Here's the abstract of a review article of the evidence, and here's a large randomized control trial. Memail me if you want the full articles.
posted by i_am_a_fiesta at 2:41 PM on March 29, 2017 [1 favorite]

Another removal was a nightmare person here. IT SUCKED for me. Putting it in, nbd. I'm on round two and it's a very personal experience.
posted by coldbabyshrimp at 6:58 PM on March 29, 2017

I am on implant #2, and I love it. I don't have my period-- though I had about three weeks of a period at first insertion, and a regular cycle the next month, and maybe some occasional breakthrough bleeding but it's pretty light.


I previously loved my NuvaRing, but I was truly terrible at tracking it. This really pre-dated all the apps I'm sure there are these days that could remind me when things need to be inserted or removed. Also, you're supposed to refrigerate them before use, which was hard during college, between roommates, study abroad, and summers at home with my mother.
posted by jenlovesponies at 7:17 PM on March 29, 2017

Response by poster: We are actually planning to try to conceive in about a year, year and a half. So the prospect of leaving it in for longer is quite interesting to me.

And thank you for all the stories! Looks like Mirena is still popular, but I had no idea they had other kinds now. That will be something I can discuss with my gyno and also with my insurance to see what they cover.
posted by madonna of the unloved at 10:53 PM on March 29, 2017

Speaking as someone who had a lot of fertility issues, if you want to TTC within the next year I suggest removing it and then forgoing hormonal BC for a while and allowing your body get back to it's natural cycle.

You most likely won't have any of the issues I had, but in the very off chance that you do, your doctor will tell you to do exactly what I'm telling you to do, except then you will have to wait another six months or a year before TTC. Better to get to know your cycle now (protip: start charting as soon as you remove the IUD) so that if you do end up needing medical help you won't waste additional time.

Second protip: Before you start TTC, read one of Metafilter's favorites, Taking Charge of Your Fertility.
posted by vignettist at 9:37 AM on March 30, 2017 [1 favorite]