Should I go? Overdue IUD removal vs. coronavirus
March 15, 2020 6:36 PM   Subscribe

Should I leave my IUD in until the peak of the coronavirus epidemic has passed in this area?

I got the Skyla IUD, which lasts for 3 years, in January of 2017. That was also the date of my last physical exam. I have an appointment to get it taken out in mid-April and get my long-overdue physical exam then too.

I’m leery of going to the doctor’s at the moment, because it seems like a high-risk place to be in terms of possibly contracting the coronavirus, but I’m not in a super high-risk demographic—turning 40 soon, no medical conditions I’m aware of that would put me more at risk. My older relatives all live far away, so I won’t be seeing them during this time. There are currently about 5 cases in my area, 20+ in my state, no known community transmission as of yet.

What should I take into account in making my decision about whether to keep this appointment? Assuming they don’t make the decision for me by calling and asking me to reschedule.

What happens if I leave the IUD in longer than is recommended? If/when things get serious, it could be months before I could get it taken out. Is it better to avoid the doctor’s office until things are feeling a bit more normal? Or does it make more sense to go ahead with it before the shit hits the fan (if we’re so lucky in a month)? I worry that if I decide to leave it, I could later end up in an emergency situation that would force me into the ER after there are no beds left.

I don’t feel great about not having had a physical for a while; I have a family history of diabetes, so I’m nervous of what my bloodwork might look like after this long gap and want to make sure I haven’t become prediabetic or diabetic in the meantime (I feel ok, but you never know, and I’ve gained weight since the last exam too.)

Any thoughts or words of advice?
posted by music for skeletons to Health & Fitness (9 answers total)
Best answer: You'll probably be fine either way for the IUD.
1) It does not need to be removed at the expiration date, assuming that you're not having problems with it. The effectiveness will begin to decline, so you should consider using another form of birth control. Many IUDs are actually effective beyond their expiration date for at least some populations, but I wouldn't count on it.
2) The process of getting an IUD out (assuming no complications) is also very quick, easy, and painless. Less than five minutes. So if you decide to get it removed, you'll be in and out very quickly.

For the exam and bloodwork, you could look into whether your doctor had any kind of telemedicine option. They may be able to do an initial screening over phone/ video and then help you prioritize tests or advice you to hold off.

I would probably keep the appointment, as long as the doctor's office wasn't in a larger hospital or medical center.
posted by oryelle at 6:52 PM on March 15, 2020 [6 favorites]

You should call or send a message to your doctor's office with this same question.

Ours had us just come in to do a kid's immunizations, and the checkup found something that we did want to take care of right away (an undetected ear thing), so I'm glad we did. But ask me again after 11 more days.
posted by slidell at 6:55 PM on March 15, 2020 [2 favorites]

I researched this a while back with a non-Skyla IUD, so I would definitely recommend putting in a call to your provider in case there are Skyla specific considerations. But with my type of IUD, the situation was basically "fine to leave in for months and maybe years past planned removal date, but effectiveness will wane, so use backup barrier contraception if getting pregnant would fuck your shit up right now."
posted by Stacey at 7:04 PM on March 15, 2020 [7 favorites]

Best answer: To answer your question, I came to say what Stacey said; basically, if you can take care of your contraception in another way, there's no reason not to wait. (I let my last IUD removal slide by many, many months and my doctor expressed no concern at all; it was a Mirena.)After three years, another two months is really unlikely to make any difference in the results of your physical, unless you have symptoms you're worried about. So from that point of view, wait.

But I also wanted to add that the amount of change in what we know that's happened in the past four days, I'd wait till the end of March to even bother making a decision. At that point we (and your doctor) will have a lot more information about risks, the availability of minor medical care, etc. There's no reason to decide this now.
posted by gideonfrog at 7:12 PM on March 15, 2020 [2 favorites]

I have Skyla, it was due out in February but I avoided it and now I’m waiting. Im in a highly affected CA city with high risk folks in my immediate orbit. I’m having some cramping and spotting but no really awful side effects of it being overdue. I’m not counting on it as birth control, though, and obviously IANAD.
posted by assenav at 7:13 PM on March 15, 2020

Heya - to get technical, there is no data whatsoever to support Skyla for extended use, unlike Mirena (which can be used totally fine for 7 years, yay!). Do not count on it as your primary contraception after the 3 years. It's such an incredibly low-dose method there isn't a lot of wiggle room at the end there.

Other than not being effective as birth control, you can generally leave those little suckers in a long time without serious complications. Had a patient who had left her Mirena in for 12 years one time, another patient who had left her ParaGard in for 19 years.....
posted by circle_b at 6:55 AM on March 16, 2020 [4 favorites]

Response by poster: Thanks, everyone! I feel a lot better knowing it should be OK to leave in as long as I'm using a backup method. I think I'll wait till the time gets closer and then call and ask. Who knows where we'll be by then.
posted by music for skeletons at 2:20 PM on March 16, 2020

I wouldn't count on yours for birth control since it's a hormone-releasing IUD, but my copper IUD has been in for 15 years and nothing bad has happened yet. My understanding is that in many parts of the world, they just put IUDs in and leave them there forever.
posted by Jacqueline at 8:56 PM on March 16, 2020 [1 favorite]

Response by poster: update: the doctor called to reschedule this to June, so clearly no concerns from their end about leaving it for a while longer!
posted by music for skeletons at 2:59 PM on April 23, 2020

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