IUD Recommendations: NYC Edition
November 23, 2022 10:25 AM   Subscribe

Did you either have a very positive IUD insertion experience (as a person who has not given birth) in NYC or have you had a positive experience with Nexplanon? Please tell me about it!

I was a very happy with my IUD (Mirena) for 7 years so earlier this year I attempted to have it replaced. I tapped out of the replacement about 2/3rds of the way through because of extreme pain. Many things went wrong:
- The doctor I saw had atrocious bedside manner
- Her technical skill seemed questionable - what she narrated and what I experienced/understood to be the steps in the procedure did not actually line up. It also took longer than it should.
- I couldn't time my IUD replacement for when I was on my period because I haven't had one for years
- I have a sensitive cervix and suspect the combination of removal and insertion was just too much in one go and that possibly having a topical lidocaine injection made things worse instead of better because it was another thing messing with my cervix
My original experience was definitely painful, but I drove home afterwards with no trouble. This time I hyperventilated and cried on the subway most of the 30 min ride home.

I attempted to use other forms of birth control, but after one of them seemed to trigger migraines with aura, I can't use estrogen-containing forms of birth control and I'm back to IUDs and and Nexplanon as my only high-effectiveness options, hence this question.

1. Do you have a positive Nexplanon experience to share? It seems like it's a somewhat rarely used option with somewhat higher incidents of negative side effects than other forms of birth control, so all I can find is bad stories on the internet and no one I know personally has tried it. I consider not having my period to be an extreme positive.

2. Have you had a good experience with a doctor in NYC and can you share the name? I am only interested in recommendations from folks who have not given birth because that is highly correlated with a painful experience. I am particularly interested in doctors with good technique who can work quickly and also are willing to prescribe anti-anxiety meds because apparently I have substantial anxiety/PTSD from my prior experience, those who are willing to do ultrasound-guided insertions which make the procedure much faster and less painful, and/or IUD insertion under sedation. All of these approaches appear to at least sometimes be available outside of the US but are rarely used here except for pediatric IUD insertions, but I don't want to see anyone who will make me feel like I child for having a pain reaction that is common.
posted by A Blue Moon to Health & Fitness (16 answers total) 2 users marked this as a favorite
Do you have a positive Nexplanon experience to share? It seems like it's a somewhat rarely used option with somewhat higher incidents of negative side effects than other forms of birth control, so all I can find is bad stories on the internet and no one I know personally has tried it. I consider not having my period to be an extreme positive.

this is not personal experience by me, but by my friends. exactly zero people i know well that tried nexaplanon or any other implant had a good experience. Most of them extreme weight gain, several of them with periods that were months long.

not very scientific but enough for me that i told my daughters to try all the other things first.
posted by domino at 10:38 AM on November 23

I have a nexplanon and I love it. I’ve had it for about two years now. The mirena would give me random pinches and occasional light spotting, occasional BV flare-ups, and some pain during sex. It eventually got partially dislodged and finding an open clinic who was comfortable removing it was a very hellish experience that I never want to repeat. And then the insertion was so painful and the spotting and pain for the weeks after was a nightmare.

With the nexplanon, there is no pain, and the BV has never been seen since. I have a tiny scar on my arm and sometimes the implant can feel a bit weird - as I suddenly remember I have a plastic tube in my arm. No periods, no cramps, no mood swings. My body seems happier with it than it ever did with pills or the IUD, and I used to sing praises of the mirena, despite all the issues I was dealing with. I am the only one of my friends with one, and there was a lot of initial pushback from them when I said I was considering it. But as long as it keeps going as well as it has, this will be the only birth control I will consider.
posted by umwhat at 10:55 AM on November 23 [1 favorite]

I am on my third Mirena and have never been pregnant. Like you, I also found the first insertion to be the easiest, with each of the two removals/reinsertions having more challenges. During my replacement earlier this year, the the strings had disappeared, so it was much harder to remove, which was painful and took a while, but once that was done, the insertion of the new one was mostly okay.

I like and recommend my doctor, Dr. Helaine Worrell, who is affiliated with Mt. Sinai and her office is in Midtown East. I find her technique generally to be very good. However, I have never asked or been offered medicine in connection with my IUD insertion, nor did she use ultrasound or sedation, so you would probably have to ask her office about that in advance. I note that she has also never given me a topical lidocaine injection either, but again, I'm not sure what her overall practice is.
posted by Caz721 at 10:58 AM on November 23

Check Reddit - there are a few threads there on r/askNYC. https://www.reddit.com/r/AskNYC/comments/m1ac21/iud_insertion_in_nyc_w_pain_relief/?utm_source=share&utm_medium=ios_app&utm_name=iossmf

I think pursuing getting a copper IUD under sedation is a great goal. The best form of birth control!
posted by haptic_avenger at 11:30 AM on November 23

I don't know if this lines up with the healthcare model in your location, but in British Columbia we have OB/GYNs who have their own practice, and do a variety of gyne work, contraception being one of them, and IUD insertion/removal being a subset of the whole umbrella of contraception. But then we also have "women's clinics" that focus mostly on contraception.

My impression is that the folks who have a broad practice maybe do an IUD insertion a few times a week? Whereas at the clinic I went to, there were literally 5 of us with hot pads in the "recovery" area, and that was within the span of ~1 hour I was there, and then they were ushering in the next batch of 3 patients. Which is to say, by volume, the folks at the women's clinic do a lot more of the procedure, and experience for me was night and day. Not just the skill level, but also the bedside manner, and other interventions/other practitioners are around to help out if things are not going according to plan.

That is my long way of saying, if you can find a practitioner who works at such a clinic (assuming one exists in your area) I think it would go a long way towards having a better experience. Wishing you the best of luck for next time!
posted by tinydancer at 12:20 PM on November 23

I'm another happy nexplanon user. Side effects for me were generally milder than any other form of BC, including less of an impact on my blood pressure and milder periods (compared to both my unmedicated and pill BC ones). They also get milder as time goes on with each implant.

Supposedly a third of people will get no periods, so you may luck out and be better off than I.

I originally wanted the mirena, but my cervix was uncooperative. I loved my provider at the time: she had a great bedside manner and neither gave up too quickly nor kept trying when things weren't working. Turns out my anatomy isn't really conducive to an IUD (sedated insertion was ruled out as an option after they got a look at things).

I did have the really long unending "breakthrough" bleeding with my first nexplanon. But after checking in with my PA, she had me take a month of BC and ibuprofen (can't remember how long does that), and that got things back on track. I've changed it out twice, and both times I had increased spotting for a bit, then a normalish cycle: it's lighter and less frequent than my normal bc cycle, but roughly monthly (pre-bc I'd have a period every 2-3 weeks sometimes).

The doctor I had for my second nexplanon did brush off my prolonged breakthrough bleeding . So I self-managed by just taking ibuprofen until the bleeding stopped, which seemed to work. Third one I had done at planned Parenthood right before the pandemic, so I didn't even bother checking with a doctor at that time and went right to self-managing.

Removal isn't great, but better than my unsuccessful attempt to get a mirena.

Supposedly now i can wait 5 years to change out the nexplanon, so the annoying start of a new one won't happen as frequently now.
posted by ghost phoneme at 12:35 PM on November 23

Happy Nexplanon user here! I took oral BC for many years, got a Mirena, had a horrible experience (basically 9 months of varying degrees of pain and bleeding until I got it removed), then tried Nexplanon and am on my second one now. My main side effects have been almost no period (the pattern established with my first one that seems to be holding true for this one is that I have no period for the first year and a half or so, then a barely-spotting amount of period afterwards) and...basically nothing else that I've noticed.
posted by quatsch at 12:46 PM on November 23

Response by poster: Should have said this up front, but I'm also open to recommendations in Brooklyn. Thank you all for the suggestions so far!
posted by A Blue Moon at 12:50 PM on November 23

I LOVE my nexplanon after having a Mirena that dislodged. I highly recommend it. I never get my period.
posted by bookworm4125 at 1:33 PM on November 23

I've never been pregnant or given birth and I have a titled/off-center uterus, so some extra weirdness there. I have a Paragard IUD that Dr. Anne Davis placed about 8 years ago. She did an excellent and quick job and had a reassuring no-no sense bedside manner. I don't know if she's still practicing, but Ashley Tedone had been her associated NP so you might check there. Good luck!
posted by eunique at 1:36 PM on November 23

I have Nexplanon and overall like it a lot. My only negative side effect is irregular and rather frequent bleeding. I consider that the side effect I’m most willing to live with given negative experiences with oral birth control and aversion to IUDs due to pain issues.

My doctor, Dr. Davison at Maiden Lane Medical, has mentioned her willingness to do an IUD insertion under sedation. She’s excellent with considerations about pain, and the clinic has a specialty in pain management.
posted by rabbitbookworm at 1:38 PM on November 23

I just had an IUD inserted by Dr. Justine Kim at OBGYN Westside, which is affiliated with Mt. Sinai. I was super freaky about it but she was really calming and supportive. I have never given birth but the insertion was very quick with minor discomfort. She prescribed misoprostal beforehand — not sure about anti-anxiety drugs — and most importantly, they offer nitrous ($70), which really helped. There was plenty of availability when I called even if nothing is showing up online. I had been putting this off for years due to dread and sensitivity but it was totally fine and I wouldn’t hesitate to get a replacement from Dr. Kim in the future.
posted by ohkay at 1:45 PM on November 23 [3 favorites]

The strings for my first Mirena went walkabout and after two failed removal attempts (one with my PCP, one with a gyn) I ended up getting it swapped out for a new one under general anesthesia via a hysteroscopy. I'm not sure I would really recommend doing it that way, but it was totally painless and I was in and out of the hospital in about an hour and a half.
posted by fancypants at 1:48 PM on November 23

I live in NYC and while discussing another kind of procedure with my OBGYN, who is part of the Mount Sinai system, she said that they do IUD insertions with sedation in an outpatient setting. I got the impression from her that it's not uncommon.
posted by virve at 2:46 PM on November 23

Recommendation: Dr Linda Cho at Spring Obgyn (great doc and good job with mirena insertion, tho it was 10+ yrs ago now)
Avoid: Dr Monica Simons at Every Woman Wellness (she removed my mirena and it was a horrible experience)
posted by paradeofblimps at 1:35 PM on November 24

Lucy Knisley made a comic about how much she likes the implant. To the best my knowledge, at the time of writing, she had never been pregnant.
posted by spiderbeforesunset at 7:34 AM on November 25

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