IUD stressing
November 15, 2024 9:34 AM Subscribe
I’m feeling really nervous about getting an IUD and would like some solid resources to read and to help me decide on which one.
I’ve only ever used the Nuvaring and condoms as birth control. Nuvaring felt fine except I did gain weight. I’ve had a kid and don’t want another so am thinking of getting an IUD. My doctor gave me a quick run down and we’re scheduled to talk again to pick an IUD. But reading comments online have gotten me really nervous about the side effects and pain. I already have heavy periods and anxiety, and I’m worried the IUD will exacerbate it. I’m thinking any solid research might help me instead of reading anecdotes? Thanks!
I’ve only ever used the Nuvaring and condoms as birth control. Nuvaring felt fine except I did gain weight. I’ve had a kid and don’t want another so am thinking of getting an IUD. My doctor gave me a quick run down and we’re scheduled to talk again to pick an IUD. But reading comments online have gotten me really nervous about the side effects and pain. I already have heavy periods and anxiety, and I’m worried the IUD will exacerbate it. I’m thinking any solid research might help me instead of reading anecdotes? Thanks!
I’m sorry, I misread your question and thought you were considering various birth control options, not just IUD options.
posted by raccoon409 at 9:46 AM on November 15
posted by raccoon409 at 9:46 AM on November 15
Here's a comparison chart.
The hormonal options are, afaik, all pretty similar. Some are better for people who haven't been pregnant, and they last different amounts of time. Your doctor is well positioned to advise you which one to choose based on your medical history and goals.
IUDs are generally very easy to remove if you decide they don't work for you - way easier than insertion!
posted by toastedcheese at 10:00 AM on November 15 [1 favorite]
The hormonal options are, afaik, all pretty similar. Some are better for people who haven't been pregnant, and they last different amounts of time. Your doctor is well positioned to advise you which one to choose based on your medical history and goals.
IUDs are generally very easy to remove if you decide they don't work for you - way easier than insertion!
posted by toastedcheese at 10:00 AM on November 15 [1 favorite]
Also don't have resources but seconding that they are extremely easy to take out if you’re having trouble.
posted by knobknosher at 10:05 AM on November 15
posted by knobknosher at 10:05 AM on November 15
Purely anecdotal but my unmedicated periods are hemorrhagic, like complete disaster, I didn't realize until I saw a Reel about it like 2 years ago that my teenage periods had decidual casts and that it isn't, you know, typical. Been on some form of hormonal birth control continuously since I was 18 years old.
Anyway, I had a Mirena for several years and am absolutely a person with a history of heavy periods, and with the Mirena they disappeared almost completely.
It ended up not being a great solution for me long term (I only got a couple good years of hormone out of it and other endometriosis symptoms broke through) so now I run pill packs back to back and haven't bled in years. Wheeeeee.
posted by phunniemee at 10:13 AM on November 15 [5 favorites]
Anyway, I had a Mirena for several years and am absolutely a person with a history of heavy periods, and with the Mirena they disappeared almost completely.
It ended up not being a great solution for me long term (I only got a couple good years of hormone out of it and other endometriosis symptoms broke through) so now I run pill packs back to back and haven't bled in years. Wheeeeee.
posted by phunniemee at 10:13 AM on November 15 [5 favorites]
I am on my second Mirena. They last 7-9 years, for me they made my periods only-use-a-pantyliner light, and I have basically no side effects. It does take a little while for periods to lighten (a few months) and I had some bad period cramp type pain off and on for the first couple of weeks post-insertion. That was all very much worth it for my peace of mind in having low maintenance birth control.
The only downside for me is insertion pain, but my understanding is that most women who have given birth find it non-painful or slightly painful as compared to women who have never given birth like me. If you’re a person who likes medical studies, lmk and I will dig up the one that covers this.
posted by A Blue Moon at 10:39 AM on November 15 [2 favorites]
The only downside for me is insertion pain, but my understanding is that most women who have given birth find it non-painful or slightly painful as compared to women who have never given birth like me. If you’re a person who likes medical studies, lmk and I will dig up the one that covers this.
posted by A Blue Moon at 10:39 AM on November 15 [2 favorites]
I had a Mirena IUD inserted six weeks post partum, I am on my third one. Haven’t had a period since 2006, which is fantastic. Improved my mood and fixed my acne. Only getting weird now because I don’t have periods as a guide to progress in perimenopause. A+ recommended, I think happy people are not writing online.
posted by shock muppet at 10:41 AM on November 15 [5 favorites]
posted by shock muppet at 10:41 AM on November 15 [5 favorites]
I am on my third Mirena IUD as well. I used to have very heavy periods and haven't had a period since. I agree with shock muppet, with nothing to track the odd mood swing and cravings can be a bit confusing. But I also A++ recommend and echo that happy people are not writing online.
posted by Juniper Toast at 10:54 AM on November 15 [1 favorite]
posted by Juniper Toast at 10:54 AM on November 15 [1 favorite]
Have had two mirenas, love them, will absolutely opt for a 3rd. Insertion sucks but nowhere near as bad for me as I’ve heard horror stories online.
The worst gripe I’ve had with insertion is that it’s treated like it’s a vaccine or booster of some kind (ex. as soon as you’re out of the clinic you’re fine) when IMO it’s more like a root canal (ex. you and your body are both gonna be a bit jarred / you might need .5 - 2 days of recovery time. You might not.)
posted by seemoorglass at 10:58 AM on November 15 [6 favorites]
The worst gripe I’ve had with insertion is that it’s treated like it’s a vaccine or booster of some kind (ex. as soon as you’re out of the clinic you’re fine) when IMO it’s more like a root canal (ex. you and your body are both gonna be a bit jarred / you might need .5 - 2 days of recovery time. You might not.)
posted by seemoorglass at 10:58 AM on November 15 [6 favorites]
Re pain, I believe it’s possible to request both painkillers and a sort of cervix softening pill ahead of the appointment. The clinic I went to was kinda sketch so this wasn’t an option I was presented with, but friends have said they did this. For me, insertion was uncomfortable but not horrible or anything. I got the copper one because I didn’t want to be on hormones, and it definitely did make my periods heavier and crampier; for me this was acceptable because my periods are otherwise light, but if I got another one I’d probably go for the hormones to avoid that. I have since had it removed, which again was uncomfortable but not super painful.
posted by showbiz_liz at 11:35 AM on November 15
posted by showbiz_liz at 11:35 AM on November 15
I am due for my third Mirena (had one copper, cyst problem, better now) and my awesome gyn offered me twilight sedation with in-office propofol. Some of the providers are getting better at realizing this.
posted by cobaltnine at 11:56 AM on November 15 [2 favorites]
posted by cobaltnine at 11:56 AM on November 15 [2 favorites]
I love my Mirena. So much. I was quickly pulled off all other form of hormonal BC in my late 20s due to the stroke risk (as it turns out im a high stroke risk for other reasons) but the Mirena is ok. I am on my third which is well due to be replaced, but i currently dont care about the BC aspects so its fine. I haven't had a real period in well over 15 years. I only recently have gotten a few period-ish cramps which is how I know its due to be replaced (They say its good for 5 years, but you can go 7+ no problem ,they just wont guarantee its efficiency after 5). Insertion for me at least was not much more painful than a pap. Ive heard the horror stories, but have not experienced them myself.
posted by cgg at 12:03 PM on November 15
posted by cgg at 12:03 PM on November 15
It might be comforting to know that many people find that the insertion is drastically less painful / easier if they have given birth. Personally I have given birth and found the IUD insertion mildly uncomfortable, but not significantly worse than a pap test - I actually find the speculum worse than the actual Mirena insertion. And I loooooooooove not having a period or any period cramps.
That is not to diminish the potential pain of insertion - my friend who has not given birth says the first insertion was the worst pain of her life, but getting rid of her (extremely painful & heavy) periods made it worth it, and she’s now on her third. She now has a doctor who prescribes a benzodiazepine to make the insertion easier - it helps her relax both physically and mentally, and takes the pain down from “worst pain of my life” to “painful and unpleasant but very tolerable.” There are lots of options for pain relief including sedation if needed.
Note that if you do get a Mirena-type IUD, you could have spotting for several months after the first insertion - it took I think 3-4 months for me, which was very annoying, but now I haven’t had a period for years and it’s amazing and has been worth it!
posted by maleficent at 12:16 PM on November 15
That is not to diminish the potential pain of insertion - my friend who has not given birth says the first insertion was the worst pain of her life, but getting rid of her (extremely painful & heavy) periods made it worth it, and she’s now on her third. She now has a doctor who prescribes a benzodiazepine to make the insertion easier - it helps her relax both physically and mentally, and takes the pain down from “worst pain of my life” to “painful and unpleasant but very tolerable.” There are lots of options for pain relief including sedation if needed.
Note that if you do get a Mirena-type IUD, you could have spotting for several months after the first insertion - it took I think 3-4 months for me, which was very annoying, but now I haven’t had a period for years and it’s amazing and has been worth it!
posted by maleficent at 12:16 PM on November 15
I’ve had a Mirena since 2013 minus a break to have my son (pretty much immediately got pregnant after removal!) and have not had more than light spotting for a period since then. Truly amazing, will keep one forever, insertion was uncomfortable but better post-vaginal birth and not ever thinking about or worrying about my period is VERY comfortable!
posted by MadamM at 12:21 PM on November 15
posted by MadamM at 12:21 PM on November 15
My third Mirena insertion was done with local anesthetic injected directly to cervical area during the procedure.
The difference was night and day when compared to my other two insertions which for my 1st time just had the cervix softening/dilating pill (which did not work well for me, apparently I was supposed to wet it beforehand but I didn't know that) or 2nd time no anesthetic at all.
I am in Canada, and the latest insertion I had was a women's health clinic that must do this and other forms or reproductive health procedures day in and day out, so they were such pros about it. The other two were at a gyne office.
Two out of the three times I've had Mirena, my period stopped completely after ~6 months. My 2nd Mirena I still had spotting every now and again. Best feeling in the world to not have to deal with periods! And lucky for me no bad side effects.
posted by tinydancer at 1:01 PM on November 15
The difference was night and day when compared to my other two insertions which for my 1st time just had the cervix softening/dilating pill (which did not work well for me, apparently I was supposed to wet it beforehand but I didn't know that) or 2nd time no anesthetic at all.
I am in Canada, and the latest insertion I had was a women's health clinic that must do this and other forms or reproductive health procedures day in and day out, so they were such pros about it. The other two were at a gyne office.
Two out of the three times I've had Mirena, my period stopped completely after ~6 months. My 2nd Mirena I still had spotting every now and again. Best feeling in the world to not have to deal with periods! And lucky for me no bad side effects.
posted by tinydancer at 1:01 PM on November 15
I have had a Mirena IUD since 2021-2022ish due to untreated menorrhagia and my ADHD making it difficult for me to take daily pills (lol). I had localized anesthetic, but I wasn't made aware of the other options to prep for it, which sucked. I found it painful, but not as painful as when I had to pass a kidney stone without any help, and I have an extremely high pain tolerance due to chronic illness, so YMMV. The thing I hated the most was that they didn't tell me to bring a change of underwear and didn't leave any towels for me to wipe myself with due to bleeding after insertion, and I only brought it because I am prepared for medical neglect.
I still would do it again though, because I rested for about 2-5 days afterwards and not having to throw out underwear and clean my sheets constantly due to intense bleeding helps. The only issue now is that my cramps are now worse than usual, and I oscillate between no blood, to some spotting, to a light period and clots and again, but I used to have menorrhagia without cramps, so super weird. My anxiety has improved, lost weight due to less stress and not having to constantly eat a ton of steak to ward off anemia, and my skin got drier but no new acne.
posted by yueliang at 1:07 PM on November 15 [1 favorite]
I still would do it again though, because I rested for about 2-5 days afterwards and not having to throw out underwear and clean my sheets constantly due to intense bleeding helps. The only issue now is that my cramps are now worse than usual, and I oscillate between no blood, to some spotting, to a light period and clots and again, but I used to have menorrhagia without cramps, so super weird. My anxiety has improved, lost weight due to less stress and not having to constantly eat a ton of steak to ward off anemia, and my skin got drier but no new acne.
posted by yueliang at 1:07 PM on November 15 [1 favorite]
I am on my 4th Mirena and love it. I wouldn't go back. I haven't had a period since I started using the Mirena.
Insertion is uncomfortable and has some pain associated with it - I would describe it as similar to a really painful pinch - imagine if someone pinched your arm as tightly as they could. It lasts just a couple of seconds. There is some recovery - generally you can expect to want to take it easy for a half day after your insertion (for me, I wanted to take it easy only 1 out of 4 insertions, but the day I didn't feel good I felt achy. I felt better with aspirin, warm tea and snuggles with my partner and relaxing on the couch.) There was no bleeding during the appointment, but mild spotting for a couple of days after.
My major takeaway is finding the right person to insert your IUDs is good. My #1 insertion was done by a very experienced (and good) general practitioner who inserted an IUD once a week. All subsequent insertions (installations?) have been done by GYNs who insert IUDs daily. I think the experience helps with the level of comfort with the procedure.
If you presently are younger than 30 or are unpartnered, you may want to particularly vet possible IUD inserters - before I had my first insertion I was given a hard time by a doctor who didn't want to let me have an IUD because of the extremely low risk of an IUD impacting fertility. I didn't go back to the doctor and left them a snippy review and a board complaint (they deserved it, they told me that my future husband would be angry with them if they allowed me to get an IUD). Reddit is great for finding providers who will give you the facts but respect your decision.
Feel free to message me if I can offer you any other parts of my experience with this (or offer referrals for practitioners I like).
posted by arnicae at 4:11 PM on November 15
Insertion is uncomfortable and has some pain associated with it - I would describe it as similar to a really painful pinch - imagine if someone pinched your arm as tightly as they could. It lasts just a couple of seconds. There is some recovery - generally you can expect to want to take it easy for a half day after your insertion (for me, I wanted to take it easy only 1 out of 4 insertions, but the day I didn't feel good I felt achy. I felt better with aspirin, warm tea and snuggles with my partner and relaxing on the couch.) There was no bleeding during the appointment, but mild spotting for a couple of days after.
My major takeaway is finding the right person to insert your IUDs is good. My #1 insertion was done by a very experienced (and good) general practitioner who inserted an IUD once a week. All subsequent insertions (installations?) have been done by GYNs who insert IUDs daily. I think the experience helps with the level of comfort with the procedure.
If you presently are younger than 30 or are unpartnered, you may want to particularly vet possible IUD inserters - before I had my first insertion I was given a hard time by a doctor who didn't want to let me have an IUD because of the extremely low risk of an IUD impacting fertility. I didn't go back to the doctor and left them a snippy review and a board complaint (they deserved it, they told me that my future husband would be angry with them if they allowed me to get an IUD). Reddit is great for finding providers who will give you the facts but respect your decision.
Feel free to message me if I can offer you any other parts of my experience with this (or offer referrals for practitioners I like).
posted by arnicae at 4:11 PM on November 15
Anecdote time: everyone's bodies are really different! Women's bodies are so, so badly understood by the medical community because for so long the paradigm was "ok, so this is a man's body but weird"
I have had two mirenas and am happy, second one post having kids and my period has become practically non-existent, my sister in law had a really bad Mirena experience, and my friend who loved her Mirena before having kids had a really bad time after her son. Some people gel really well with them, others don't, and it can change over time.
You will find so many scare stories online about them but also they work well for lots of people who don't post about a non-event.
posted by freethefeet at 4:33 PM on November 15
I have had two mirenas and am happy, second one post having kids and my period has become practically non-existent, my sister in law had a really bad Mirena experience, and my friend who loved her Mirena before having kids had a really bad time after her son. Some people gel really well with them, others don't, and it can change over time.
You will find so many scare stories online about them but also they work well for lots of people who don't post about a non-event.
posted by freethefeet at 4:33 PM on November 15
On my 3rd Mirena, had my first at 20, have never had kids. I was super nervous about getting my first one and looking up all the stuff online to figure out if it would be a good idea and would it hurt and etc. Now I have no periods and would never go back to non-hormonal-IUD’d life. I think if you are thinking about it and your doctor thinks it’s a good option for you you should go for it!!
posted by crime online at 5:30 PM on November 15 [1 favorite]
posted by crime online at 5:30 PM on November 15 [1 favorite]
I'm about to get my 3rd Mirena. Exactly when is TBA, because I'm getting some perimenopause symptoms, and if I'm willing to have a gap between removal and insertion then there's some more hormonal testing that can be done. I haven't decided if such a gap is worth it for me -- haven't had a period in 11 years and don't really have any interest in having them again. Not having periods is the best.
And I may have to bother some of my fellow commenters here for recs on how they got some actual pain control for insertion-- the actual insertion for me is indeed "worst pain I've ever felt", but it's fortunately brief (some people get cramps etc for a few days/weeks after, but I never have; it's something like 2 min of the worst possible pain and then everything is fine). There's significant variance and indeed since you've had a kid you'll probably have an easier insertion process.
posted by nat at 6:08 PM on November 15
And I may have to bother some of my fellow commenters here for recs on how they got some actual pain control for insertion-- the actual insertion for me is indeed "worst pain I've ever felt", but it's fortunately brief (some people get cramps etc for a few days/weeks after, but I never have; it's something like 2 min of the worst possible pain and then everything is fine). There's significant variance and indeed since you've had a kid you'll probably have an easier insertion process.
posted by nat at 6:08 PM on November 15
IUD Divas is a community on livejournal that used to be far more active but the archives are a phenomenal resource.
I had a copper IUD for about five years. Insertion was about as painful as a bad menstrual cramp for about 30 seconds. Removal was maybe 10 seconds of pain.
It was great for me because I can't tolerate hormonal birth control options. Downsides were: I had a year of yeast infections/BV symptoms (which could have also related to being more sexually active) following insertion and it also gave me week-long, heavy periods.
If you get a hormonal IUD, you could have lighter, shorter periods. A hormonal IUD could also lead to a reduction in PMS/PMDD symptoms.
Also, per a study from 2015, women’s health care providers are three and a half times more likely to choose IUDs and implants.
posted by dearadeline at 8:56 PM on November 15
I had a copper IUD for about five years. Insertion was about as painful as a bad menstrual cramp for about 30 seconds. Removal was maybe 10 seconds of pain.
It was great for me because I can't tolerate hormonal birth control options. Downsides were: I had a year of yeast infections/BV symptoms (which could have also related to being more sexually active) following insertion and it also gave me week-long, heavy periods.
If you get a hormonal IUD, you could have lighter, shorter periods. A hormonal IUD could also lead to a reduction in PMS/PMDD symptoms.
Also, per a study from 2015, women’s health care providers are three and a half times more likely to choose IUDs and implants.
posted by dearadeline at 8:56 PM on November 15
Oops! I mislinked: Scratch the information about PMS/PMDD symptoms- there is not sufficient evidence to indicate that mirena or other hormonal IUDs reduce those symptoms.
posted by dearadeline at 9:07 PM on November 15
posted by dearadeline at 9:07 PM on November 15
I am sometimes a defender of the copper IUD (Paraguard) because one of my doctors told me that many women are comparing pill-modulated periods to the hormone free ones on the Paraguard, so it’s not necessarily the IUD itself that makes them heavier. I’ve always had light periods and mine did not change on the copper IUD and it has been a wonderful, reliable form of BC for me for 15 years.
However, given that you said you already have heavy periods, I wouldn’t risk it; if the hormones are right for you go for the Mirena.
posted by misskaz at 6:07 AM on November 16
However, given that you said you already have heavy periods, I wouldn’t risk it; if the hormones are right for you go for the Mirena.
posted by misskaz at 6:07 AM on November 16
To add a potential explanation why some women have more pain with insertion than others, I have a retroverted uterus, which means that the opening (os) of the cervix is oriented downward, toward my back (if I was lying flat, rather than a more typical horizontal orientation). This means that the IUD inserter needs to grasp the cervix with an instrument and tilt the uterus upward, more horizontally so she can slide the insertion device into the os of the cervix. I did have quite a lot of pain with insertion, but that really was more a reflection of the grasping and repositioning of my cervix. I would have appreciated premedication, but this was years ago and I had a male gyn. He was kind, but really could not appreciate how I experienced pain.
Ask your gyn if your cervix is retroverted - this anatomy is not that uncommon. You can then insist on effective premedication.
posted by citygirl at 8:18 AM on November 16
Ask your gyn if your cervix is retroverted - this anatomy is not that uncommon. You can then insist on effective premedication.
posted by citygirl at 8:18 AM on November 16
Response by poster: Thank you all for your comments! Really appreciating the support as I’m still stressed. My doctor is recommending the Mirena or Liletta. I asked her for pain management and she said two Advils. She said since I’ve had a kid it should be fine and she’s done it for decades so…
posted by inevitability at 9:12 AM on November 16
posted by inevitability at 9:12 AM on November 16
Just so you know, I have a Mirena and my very experienced doctor said it was the worst insertion she'd ever done and it was not that bad. And that's a worst case scenario as a nuliparous woman.
It's absolutely OK to be scared but also just know the fear can be much larger than the event in the end.
posted by DarlingBri at 9:09 AM on November 17
It's absolutely OK to be scared but also just know the fear can be much larger than the event in the end.
posted by DarlingBri at 9:09 AM on November 17
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Hormonal IUDs can reduce or completely eliminate periods (and cramps).
You can schedule a “birth control consultation” appointment, you don’t have to go in knowing what you want. They may be able to then give you whatever method you’d like then and there on the same day, or have you go back. If you choose an IUD, it’s extremely reasonable to ask what kind of pain relief they offer for insertion.
The Planned Parenthood website offers a good resource on different options.
posted by raccoon409 at 9:45 AM on November 15