Too small for Mirena IUD
August 22, 2008 4:24 PM   Subscribe

Why don't they make a special IUD that's a better size for nulliparous women? Is there anything I can do about the fact that I'm too small?

I am just under 5' and a tiny person all around, never been pregnant, and was told after a manual exam that I am not a candidate for Mirena, unless I am "very motivated." My doctor is a huge believer in IUDs in general, but says for me, the chance of expulsion and perforation is really high, and the thing might just be impossible to place, period. I am guaranteed pain and discomfort if I try. She says if I really want she'll take a shot, but that there's a really high chance that the device won't work as intended. This sucks, because I was all excited about the effectiveness and convenience and not worrying about anything for 5 years.

Should I go for it despite the chance of failure?

And more importantly, why isn't there a special size of IUD for nulliparous women?! Given that most women wait longer now before having kids, and many have no kids, ever, it seems absolutely foolish that no one has addressed this. Is there something in the works with the FDA, or available anywhere outside the US? I'll go on taking the pill, but I want my Mirena, damnit!
posted by slow graffiti to Health & Fitness (10 answers total) 2 users marked this as a favorite
I think the copper T is smaller, but it's that line they have to walk... small enough to fit in a woman who has never had a kid vs. large enough to not slip out the cerevix on its own later on.

Although IUDs are used a lot more commonly in Europe than in the US, and they aren't as big on pushing women who have never had kids away from them.
A friend of mine who is not much taller than you has a Minera (she's plus-size, but I don't think that would really impact the size of her uterus). Said it hurt like hell to get it put in, but loves it now and doesn't regret it at all. I guess hers did slip once, though, not long after she got it in.
posted by Kellydamnit at 4:56 PM on August 22, 2008

If you're under 5 feet tall, you're much smaller than the vast majority of women in the Western developed world. You and your fellow delightfully petite ladies who have never had children probably don't make up a significant enough market segment for the IUD manufacturers to profit by making something in your size for the US, Canadian, or European markets.*

Now, I wonder if there are other manufacturers who cater to other markets where there are a larger percentage of women your height? If so, perhaps you could find someone who imports IUDs from there?

* This, of course, sucks and is unfair and stupid and inconvenient to you, the consumer.
posted by Sidhedevil at 5:02 PM on August 22, 2008

According to this article, manufacturers are experimenting with smaller sizes of IUD, but these weren't available in the US as of the time of publication.
posted by Sidhedevil at 5:08 PM on August 22, 2008

Gynefix. If you figure out how to get one in the US, let us know!
posted by footnote at 5:10 PM on August 22, 2008

Two US people on the LiveJournal IUD Divas community posted their trip reports of getting a Gynefix in the UK and in Belgium.
posted by Sidhedevil at 5:14 PM on August 22, 2008

Just FYI, I'm 5'10" and have a rather large frame, and my nulliparous uterus was almost deemed too small for the Mirena. The doctor expressed her doubts much like your doctor did. I went ahead and got it, and I'm thrilled with how well it works for me.

However, another girl I know got the smaller Copper T and her uterus managed to crush it in half. As I like to say, your uterus is a ninja.

If you aren't planning on flying to Europe to get the Gynefix, might I suggest the new implant form of birth control, Implanon? It has all the convenience of an IUD with no regard to the size of your uterus. Good luck, and feel free to email or MeMail me if you have any questions.
posted by nursegracer at 7:25 PM on August 22, 2008

I went to see my doc about an IUD since I had trouble with taking my pills on time. She suggested I try nuvaring for a few months first, since I was a poor IUD candidate for many of the same reasons as you.
I'm still on nuvaring years later.
So, if the IUD doesn't work out there are options beyond every day pills.
posted by Kellydamnit at 8:25 PM on August 22, 2008

Another option: after a failed implant of a copper IUD, I followed my doctor's suggestion of getting a hormonal implant. It's unobtrusive and you don't need to do anything with it during the 3 years that it lasts, but it's likely to change your menstrual cycles.
posted by gorillawarfare at 9:02 PM on August 22, 2008

From Wikipedia:

Contrel, the Belgian company that developed the frameless GyneFix IUD, is developing a lower-dose (14 micrograms levonorgestrel per day) T-frame IUS named Femilis. Femilis would come in a smaller size (Femilis Slim) for nulliparous women. It would be inserted without a plunger, and it is hoped its performance would be less dependent on the experience of the health care professional.

Several trials with positive results have been done on a frameless IUS called FibroPlant-LNG (also from Contrel). FibroPlant is anchored to the fundus of the uterus rather than being held in by a frame. It initially releases 14 micrograms of levonorgestrel per day, and may be used for at least three years. As of 2005, it was not commercially available.

posted by BrotherCaine at 2:33 AM on August 23, 2008 [1 favorite]

If Belgium is too far, you could check out coming to Canada for a nova-t. It's non hormonal but smaller than the paragard that they use in the states. (Also, not approved for as long a time, unfortunately!)

Also, a second opinion never hurts.
posted by Salamandrous at 12:10 PM on August 23, 2008

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