DISCLAIMER: This post is about my own experiences researching and getting an IUD. I am definitely not a medical professional and this isn’t medical advice. But hopefully this can help you decide if IUDs are a worthwhile birth control method to speak with your doctor about, and what to expect if you choose to get one.
Due to the outcome of this U.S. presidential election, people with uteruses are asking a lot of unanswerable questions about what may happen to their bodies over the next four years.
Many of my friends have birth control through “Obamacare”/the Affordable Care Act and, the way our President Elect has been talking, he intends to do away with this.
There have recently been some articles circulating that he recently met with Obama and “wants to keep parts of Obamacare”. The two aspects he mentioned are barring insurance companies from rejecting people for pre-existing conditions and allowing people to stay on their parents’ insurance until they are 26.
Unfortunately, that leaves countless people with uteruses (I say it this way because some transmen have uteruses as well) wondering if they will still have easy and affordable access to birth control options within the next year.
The IUD or “Intrauterine Device” has been the buzz amongst my friends this past week.
Based upon which type you get, once installed, it is good for 3-10 years! This means that, for many people, they could have worry-free birth control that could last them until this hopefully blows over.
I had an IUD installed this spring, the copper Paragard version, and I have been planning to write about my experience and my choice for a while. But now it is more pertinent than ever. I have been talking with several friends individually about it, so I thought it was now the time for me to write this thing!
Before my IUD, I had only been on birth control once before. I tried the Apri pill in 2011 and, at the time it was solely as an attempt to regulate my very irregular, though very mild period. I was dating my now ex wife at the time, so actual baby prevention wasn’t an issue. While on it, I experienced the most painful cramps of my entire life and thought I was going to die. Since I wasn’t worried about accidental babies and my periods were naturally less frequent, less bloody, and less crampy than the usual person, I decided I was better off without it.
But, after my divorce, I realized that baby-prevention was something I now needed to consider again. I didn’t have any current prospects, but I foresaw dating people with penises, and decided I should be proactive.
While I was doing my research this past spring, I had just begun to get my life back in order after my divorce. At the time, I had lost at least 45 pounds and had found the right dosage of medication to get my depression and anxiety under control. I had also regained my sex drive for the first time in years, due to changing my medication.
I also know for a fact I can’t be trusted to take pills in a timely fashion. And I didn’t want to risk the mood swings and weight gain I knew was possible with this method.
I looked into the arm implant and spoke with a friend who had it and recommended it. Though I still didn’t like that it was hormone-based.
I read about the NuvaRing, but one the hosts on one of the podcasts I listen to (Call Your Girlfriend, a great show strongly rooted in intersectional feminism in which two “long distance besties” discuss things from politics to pop culture to what’s happening “this week in menstruation news”) commented on how she rolled over in bed one morning and her NuvaRing was chilling right there beside her. I believe she also shared a similar anecdote about a friend. Noooope. I was wanted as foolproof a method as I could find. Also, hormones. Though this was more localized, so that could be slightly more acceptable.
I read page after page of information on various methods, success rates, etc. I talked with friends and the same question kept coming up. “Have you considered an IUD?”
I flashed back to a conversation at the lunch table with a coworker several years earlier. She told me that she had an IUD and highly recommended it, and I remarked, “wow, if I ever have a dick in my life again, I think I should look into that.”
The more I asked around, I discovered that a huge swath of my friend group had recently gotten IUDs.
The IUD Renaissance. This was worth looking into.
I’m not gonna lie. The concept of an IUD is terrifying AF, and there are many horror stories out there.
Some of you are probably waiting for me to tell you what the hell an IUD really is, and how it works. And I’m not going to sugar coat it because it is pretty gnarly, but hear me out.
An IUD is a small T-shaped piece of either hormone-infused plastic (Mirena or Skyla) or plastic wrapped with copper wire (Paragard) that gets shoved up through your cervix (it’s collapsed at the time of insertion so it’s just a stick…the arms fold up once in!) and rests like a proud soldier in your uterus.
This animation of insertion may make you clench just a little….
With the hormonal varieties, it releases a small localized dosage of hormones that will make your mucus thicker and will trap and murder the little invading swimmers before implantation.
And the copper one, which is completely without hormones works by what seems like some sort of sorcery. In reality, sperm just really hate copper and the copper makes the environment of your uterus inhospitable to the little dudes.
Okay. This seemed kind of scary. Scratch that: vaguely terrifying. But what if I told you once it was up there, you didn’t have to worry about it for 3-5 years for the hormonal varieties and at least 10 years for the copper one? It just chills up in there, and once a month or so, you just need to check the short strings coming from the bottom of the device dangling oh-so-adorably from your cervix to make sure it’s still there and hasn’t shifted.
For a LazyGirl like me, this seemed like the perfect arrangement.
It was not unlike infomercial guru Ron Popeil’s famous tag line “SET IT AND FORGET IT!”
PROS AND CONS
So the next question was: hormonal or non-hormonal?
There were pros and cons to both:
Hormonal Pros: Lightens period cycles, bleeding, cramps, and often will completely eliminate periods after a while. Works for 3-5 years, according to the brand you get.
Cons: I kind of find comfort in my period letting me know I’m not pregnant. Even though hormonal IUDs are 99.9% effective, and that failure rate comes if it happens to shift or your uterus starts to reject it, I like knowing I’m not knocked up.
Also, even though it’s a small localized dose, there are hormones involved.
Copper Pros: Lasts for 10-12 years. No hormones at all. Some sources say 99.2-4% effective, all the way up to 99.9% effective again, with similar reasons to failure as mentioned above.
Cons: This is where it gets a bit gnarly. Paragard often makes cramps worse and bleeding longer and heavier, especially within the first 6 months to a year or so. It’s quite a tradeoff.
And then there’s the Worst Case Scenario horror stories that people talk about:
There is a small chance that the device could push into or puncture the uterine wall. And sometimes your body just decides it doesn’t like this foreign object in it and will reject it. Unfortunately, my bestie’s uterus decided to reject her IUD, but it is possible to try insertion again.
MY DECISION MAKING PROCESS
Like I said earlier, my periods, while unpredictable in timing (it’s been finally getting better now that I’m a real adult and not stressed out constantly with school and rampant anxiety) have always been extremely light and I can honestly say I never experienced real intense cramping in my life. Sure, my bleeding could last 10 days, but I hardly ever used a Super tampon and most of the time a Regular could be overkill.
I was really lucky.
While the “side effects” of the hormonal IUDs seemed great, there was still that pesky issue of hormones. My body was such a delicate ecosystem nowadays, and I was terrified to rock the boat in any way.
And I really liked the idea of not having to worry about babies until I was 40 if I so chose (mine was inserted a month before my 30th birthday) when, chances are, my eggs would be half-desiccated by that point anyway.
I was not excited about the prospect of having heavier periods or cramping, but I rationalized that I had been extremely lucky for the past 15 years with my mild cycle and it was time to pay my dues. Perhaps it would just bring my cycle up to “average.” I had no idea what that meant, but I had made peace with that.
So, the copper Paragard it was.
My normal GP didn’t perform the insertion service, but my coworker had recently gotten hers at the local Planned Parenthood. So I made an appointment. I am lucky that I have a job with amazing health insurance, so I never saw a bill for it. Without insurance, I’ve seen that it can cost up to $1000, but if you consider that’s for 10+ years of protection, that’s $8.33 a month. Probably cheaper than your prescription for the Pill, and way simpler in the long run.
I’m quite a researcher, if you haven’t guessed, and like to be informed. The night before, I made the mistake of looking at that animation on Youtube I posted above and I nearly puked and passed out.
“No babies for ten years,” I kept muttering to myself.
Every person has a different experience, but the general consensus was: insertion is gonna hurt like a mofo.
I arrived at Planned Parenthood before any of the employees were even there. I had an 8 am appointment and was full of nervous energy.
When I finally made it to the exam room, I filled out a health and history form, and we discussed what was going to happen.
First, she was going to stick something in my cervix to dilate it and check the depth of my uterus. The positioning of the IUD was super important, and she needed to know where to stop so it wouldn’t do The Dreaded Thing of uterine perforation.
As someone who has never experienced childbirth or any invasive medical procedures in this region, the sensation of your cervix being invaded is weird AF. There is pressure and some cramping and just a general feeling of “this shouldn’t be happening right now.”
I closed my eyes and concentrated on breathing. While there was cramping, it wasn’t excruciatingly unbearable like some of the accounts I had heard. Just super weird. She then slipped the device down the tube and into position, making things cramp and feel even weirder. Yeah, it hurt, but not as much as I was expecting. Maybe I was lucky.
And then it was over. It took maybe five minutes.
She told me that I would be spotting for a while, perhaps more than a month, and perhaps a bit through the first six months. (Spoiler alert: Only the first month, if that!) She warned me that I would be experiencing some pretty intense cramping for the next day or two because my uterus was going to be all “WTF IS THIS IN MY SACRED SPACE?! GET IT OUT MAKE IT GO AWAY!” (My words, not hers…)
In all my research, I neglected to read the bit about how, half an hour before the procedure, you should take 800 mg of ibuprofen to make it more bearable. Thankfully my experience was okay, but as I made it to the car, I felt the waves of cramping begin. I took some ibuprofen and booked it the two miles back home, making it to my bed just in time.
Dude, those next 12-18 hours were AWFUL. I was alternating 4 ibuprofen with 2 Tylenol every time I could take more, and it wasn’t even touching the pain. Finally, I was able to find the right angle of fetal position to fall asleep for a bit to distract me. And, privileged little me, for the first time in my life, learned about debilitating cramps. I guess it was time.
Confession: I actually googled “how to get rid of period cramps” that afternoon. I told you I had led a charmed life!
And also, an IUD tweeted an apology at me that first day for the cramps. BEST. EVER.
Finally, the pain began to lessen. There was still some cramping and spotting, but nothing like the first day.
And yes, my periods have gotten heavier. Sometimes, I can even fill up a (gasp!) Super Plus tampon. And sometimes I have debilitating cramps, but that has only happened a couple times over the six and a half months I’ve had it.
Each person’s experience is highly unique. Yeah, this sucks more than if I had nothing stuck in my uterus, but for the “no babies for ten years if I choose” aspect, it’s worth it.
THE CERVIX HUNT
A couple weeks after insertion, I decided it was time to “check the strings” to see what that was all about. Then I had this realization that I didn’t know where my cervix was. I knew it was way up in there somewhere.
So, in the shower, I went on a Cervix Hunt. I panicked. I couldn’t find it anywhere! Had my IUD already shifted or magically fallen out/disappeared? I squatted and “beared down” like I was trying to pop out a baby, and was finally able to feel a few rough poly strings coiled cozily around what I assumed must be my cervix. I tried to make a mental note about how long the strings were, but when you’re what feels like elbow-deep in your vagina, that’s all a bit relative. At least I found my cervix.
After this episode, I texted my friend and told her “either I have very short fingers or a very long vagina.” This was after I texted her, panicked, “I THINK I LOST MY CERVIX I CAN’T FIND IT ANYWHERE!” She was glad it hadn’t, in fact, gone anywhere.
But then there was the time I checked the strings a few days after my period and I discovered something no one had ever warned me about: my cervix wanders. Maybe the Victorians were on to something with their batshit theories about “hysteria” and how women went crazy because of their “wandering wombs.” (One of my favorite podcats about weird medical history, Sawbones, did a great episode on the topic) At this point in my cycle, my cervix was super low, like two inches closer to my vaginal opening. Who knew this was a thing?! The strings felt longer. I panicked and went to The Google, and learned it was normal. To check again in a week. And there it was again, in its barely-reachable state!
Our bodies are so weird.
Since its installation in late April, I’ve had plenty of chances (not to brag or anything…) to test it out, and, let me tell you, this little copper soldier does its job well. Either that or I happen to be infertile or something. At any rate: no babies.
Each person’s experience will be different. What’s right for me may not be right for you, and my level of cramping and pain and bleeding may not be what you experience.
But if you’re concerned about the future of your reproductive health, I would highly recommend considering an IUD.
If you have any questions (though I feel like I’ve given you a TMI look into the process already) please don’t hesitate to contact me. Or if you want to share your own story, that’s great too!
Copper warriors for all!
(Or hormonal plastic ones, if that’s your jam…)