Plz to tell me 'bout your experiences with 'em. I’m in the market – used to use the Pill or the Ring, but now I’m old and getting lots of migraines, and my docs think I shouldn’t use HBC anymore. Oh, and I recently gave birth to a son conceived while using condoms (apparently correctly!) so we’re spooked off those too.
Well, I have little experience with this, but I’ll offer what I can.
My late DH and I were together 23 yrs. For the first 9 mths or so of the relationship, I was on the pill, but even the lower dosage really fucked me up (wacked out cycles, mood swings, gained 15 lbs, etc…).
We tried the Sponge briefly (the spermicide made me burn and itch, esp. having to leave it in for 6 hrs afterwards, and he complained he could feel it inside…it was about a 1/2 to 1 inch thick and fitted up against my cervix…let’s just say there was not a lot of wiggle room to begin with and he didn’t enjoy the sensation of bumping IT instead of ME. :o)
The only other methods we ever used were FAM (Fertility Awareness Method) and condoms.
We were content with that arrangement (though vasectomy was an option we discussed quite a bit after our second child was born…never got around to it as it turned out).
By FAM I mean that I took my temp upon waking and kept charts and monitored my cervix and mucus and basically got very familiar with my fertility. No calendar method crap.
We practiced, for the most part in the early months, the “strict”, aka the “French” method, in which you refrain from unprotected (condomless) sex until 24-72 hours AFTER ovulation has been confirmed (signs and the temp rises and remains high).
Later, we routinely took advantage of the few days we could post-period but pre-ovualtion window (not recommended, as there is always the risk of early ovualtion, but after 8 yrs or so of closely monitoring my cycles, we both felt safe enough with it.)
We produced 2 children in our over 2 decades of regular sex. The first was a broken condom baby. The second was a “WTF” baby (as in, we both knew I was quite possibly fertile/borderline fertile and said WTF, and BINGO!) 
I knew the exact conception dates of both kids and both were born to the DAY afterwards…no question about it.
Neither repesented a failure of the method, per se, which is, actually, when practiced properly is as effective as the pill. I have always thought it overkill to take hormonal BC every day or almost so when the egg only lives for 24 hours of the month (and allowing for sperm life, avoiding sex or using other methods for 3-4 days a mth totally or virtually eliminates the possibility of pregnancy).
But for us older gals, (you mentioned you were “old”…not sure what that means to you, but I’m 44) it can be less reliable, and I would be cautious of relying upon it past the age of 40 or so as our cycles and hormones can get a bit wonky.
I’ve never used one, but the idea of a diaphram has always struck me as an option I would be open to (no pun intended :D). Not so sure about an IUD…I just prefer less invasive, and sealing off the cervix seems a lot simpler than blocking conception AFTER the critters have gotten in…a case of locking the barn door after the fact. Of course, I hear you should use them with spermicide, which, as mentioned, irritates the hell out of my girly bits, even when on condoms. 
I’m 41 – old enough to have been a “geriatric” prima gravida case!
Not thrilled about spermicide because I’m lousy about handling such things in the heat of the moment.
Everyone I know with copper IUDs raves about them. Hormone-free. Only drawbacks are possible painful insertion and possible increased flow for the first few months.
I’ve tried both the diaphragm and the copper IUD.
Diaphragm pros:
No pain to insert, and if you aren’t having sex you don’t have to worry about it at all. It’s cheap and lasts for a year. No hormones.
Diaphragm cons:
It’s not as effective as other methods. If you use it correctly (with tons of spermicide) it can sometimes be hard to insert (slippery). You have to leave it inserted after sex for a few hours, and sometimes, if you’re like me and have a small cervix/other internal bits, you can feel it sitting there as you bend to pick things up. You also have to think of it every time you have sex and it can interfere with foreplay – although I’ve heard some people use is as foreplay, I wouldn’t want my partner inserting it, as it can easily be inserted incorrectly, rendering it useless. You also have to deal with the resulting mess when you remove it.
Still, this was my favourite method.
Copper IUD pros:
You don’t have to think of it at all. Always there, always close to perfect effectiveness. You can be spontaneous and you don’t have to worry about taking it with you when you travel, or taking it every day. It’s non-hormonal, so if you’re like me and have a family history of stroke and heart disease you don’t have to worry about that. The cost is cheap when you consider it’s spread out over five to ten years.
Copper IUD cons:
Hurts on insertion, a LOT. I almost passed out the first time. It also hurts for a few days after that – I took a LOT of painkillers. You bleed, you don’t want to walk anywhere, you have nasty cramps, and generally regret the whole thing. Also, you have periods on this method, which are not a piece of cake. Heavy bleeding, heavy pain. I never, not once in my life, had a period cramp before, and now I do. Also when I orgasm the damned thing pinches. Maybe it’s because my uterus is on the small side as well, but sex is not as nice any more. My partner can also feel the string (which is like fishing line) and it pokes him, which hurts, and so some things aren’t lovely for each of us.
If the diaphragm were more effective I would switch to it immediately.
I am, however, a big fan of the spontaneity and ease of the IUD.
search for ‘mirena’ - it is plastic, it does have low dose hormone but many women swear by it. Note: I did not use an IUD, just reporting reading a fair number of threads where women love the mirena. It was suggested to me when I wanted to go off norethingrone orally as a possible way to suppress my menses thanks to PCOS making my life a continual living hell with menses. I ended up with a hysterectomy actually …
I second the Mirena. Two thumbs up.
The Mirena is not hormone free; the copper IUD is.
I tried to get the Mirena, but I couldn’t stand the pain and the doctor couldn’t get the sound (measuring device) through the opening in the cervix, much less the IUD itself. She gave me a prescription for Cytotec to open the cervix and instructions to come back another day after taking it. Well…I have a vertical incision on the uterus from an early c-section, and I consider the risk of uterine rupture with Cytotec (which is *not *FDA approved for that use) just too great in my case, so IUDs were out for me.
FAM is great if you’re still ovulating regularly, but not so good when you enter perimenopause. It’s also not good if you’re not good at self-restraint and don’t want to use condoms on your fertile days.
Essure is an implant that goes into your tubes and makes them scar over. It’s less invasive than a tubal ligation but accomplishes much the same thing. It’s permanent, so if you’re not certain you’re done having babies, it’s not the way to go.
Vasectomy for your partner is a good option, if you’re monogamous and likely to stay that way. It’s cheaper than Essure and safer than tubal ligation.
That’s me! One trip to the doc every five years for a change.
Speaking as a guy, I love the copper IUD. A girlfriend had one and we had tons of unprotected sex over the 20 months we were together with no pregnancy. It would bother me a little because I could feel it poking me–sometimes it was kinda distracting, but never painful.
I have the Mirena IUD. WhyNot’s correct - it is a hormonal form of BC, but it’s also a much lower dose than you’re getting with the pill. Since it’s delivering it right at the target spot, so to speak, it doesn’t need to be as concentrated as the pill. Talk to your doctor - maybe lowering the dose of hormones would also work for you, instead of eliminating them completely. When I got my new one put in, my doctor said that many of her patients 45 and older continue to use the Mirena IUD as a sort of low dose hormone replacement therapy to help them through menopause with less of the side effects/worries of traditional HRT.
Oh. To clarify - the Mirena IUD is hormonal; copper IUDs are not.
Love the Mirena. Love love love it. I’ve posted about it tons before - a search will bring those details up. I love that I never ever think of birth control anymore (except every 5 years when I get it replaced). Insertion did suck, but I’m childless, so that might have something to do with it. The first time, I hurt for most of that day, was crampy the next day, fine by day 3. This last time, I took some ibuprofin before and was fine by that same evening - I expected worse, so it was a nice surprise. It’s an economical choice, too - I think I paid something like $150 or some such, all told (after insurance, but including co-pay), which is way way cheaper than pills.
Love it.
I just got a copper IUD 6 weeks ago. Love it!
The insertion process was nowhere near as bad as I had feared. Granted, I did have 2-3 shots of vodka beforehand to relax. 
I’d describe it as 2 sections (about 10-20 seconds long each) of ohmyfuckingGODTHISHURTSSOFUCKINGBADHOLYHELL sandwiched between about 5 minutes of uncomfortableness-to-mild-cramping.
I took 3 ibuprofen after I got home (and took some on a schedule for the next day or two) but honestly… felt nothing after. No bad cramps, nothing. There was a tiny bit of bleeding but that’s it.
Now, I will say that my first period was heavier, but I’d only been off HBC for about 3-4 months so I was used to light periods from that; my pre-HBC shark weeks were pretty dang heavy and this first IUD period wasn’t even that bad. I didn’t have horrible cramps during that period. I did have random period-ish cramp twinges randomly this first month, but it wasn’t anything I’d even consider taking medication for.
Love it!!!
Also: a friend of mine has the Mirena and wishes she had gone copper. She figured the reduced hormone amount would be fine, but it’s really hit her hard (especially with depression and irrational anger).
Nuvaring is also lower-dose and localized rather than systemic, and her doctor has recommended she stop taking it, so I’m thinking he wouldn’t be okay with a Mirena.
My doctor hasn’t specifically told me not to use Nuvaring yet, actually. I haven’t seen her for the discussion yet – my appointment is next week – and the last time I used Nuvaring was, let’s see, four or five years ago.
I can’t tell from Googling whether low-dose stuff is considered safe for me or not. I have migraines without aura and am over 35, with no other stroke risk factors. The stuff I’m seeing is clear that migraine *with *aura is a deal-breaker, but I can’t tell what the prevailing wisdom is on the auraless kind.
I love my copper IUD, and I didn’t even have the amount of pain that zwiesamkeit describes, let alone the nightmare that Elysian describes, on insertion. I would say that it hurt as much and as long as stubbing my toe. I had two or three rather uncomfortable periods after it was inserted, and now I am back to totally normal - 3-4 day period, maybe mild cramps on one day or maybe none.
**ENugent **- may I ask, did you have kids before the IUD insertion? My understanding is that it would make a difference.
I had one before I had kids, one between the two, and now I’m on my third after my son was born. No trouble with any of them.
Mirena user here. I had mine inserted about 3 months after the birth of my daughter. The insertion was horrible. It hurt so much I nearly passed out. Couldn’t stop shaking, got so cold my husband had to bring in my winter jacket and the doc brought in a space heater. Once I had calmed down it wasn’t too bad. I took some Advil for a few days for the minor cramping. I think much of the reaction was just from my psyching myself out - a vasovagal response.
Now I love the thing. My periods are so light I barely even need a pantyliner but they seem to last longer - a week or so compared to my previous 5 days. The cramps, bloating, and PMS I used to get are gone.
As bad as the insertion was I will gladly go through it again in another 2 years or so when my 5 years are up with this one. You just can’t beat only having to deal with birth control once every 5 years or so.
And BTW, I get bad headaches of all sort - sinus, tension, and migraine and I’m fine with it. If anything I seem to have gotten better.
Just a side note: vasovagal response isn’t “psyching yourself out”. It’s a real physical phenomenon from pressure on the vagus nerve, just below the diaphragm. If you are tensed up with your throat tight (epiglottis closed) and “bearing down” with your pelvic floor muscles - whether from fear or pain or, as often happens, even having a tough bowel movement - then you can overstimulate the vagus nerve, which in turn slows down your heart rate. The woozy, clammy, cold feeling, shortness of breath and even unconsciousness can quickly result from too slow a heart rate and too little oxygen getting to your cells.
So yes, it’s quite possible you “vagaled out,” but that doesn’t mean it was “just” anything, much less just “psyching yourself out”. Vasovagal responses are real physiological phenomena, and they can be terrifying to go through or to witness.
My first copper IUD was wonderful. I got it when I was…24? I had not yet had a child, and insertion was somewhat painful for a couple of seconds–I remember gripping the sheet on the exam table–but it faded to dull cramps quickly. The entire insertion process, from doc walking in the room to “go ahead and put your clothes on” is about five minutes, tops. Take a few Aleve beforehand and you’ll be fine. Anyway, the first one didn’t make my periods heavier or my cramps worse, and I LOVED it. I took it out to conceive my daughter.
The second one went in about eight weeks after I had her, and I swear is part of the reason why I’ll be getting Essure shortly. My periods went from fairly light to OMG I AM HEMORRHAGING TO DEATH. I used to empty out my Diva Cup twice a day, and it would be about half full. Today, I have emptied it out eight times, starting at 4:45 AM when the leaking woke me up, then once at 6:30 when I got out of bed, once at 7:30 before I left the house, once at 9:00, once at 11:30, once at 4:00, once at 7:30, and once just now. I will likely be awakened once or twice at night by the feeling of blood literally SPURTING from me. Each time I empty the cup, it’s because it’s overflowed. I HAVE to wear a pad for backup now, and I spot in between periods and for several days before it officially starts as well. I lose somewhere between a half-cup and a cup of blood on the heavy days–the Diva Cup has measurements on the side, so I know how much I’m dumping out. Fuck that noise. I’m getting the IUD removed, getting sterilized (I don’t like hormonal BC and do not want more children), and if my periods still stay heavy, begging every doc I know for a hysterectomy.