I admit that the idea of an IUD does creep me out a little and I don’t know if I’d get one myself, but all BC threads interest me greatly. I loved the Pill when I was on it before, and am thoroughly enjoying them again (monophasic now instead of triphasic as before) now that I’m on them short-term (but I am going to see if I can get back on for longer term) and I thought the NuvaRing might be a good option for me as well. An IUD, if it works out, does seem to be a more convenient choice, though.
I have the Mirena one. (I’d actually only ever heard its name, not read it, so I’d assumed ‘Marina’. The things we learn!)
I have about another year on it before it has to come out but boy…I love that thing. Ever since being on it I haven’t had a single period, which has been fantastic.
My IUD was put in under a general anaesthetic because I was having a curette done at the same time (which turned into a polyp-removal, but that’s another story) so I can’t say how much it hurts when you’re awake.
I rather dislike the idea of having one put in … or worse - taken out! Please tell me I’m sedated for that!
I do have zero sex drive, but since I only ever had any significant sex drive for perhaps one day out of the month - actually, maybe for 20 minutes out of that one day - before it went in, I dont’t think the IUD has had anything to do with it. Odds are I was only interested during some peak fertility time. (My body hates me enough to have played that trick on me, I don’t doubt.)
Anyway, I’m all for IUDs. I am absolutely sold on this one. 
Stainz, can I say 2 things?
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Plastic (inert) IUDs are more old fashioned than copper containing ones. They’re also bigger, less effective and cause more cramping and bleeding. While copper is toxic to sperm and embryos, the Plastic IUDs set up an irritant foreign body response in the uterus to prevent implantation. Inert IUDs are almost obsolete now, and are only used in special circumstances, like to hold the walls of the uterus apart in order to prevent adhesions forming after uterine surgery.
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The dose of hormones in Mirena is so low that it has almost no effect on return of fertility. Many women ovulate almost immediately it is removed (in some women it doesn’t prevent ovulation at all), and endometrial thickness should be fully restored within a cycle- but you can still have a perfectly healthy pregnancy with a less than ideal endometrium. Our OB/Gyns tell women to use barrier contraceptives until they have a period after Mirena removal, because so many patients have found themselves pregnant within a week or two (making it hard to properly date the pregnancy).
Dosage comparisons:
Mirena delivers 20 micrograms of Levonorgestrel directly to the uterus, most of this stays where it was delivered and so systemic effects are lower.
Emergency contraception (Plan B, Levonelle) is 1.5g (1500 micrograms) Levonorgestrel.
The progesterone only pill which contains Levonorgestrel (Microval) uses 30 micrograms of Levonorgestrel every day (of which the majority is systemic).
Combined oral contraceptive pills which contain Levonorgestrel (e.g. Logynon, Microgynon, Ovranette, Trinordial) have between 50 micrograms and 150 micrograms of Levonorgestrel in each pill, in combination with an oestrogen. Again the majority of the Levonorgestrel will be systemic.
Nuvaring contains both oestrogens and progesterones, it releases 15 micrograms of oestrogens and 120micrograms of Etonogestrel (a different type of synthetic progesterone) a day. As it is a different progestagen, a direct comparison is harder to make, but it definitely has higher levels of hormones and different ones to Mirena.
All of this information is from my British National Formulary, I haven’t pulled any of these numbers out of thin air.
I’ve just looked up (with great difficulty) the prescribing information for the (now discontinued) Norplant Levonorgestrel containing contraceptive implant, in order to try and get a good comparison, as Depo Provera and Implanon use different progestins.
“Evidence indicates that the dose of Levonorgestrel provided by the NORPLANT SYSTEM is initially about 85 mcg/day followed by a decline to about 50 mcg/day by 9 months and to about 35 mcg/day by 18 months with a further decline thereafter to about 30 mcg/day”.
So, for all practical intents and purposes, Mirena has 1/3 less hormones than the next lowest progesterone only preparation, and as most of the hormones are released locally to the uterus this means that of ALL hormonal contraception, Mirena has the lowest dose and therefore would be expected to have the lowest incidence of side effects.
Obviously though, YMMV- my body, for example likes high, high oestrogen and low low progesterone - Yasmin and Dianette are the only contraceptive pills that have suited me. So I’m taking a little risk with Mirena, but hoping that the extra progesterone will be so minor that it won’t be an issue.
Crap, that should of course read:
Emergency contraception (Plan B, Levonelle) is 1.5mg (1500 micrograms)Levonorgestrel.
That’ll teach me to try and convert numbers in my head!
I promise the rest are right though.
I don’t know about your financial status, but I went to my local health department and filled out an application for the state to pay for my IUD. However, I am low-income and I have no insurance so that may not be applicable for you but it would probably be worthwhile to check out that option.
Just to update: my doc does not do IUDs at all (She refers patients to an OB/GYN; she’s just a GP.) and does not recommend them for women who haven’t had kids. So it looks like her nurse, who told me that she does do them, was wrong. She thinks I should try a Nuvaring. So now I’m trying to decide whether to go with that or to find a doc who will do an IUD.
I do not have children, and I’ve never been pregnant, but my gyn was completely fine with me getting the IUD. She said that women who have never been pregnant have a higher risk of expelling the device, and can tend to have more pain with the insertion. She said that since the devices are so small now, it isn’t as much of a concern, so she’s completely fine with having childless women have these put in.
Irishgirl, thanks a bajillion for the specific numbers on the level of hormones. I’ve done a lot of reading and research on this which said pretty much the same thing (that the hormones act locally and very little of it is absorbed systemically), but it’s really nice to see the real numbers.
Wow, thanks so much for looking these up! Geez, how do the tv commercials get away with calling Nuvaring a really low-dose hormonal birth control? Serious question, because that doesn’t look like a low dose at all, compared with the other forms.
And I’d assume then, that my, uh, adverse reaction was probably due to the synthetic progesterone?
Nuvaring is considered low dose because it is low dose oestrogen- 15 micrograms as opposed to the usual dose of 20-35 micrograms in most combined pills.
Like I said, it’s hard to compare Etonorgestrel with Levonorgestrel, because they’re different progestins, it’s like comparing codeine with morphine or Prozac with Paxil…same type of drugs with similar actions, but the dose won’t be the same.
120micrograms of Etonorgestrel could be the equivalent of 10micrograms of Levonorgestrel or 150micrograms or anywhere in between, sorry, I just don’t know.
Just yesterday I spoke to my nurse practitioner about switching from oral BC to the IUD. She recommended the Mirena, showed me what one looked like, and explained how it works. Apprently it’s the most effective method of birth control aside from abstention.
Apparently, some doctors won’t put IUDs in women who’ve never had children, mostly b/c of fear of lawsuits. I guess if you’re one of the unlucky few who experiences uterine scarring from the IUD, they don’t want to get sued. She said that the likelihood of such problems was small, anyway.
However, there is a doc in the place I go who will do it. I plan to talk to him about it next week and I may be getting one this month.
What freaks me out is that a 5 year IUD will last until I’m 39. I’m not sure how I feel about that, but maybe I’ll get lucky and will decide to have it out sooner in order to have a child.
Ruby please ask your doctor about the risks of trying to get pregnant after having a Mirena IUD removed.
According to my doc, it can take a long time to get pregnant afterwards. I have no idea if this is true or not, but since you mentioned maybe wanting to get pregnant, I thought it was worth mentioning again, so you can plan in advance.
(For example, if it can take 6 months for your hormones to get back to normal after having it removed, you can plan accordingly).
Just my $0.02 if it’s even worth that! 
I did. She said it wasn’t a problem and the Mirena website says, “Studies show the chances of getting pregnant after discontinuing Mirena use are the same as for women who have not been using any method of birth control.”
Apparently the reason why doctors don’t want to put IUD’s in for women who have never had children is because there’s residual gunshyness about the possibility of PID and the resultant scarring, which could cause insterility. They like to minimize the chance of being sued.
I like the idea of a low-maintenance form of birth control that is almost foolproof and uses localized rather than system-wide hormones. Plus, I could have it taken out at any time and be able to get pregnant pretty soon after. Sounds good to me.
Great thread, I’m recently not-single and suddenly very interested in BC options for the first time in years.
Hated taking the pill because of the ‘every day at the same time’ thing and the constant worrying about antibiotics and stuff, loved Depo so very much I have used it three different times for a coupla years each time. However, I hit the magic 35 last year and my Doc gave me a very stern talking to about risk factors of hormonal BC and aging (doesn’t help any that I’m a smoker, of course.)
I was one of the lucky ones that stopped menstruating on Depo, so perhaps I’ll slide easily into that twenty percent with Mirena? The no-maintenence aspect is greatly appealing, although somehow I’d always associated IUDs with painful cramping and bleeding, why I’ve never considered getting one before.
Guess I’m making an appointment, thanks for all the great info!
My youngest daughter was conceived while Mrs. Maxx had an IUD. It hadn’t been in for even a year when the doc confirmed her pregnancy so it should have been good. Doc removed the IUD and she carried to term. Perfectly healthy little girl. She can be a bit of a handful though.
No personal experiences, but my friend just got pregnant with twins on an IUD.
Apparently there are two types of IUD, the copper kind and the hormonal kind. According to the literature and my OGBYN, the progestin kind is 99.9% effective, the most effective birth control on the market. The copper kind have a failure rate of .4 to 2.5%. I guess people choose the copper over the progestin because it’s good for 10 years, while the progestin kind are only (!) good for 5.
I have heard stories of people getting pregnant on the IUD and I even asked my OBGYN about it. She said that the IUDs worked in mysterious ways, and there are several possible explanations for their effectiveness. Consequently, it can inexplicably fail for some people, though it’s pretty rare. Nothing is foolproof, after all.
I chose the copper over the hormonal one because of what my gyne described in her notes as “emotional lability” and what I described as “turning into a psychotic bitch with homocidal rage issues” on the nuvaring. She had no problem whatever with me choosing to stay away from any hormonal form of bc. Maybe the mirena would have been fine for me but I just didn’t care to try one more shot at seeing whether I could tolerate it.
Mind you, I’d have liked even better to have seen the comparisons Irishgirl posted, but it was a great relief just to have my gyne listen and not try and steam roll me into something.
Well, thanks to all you fine ladies, I had a Mirena placed toady. Yay!
It only took five minutes from ankles up to ankles down. The insertion was very quick, but the FNP completely lied when she said it would be painless, the bitch. I felt her pop in the speculum and poke around for a minute and thought she was just giving me a pap. I asked what she was doing and she told me she was already inserting it! I hadn’t even noticed it going in my cervix, but I sure did notice when the little arms popped open—I had a very intense twang of pain that lasted about three seconds, and then she pulled out the speculum and I was done. I had some moderate cramping for about an hour, and then it just stopped. It’s just a very mild cramp now, four hours later, and I really could have gone back for a full day of work, but I’m glad I took the afternoon off anyway.
Oh! My “time to take your pill” alarm just went off. Guess I can turn that off for, oh say, the next five years! Woot!
It’s T minus 7 for me - one week til NO MORE WORRIES ABOUT BIRTH CONTROL FOR FIVE YEARS! Man I’m excited.