Tell me about getting an IUD please

In My Humble Opinion
1

So I’m 34. My husband and I are childless by choice. I currently take the pill and he uses condoms as well (we’re paranoid - obviously). We have decided to not get my tubes tied until I’m 40 just in case.

My annual gynecologist appointment is coming up and I am interested in talking to her about an IUD. I know this has been discussed before, but IUD only has 3 letters, so I can’t search for it :mad:.

Some background:

  1. I smoke and don’t plan to quit. I know this is risky with the pill - just how risky is it?
  2. I take the pill back to back (under the advice of my doctor) so I don’t have periods. Ever. I LOVE this.
  3. I would like to stop using condoms, so the IUD would be my back up method of contraception.
  4. We are in a monogamous relationship.

So tell me:

  1. Some IUD’s have hormones and some don’t, right? Which one do you use?
  2. If you use one with hormones, do you still have a period? Is it risky to smoke with an IUD with hormones?
  3. Tell me about having it inserted. Does it hurt? Cramping? How long? :eek:
  4. How long can they stay in? I’ve heard 3-10 years depending on which kind you get.

Is there anything else I need to know before I see my doctor in February?

Thank you so much for your help! Kim :slight_smile:

2

Searching for Mirena will get you lots of threads full of folks singing it’s praises. Mirena is the low-dose hormone one made of plastic, I don’t know the brand name of the non-hormone one though.

With hormones: smaller device, lasts 5 years, less cramping, lighter periods or periods stop altogether

Without hormones: slightly larger device, lasts 10 years, more cramping and heavier periods

Insertion isn’t a picnic either way, they basically pop a drinking straw-sized tube through the cervix and slide the little puppy through, then it’s wingy things pop open into the T shape. They prefer to place them in women who’ve already been through a pregnancy, as that enlarges the cervix. Getting it placed ranges from slight discomfort to pain, much the same way pap smears range from annoyance to terror, depending on the individual. Pop a tylenol before you go.

The string remains hanging through the cervix, you’re supposed to tug on it once in a while for reassurance. I can’t feel my string, neither can the boyfriend, but the OB/GYN says it’s fine and it’s working great so I don’t fret about it.

3

I’ve had the kind without hormones for 4 years. I don’t like the effect hormones have on me, so I like not having to have them.

Having it inserted hurt a bit, but more cramping than real pain. Within a week I felt totally normal, and this kind lasts for 10 years, so I think a week of cramps is worth it.

A lot of people have increased blood flow during their period, but that usually improves with time.

I love the fact that once it is in, you don’t have to do anything or even think about it for 10 YEARS. And it’s about as effective as sterilization.

I’m very happy with mine.

4

The non-hormonal IUD is called the ParaGard. It has copper in it, which acts as a mild irritant to the uterus.

I don’t have one but have been interested in one. Keep in mind that, despite being married, you will likely run into doctors who will not insert one for you. The most common reason is that you “should” have kids before having an IUD. Their reasoning can be divided into some reasonable and some unreasonable things:

Reasonable:

  • IUDs are easier to insert after you’ve had a baby stretch you and your cervix out
  • There’s less chance of you rejecting the IUD after said baby(ies) have come out

Rather Unreasonable:

  • There is a small chance that you may be rendered infertile (which is definitely something to take into consideration), BUT even if you say, “no, we do not plan to ever have children, so I don’t care about that possibility”, they often will still refuse…
  • Because you might “change your mind” and you might end up getting a lecture about how you WILL change your mind because what woman DOESN’T want to have kids. And so on.
5

Smoking and taking the Pill after age 35 is a bad, bad idea. IMHO, a doctor who allows this to happen should have charges brought brought against her to her licensing board.

[QUOTE=http://www.holysmoke.org/fem/fem0579.htm]
3. What is your chance of having a stroke?

You are nearly six times more likely to have a stroke if you
smoke than if you do not.

You are twenty-two times more likely to have a stroke if you both
smoke and take the pill than if you do neither.
4. What are your chances of having a heart attack?

You are twenty times more likely to have a heart attack if you
smoke than if you do not.

You are four times more likely to have a heart attack if you take
the pill than if you do not, but

You are forty times more likely to have a heart attack if you
both smoke and take the pill than if you do neither.
5. What is your chance of dying?

You are two times more likely to die from smoking-related causes,
such as the above, if you smoke than if you do not.

You are five times more likely to die from pill-related causes,
such as the above, if you take the pill than if you do not, but

You are fourteen times more likely to die from pill and
smoking-related causes if you both smoke and take the pill than
if you do neither.
6. How does your age affect your chances of dying?

If you are a pill user under thirty, your risk of dying is only
slightly increased if you smoke than if you do not; however…

If you are a pill user over thirty who smokes, your risk of dying
is three to four times greater if you smoke than if you do not,
but…

If you are a pill user over forty who smokes, your risk of dying
is two to ten times that of a younger woman who does the same.
[/QUOTE]

(Unfortunately, no study citations there, but those number do seem to agree with studies that I’ve read elsewhere.)

As far as I know, there’s no IUD which commonly prevents periods, and I’d be exceedingly surprised to hear of one. That takes a pretty hefty dose of hormones, and IUDs are pretty low hormone.

6

If your doctor tries to give you the Rather Unreasonable reasons stated above, find another doctor.

I had an IUD a couple of decades ago. It hurt going in, and I’d been pregnant twice before, carrying one pregnancy to term. My cramps were worse while I had it in, and I think that I had longer, heavier periods. And I got pregnant while it was in.

Again, though, that was over 20 years ago, and IUDs have improved since then. It’s wonderful to have a BC method that doesn’t require you to remember to take a pill every day, or to interrupt things just when they’re getting good to apply a gel or foam or rubber.

7

If your doctor gives you guff about this, seriously find one who won’t. I got mine last year at 34, never having had kids and no plans to ever have them. The nurse practitioner I see didn’t blink an eye about getting me one.

I have the ParaGard, and yes my periods got heavier. If you know what your normal flow is like without hormones, be prepared to see an increase in that to some extent (I’ve had my IUD for about a year and a half, and while the initial “gush” has slowed some, my periods are still heavier than they were). If you are already starting out with heavy ones, ask yourself if you’re willing to get heavier. If not, the Mirena might be the one for you.

8

Seriously - people are probably sick of me raving about my IUD all the time.

Love it. Love it, love it, love it. And I’m not certain where WhyNot’s getting her data, but it’s pretty common for ladies with the Mirena to have lighter periods or not have them altogether. My doctor said that something like 3 out of every 10 women will have their period pretty much eliminated - I’m one of those lucky ones. I haven’t had a period since 2005 (when I had it inserted). Every once in a while I’ll get light spotting, but it’s pretty rare. And it’s getting less frequent the longer I have it.

My doctor also didn’t blink an eye when I asked her about getting one. I’m childless, was 28 when I had it inserted, and am 32 now. I even mentioned during our conversation that all my research indicated that they were only available for women who were moms already, and she said that that’s often said because it’s easier to insert, but there’s really no reason the childless woman can’t get one too. But do be prepared for possibly more pain during insertion.

Insertion’s a bitch - I hurt, a lot. But it was just for that day. Next day, I was crampy, but just standard cramps that I could deal with. Day after that, I was fine. Definitely take some ibuprofin or such beforehand.

Mine’s good for 5 years, and I’m planning on getting another in 2010 when this one comes out. It’s the best form of BC ever - I never think about birth control. Ever. You know how everyone gets evangelical in the MoonCup threads, that they never have to worry about tampon or pad supply, that they didn’t realize how much time they devoted to worrying about their period? That’s how I am about the Mirena. Since my periods have largely stopped, I never worry about having the necessary supplies (although I do have a stash for visitors; I just don’t need them for myself. I had to buy some tampons recently for my sister-in-law, and I genuinely forgot where they were in the store. I was all, “I know they’re in here somewhere!”). I never worry about trying to time vacations or whatnot with the “off” pills in the pill pack (not that you do this, either, but I’m putting it out there for others). I never think about having to refill my prescription. I never worry about having condoms or back ups on hand. I never worry about whether any antibiotics I’m taking will interfere. I never think about birth control, ever. This, right here, is worth the price of admission.

I love it. Definitely talk to your doctor about it.

9

I know the stats say 30% cease menstruation, but my acquaintances and I are all in that 30% so maybe they don’t want to necessarily promise it even though it’s more common.

10

Ditto to everything that has already been said. If your doctor gives you any hassle, find a new doctor.

Be prepared to pay for it up front in case your insurance doesn’t cover it. Mine didn’t, so I had to pay roughly ~$600 for mine.

I got a Paragard (non-hormonal copper IUD) last summer. Insertion was seriously painful for me, but everyone is different. Despite that, I’d do it again in a heartbeat. My periods have been heavier and longer but it’s a very small price to pay for the peace of mind.

I chose to go non-hormonal since I suffer menstrual migraines and have several indicators that put me at a greater risk of stroke. Despite that, I had to repeatedly insist on a Paragard over the Mirena. Every time I saw a doctor or nurse they asked why I wasn’t getting a Mirena. Each and every time I had to insist that I preferred no hormones but my persistence has paid off.

The Paragard is good for ten years, so I don’t have to think about this again until I’m almost 40.

There are many misconceptions about IUDs still out there, so do your research and do not let the misinformation and ignorance about IUDs deter you. There are many scary things associated with IUDs such as expulsion or perforation of the uterus but the #1 thing that affects whether or not that will happen to you is the experience of the doctor performing the insertion so be absolutely certain that you are comfortable with the doctor who will be inserting your IUD. Ask how many insertions they perform of the kind of IUD you choose. Ask about complication rates for their patients and ask what their plan is if something does go wrong.

11

They are low hormone, but they are Levonorgestrel (unlike pills such as Ortho Tri Cyclen which are Norgestimate and Ethinyl Estradiol) and the hormones in an IUD are delivered locally rather than throughout the body. Many women who use Mirena wind up not having a period at all.

12

This is a great thread and it’s actually been on my mind. (Second pregnancy, due next month) I see the the little Mirena demo model there and think hmmmm!

Has anyone got an IUD, then decided another method would be better - or go from the hormone to non-hormone and vice versa?

13

Mirena’s literaturesays 20% of women experience amenorrhea by the end of the first year. (“Amenorrhea develops in approximately 20% of Mirena users by one year. The possibility of pregnancy should be considered if menstruation does not occur within six weeks of the onset of previous menstruation.”) Of course, it also increases spotting and flow in some women as well (but doesn’t provide numbers for what percentage.) “Mirena can alter the bleeding pattern and result in spotting, irregular bleeding, heavy bleeding, oligomenorrhea and amenorrhea. During the first three to six months of Mirena use, the number of bleeding and spotting days may be increased and bleeding patterns may be irregular. Thereafter the number of bleeding and spotting days usually decreases but bleeding may remain irregular. If bleeding irregularities develop during prolonged treatment, appropriate diagnostic measures should be taken to rule out endometrial pathology.”

The patient sheet reads, “For the first 3 to 6 months, your monthly period may become irregular. You may also have frequent spotting or light bleeding. A few women have heavy bleeding during this time. After your body adjusts, the number of bleeding days is likely to decrease, and you may even find that your periods stop altogether.”

It certainly doesn’t prevent periods as consistently and reliably as taking pills back to back as the OP has been doing. If she wants to reliably keep skipping her periods, I wouldn’t suggest Mirena as a sure-fire way to do it. I don’t consider 20% to be “pretty common”, but I will admit it’s more than I expected to see. I am thusly surprised as predicted.

14

I got a Paragard IUD when I was 24 due to the fact that hormones totally wreck me. One of the best decisions I’ve ever made, bar none. Took it out when I was 29 and got pregnant almost immediately when we started trying. If I wanted to space out number 2 (although at 39 weeks pregnant, I don’t even want to THINK about #2) a little more, I’d get another one ASAP. As is, I guess we’ll do FAM with condoms for a couple of years, and then I’ll get another Paragard.

That having been said, it did make my periods slightly heavier, but nothing my trusty DivaCup couldn’t handle.

15

If you’re planning on using both the Pill and an IUD, I don’t think you can use a hormone-impregnated IUD such as Mirena. It and the pill both contain forms of progesterone, and you shouldn’t be layering one hormonal birth control on top of another.

16

Ditto everything Snickers said. Haven’t had a period in 5 years and haven’t missed it one bit. Hurt like a bugger tho. My doctor told me at the time that religious women often came back and had it taken out because they felt it was unnatural not to have a period.

One question my sister asked me was if they stop your period altogether, are you depriving your body of the hormones that would protect you from osteoporosis, which runs in my family. My doctor said no but it might be worth asking wrt to the non hormonal one.

17

I’m glad I’m not the only one who uses 2 methods of birth control.

I had a really awful experience with a Mirena IUD. I got it put in last year to try to control severe PMS issues. I went back to the doctor repeatedly due to severe abdominal pain and they did an ultrasound, but the IUD was where it was supposed to be.

When it wasn’t making me have my period at weird times, it was okay. The problem is the hormones just weren’t enough to keep my own in check. I was having PMS and ‘‘starting my period’’ weekly. It was completely unpredictable and horrible (I get bad PMS, excruciating pain + severe mood swings… not something I want to be happening at random intervals throughout the month.) Some months my period didn’t come at all and other times it came all month.

It wasn’t until a full year later I saw a different doctor and she immediately removed it. She said my cervix was severely inflamed and bleeding to the touch. Turns out all those times I thought I was just lightly spotting, it was really my cervix bleeding. I probably don’t need to tell you that sex was impossible that entire time.

Plenty of women have had this thing and loved it. For whatever reason my body did not want it. Just thought I’d offer one different perspective.

And yeah, it does hurt going in. If you have severe cramps though, the pain can’t really compare to what you’re already used to. In my opinion the pain is not a good enough reason to decide against it.