Quick background: female reproductive issues run in my family. My paternal grandmother had a hysterectomy at age 26 because of heavy periods, my maternal grandmother and her daughter (my aunt) had recurrent miscarriages, and my mom has had numerous fibroids, ovarian cysts, and endometriosis that impacted her fertility. She had a hysterectomy a few years ago but still continues to feel the effects of endometriosis (minus the two-week-long periods).
I first went on birth control for what felt like a heavier than normal flow and cramps that were just unbearable. Surprisingly, I didn’t have any other PMS symptoms. I was given Lo Loestrin Fe, and I was on it for about a year and a half before switching to the IUD. This pill was kinda nice. It had low hormones, which didn’t really mean anything to me. As long as it helped my periods, I didn’t care what it would do. My period length didn’t change, still stayed for about 7 days. My flow had fewer clots, which was nice. Cramp intensity went down, BUT these cramps were different. Before BC, my cramps were intense but did not last very long. On the pill, they were duller but didn’t really go away; it was a near-constant state of ache that left me exhausted. I also became irregular, which as a sexually active person, was kinda scary. Taking the pill at the same time each day was mostly okay if I had a routine, but said during a break from school when I wasn’t in a routine, it was difficult to take my pill at the same time because I didn’t always have them on me. However, I was satisfied with the pill because I wasn’t comfortable with the other options.
This past summer, I interned in an OBGYN office and basically got paid to shadow OB residents. I saw many IUD insertions, and seeing the insertion process almost every day lessened my fears about the IUD. After doing research, my doctor and I agreed that I would get the Kyleena!
I took misoprostol (Cytotec) pill the night before my insertion because my OB said that it helps to relax the cervix and makes insertion much easier. This pill makes some people feel sick or crampy. It gave me a minor headache, but because I took it around 10 pm, I slept through any side effects. My doctor said that on her end it made my cervix soft (I wasn’t on my period at the time, so it was kinda needed), so insertion was easier on her end. I know some studies have found that Cytotec doesn’t really work for pain management, but if it helped my OB, I’m glad I took it!
I also took naproxen about an hour before the insertion. I guess it helped? It didn’t kick in as soon as I would have liked though.
Insertion wasn’t too bad. It was certainly uncomfortable, but if it meant that I was effectively sterilized for 5 years, I would gladly do it again. It was my first time having a speculum inside me, so that aspect wasn’t very fun but it wasn’t unbearable either. As soon as it was over, I honestly felt energized, like I was a new woman. I felt powerful.
Until cramps hit me about thirty minutes later. They were not very fun, especially because I had a class after my insertion. In the next few weeks, I had minor cramps that came on in the afternoon like clockwork, but nothing that was unbearable.
Great news: I think I’m regular again! I've had two periods since the insertion and they were about a month apart. Cramps are stronger than they were while on the pill, but I only get a few before the start of my period and they only last for about 30 seconds. I greatly prefer these cramps, just get it done and over with. I now also get a few days of breast tenderness, so that’s a new and not so fun thing. My flow, on the other hand, is infinitely lighter. I used to use a menstrual cup, and I could probably fill it multiple times over the course of one period. Now? A panty liner would suffice.
A lot of the symptoms I’ve had with my periods are similar to what my mom had when she had periods of endometriosis. My doctor doesn’t suspect that I have it, but my mom was diagnosed at age 25-26 and I’m now 21. I’m so glad that I have a reliable birth control method, a device she did not have access to when she was around my age.
I’ve had a positive experience with my IUD, and I would certainly recommend it. So far I haven’t had any major issues, and my only regret is not getting one sooner.
What types of IUDs are there?
There are two types of intrauterine devices: hormonal IUDs and copper IUDs. The hormonal IUD, such as Mirena or Skyla, releases levonorgestrel, which is a form of the hormone progestin. There are two hormonal IUDs – one that works for five years, and one that works for three years.The copper IUD (such as Paragard) is the most commonly used IUD. Copper wire is wound around the stem of the T-shaped IUD, and this works to prevent pregnancy. The copper IUD can stay in place for up to 10 years and is a highly effective form of contraception.
How do IUDs work?
The hormonal IUD prevents fertilization by damaging or killing sperm and making the mucus in the cervix thick and sticky, so sperm can’t get through it to the uterus. It also stops the lining of the uterus (endometrium) from growing very thick, which makes the lining a poor place for a fertilized egg to implant and grow. The hormones in this IUD also reduce menstrual bleeding and cramping.
The copper IUD is toxic to sperm: it makes the uterus and Fallopian tubes produce fluid that kills sperm.
Am I a good candidate for the IUD?
The IUD is right for you if:
- You have only one sex partner who does not have other sex partners and who is infection-free. This means you are not at high risk for sexually transmitted infections (STIs) or pelvic inflammatory disease (PID). Marie Stopes encourages dual protection and the use of condoms together with your IUD contraceptive.
- You want an effective, long-acting method of birth control that requires little effort and is easily reversible.
- You cannot or do not want to use birth control pills or other hormonal birth control methods.
- You are breastfeeding.
- Require emergency contraception. The copper IUD is recommended for emergency contraception if you have had unprotected sex in the past few days and need to avoid pregnancy, and you plan to continue using the IUD for birth control. As a short-term form of emergency contraception, the copper IUD is more expensive than emergency contraception with hormone pills.
Remember that you must be free of pelvic infections when the IUD is inserted.
How effective is the IUD as a method of birth control?
The IUD is a highly effective method of birth control. When using the hormonal IUD, roughly two out of 1000 women become pregnant in the first year. When using the copper IUD, about six out of 1000 women become pregnant in the first year.
Most pregnancies that occur with IUD use happen because the IUD is expelled from the uterus unnoticed. IUDs are most likely to come out in the first few months of IUD use, after being inserted just after childbirth, or in women who have not had children.
What are the advantages of using the IUD?
The advantages of IUD usage include cost-effectiveness over time, ease of use, lower risk of ectopic pregnancy, and no interruption of foreplay or intercourse.