Thoughts on the IUD, One Month In

This is a bit different from my normal content (although I do talk about contraception sometimes on my Instagram, lol, so maybe not that far out). But when I was doing my research when I was deciding to get an IUD, I could not find enough, I was insatiable. You hear so much scary stuff about the insertion, but then nothing really after that. I am now a month and a day out from my insertion, so I have had some time to experience it and reflect on it.

The Decision Making Process

I’m going to go back in time a bit. There were a lot of factors that I took into account when I was making the choice to get an IUD. There are so many options for contraception now that it can be hard to know that you are making the best choice for you. I would definitely recommend talking to your physician, if you can.

But my factors were:

• Access to a physician. It is really hard to get onto the patient list for the one physician’s office that the general public has access to in our town. So my “family doctor” is still back in my parents’ town, now 1700 kilometers away from where I live (about a 19 hour drive, without stopping), which really isn’t practical. So I wanted something low maintenance and long term.
• I am really bad at taking the pill every day and at the same time every day. The pill (both types) are really effective, when used perfectly. And I was far from perfect. If I remembered to take it on time half the days out of the month it was a good month. And this was with setting alarms, reminders, and putting sticky notes in conspicuous spots around my apartment. So I needed something that couldn’t be forgotten.
• I wanted something that was very effective as a contraceptive device. I think that speaks for itself lol.
• I haven’t looked into the scientific evidence on this, but I was feeling weird about having added hormones cycling through my whole body. I did ask my physician and nurse practitioner about this, and the hormonal IUD does mostly keep the hormones right around the organs they are targeting, rather than all through your digestive system and all of that. I was also intrigued by the non-hormonal option of the Copper IUD.

So those were the things that were my factors going into the conversation with my health care providers. I did all my consults over the phone due to the distance and COVID, a COVID policy actually worked out perfectly for me. And then while I was talking to them, I learned that because I get migraines that sometimes have aura, most hormonal birth controls are not recommended for me. So that narrowed my options down to the progesterone-only pill (which requires even more precision than the combi-pill, so that one wouldn’t work for me), the IUDs, and then the implant, which is a little thing that goes into the inside of your non-dominant arm and releases hormones from there, and then the Depo-Provera shot, which has a side effect of causing people to gain a lot of weight. And I don’t want to do that.

The implant weirds me out. So that left the IUDs. There are three main options in Canada: the Copper, Mirena, and Kyleena. The copper is the non-hormonal option, and a lot of people go with it for that. I think in the States they say that you can have it for 10 years, but in Canada it’s only licensed for 5 years. But it has well-documented side effects of making your periods terrible. And that’s a no for me. The next are basically the same, Mirena and Kyleena. They are both hormonal options, the only real difference is that the Kyleena is smaller device. So my Nurse Practitioner recommended it for me because I haven’t had kids.

Insertion

Okay so I was nervous. I have heard so many horror stories from friends and on the internet about how painful it was and they passed out, they threw up. And then TikTok was feeding me these videos where they show you how the tenaculum pinches into your cervix so the person doing the inserting can get the IUD into the right place. And that was wigging me out.

So the NP prescribed me a couple pills, to take the night before and the morning of. I can’t remember the exact name of it, but it was a combination drug of misoprostol and diclofenac that is normally used to treat osteoarthritis, but somehow also has the effect of softening the cervix. (Misoprostol is one of the drugs used in a “chemical abortion” with mifepristone, so there is definitely something happening with the cervix and uterus).

Then I picked up my IUD at the pharmacy and went to the clinic. I did get slightly alarmed at the size of the box the IUD comes in, but the box includes the whole kit, including the applicator which has to be quite long to reach your uterus, so the box is big. We chatted for a bit and then we got to work. She didn’t use any numbing or local anesthetic. We also did my pap smear at the same time, so she did that first, and then she attempted to insert the IUD without using the tenaculum, and was successful! It definitely wasn’t a pleasant feeling, but I was bracing myself and bracing myself, and then she said “It’s in!”. And then the big bad cramp came. She then left me to lie down for about 10 minutes because many people have what is called a “vasovagal response” (we talk about it a lot in my work with vaccination, so I knew that one!), which is basically fainting. And I was glad of that, because my head did do that “woo” feeling that happens when you feel faint. Then she came in and checked on me and asked if I felt okay and I did and I got dressed and left.

And that was it, I couldn’t believe it. I was so prepared to have a terrible experience. But afterwards I just got in my car and went to a bookstore and bought a sandwich. I couldn’t believe it.

After Insertion

Honestly, this was probably worse for me than the insertion. I have been very lucky with my periods and I almost never have bad cramps, nausea, anything bad. But these cramps were bad and my tummy was sensitive, if you can catch what I am alluding to. I felt really bloated all the time. But then they mostly went away about 4 days after. I was spotting pretty significantly and I would recommend liners so you don’t ruin all your underwear.

Then came the first period after insertion. This was terrible. It was like 10 days long, which is way longer than is normal for me, I was super crampy. It felt like my uterus was trying to push the IUD out itself.

I actually got really paranoid that that would happen, and I was checking the strings very frequently. So the IUD sits up in your uterus and you should not be able to feel it ever, but there are a couple strings that feel like fishing line or plastic thread, that hang out through your cervix. Towards then end of my period it felt like the strings were sitting just inside the entrance to my vagina and I was so scared that it was coming out. I called Tele-Health because it was a Friday evening and all the doctors except the emergency room were closed, here and at home. And they recommended that I see someone and have it checked if it is in the right place.

Except, I had to wait until Monday to even try and get one of the same day appointments, and then I didn’t get one and so I didn’t see anyone until Tuesday. The doctor there was great, and she checked and couldn’t see anything, but she did say that the strings were left very long. She ordered an ultrasound, and then they called me that afternoon and I was able to get one for the next day. And then the ultrasound showed that it was in the right spot! So I was panicking over nothing. But I was so paranoid about it coming out, and somehow that ultrasound really helped calm me down. That was last week and I’ve barely thought about it sense.

I am still a bit crampy and still spotting, but less. Although there does seem to be more goop (TMI, but this whole post is TMI so whatever), that is different than it was before.

The NP did say that it can take 6 weeks to 6 months to fully settle in. So, there is still lots of time for things to happen and it to get comfortable. But you’re good to partake in relations after a week if you have the opportunity.

I am feeling sufficiently embarrassed now, so with that, good day.

Laura