Everyday Goddess

IUD FAQ

Since my original post about my IUD, I've received numerous and regular e-mails in addition to the copious comment chain on that post, which I would encourage you to read if you're interested.  Thanks to the magic of Google, it's grown fairly regularly, and there are many interesting stories, questions and comments there.

So, in this space, I'm going to begin an IUD FAQ, starting with the most recent batch of questions from my inbox.  If you've e-mailed me about your IUD or with questions, please know I always flag those emails and make an honest attempt to answer them as promptly as possible.  Sometimes, that is quite a challenge, and that's why I've decided to start this FAQ.

Please feel free to suggest additional questions in the comments here, and I will update this post as I can.  As of its initial posting date, it will hardly be comprehensive.  For the most obvious questions (what is it, how does it work) please read my initial IUD post or the Planned Parenthood IUD information page.

Effectiveness:  I just had my baby and I'm not in a hurry to have another, did your doctor tell you how effective it was in preventing pregnancy?

From Planned Parenthood -

The IUD is one of the most effective reversible methods of birth control. Of 100 women who use ParaGard or Mirena, one or fewer will become pregnant during the first year of typical* use. Fewer than one will become pregnant with perfect** use. Fewer pregnancies occur with continued use.

It is very important to remember that the IUD does not protect against sexually transmitted infections. Use a latex or female condom with the IUD to reduce the risk of infection.

*Typical use refers to failure rates for women whose use is not consistent or always correct.
**Perfect use refers to failure rates for those whose use is consistent and always correct.

With the IUD, the only "incorrect use" situation I can think of is not checking the strings.

Can't Find the String:  i saw your website about and IUD and i have one and i love it, its such an awesome form of birth control and its easy to maintain. however, i have one qualm with it, which kind of irriates me. i cant seem to ever feel the string, i go to doctors and they see it and feel it and they tell me its fine and its right there, but whenever i try to search for it i cant find it.  my question is, have you ever had such an issue? how do you actually find the string? i already have my IUD for almost over 2 years and i have never felt the string. thanks

I haven't had too much of a problem feeling the string. Certain times of the month it is more difficult, because I think it gets harder to feel when it's more moist. I generally feel it with my finger at the opening to the cervix. I feel it against the cervix opening. Rather than trying to just feel it floating about.  Note that I have a Paraguard, so I don't know what the Mirena string is like.

And here's another method from an e-mail I received:

my doc cut mine really short, so to feel them I have squat, use my longest (middle) finger and (Ok, this is slightly gross and TMI, but whatever) then I bear down. Um...yeah. You know. Kind of like if you were going to the bathroom. DON'T GO THE BATHROOM! lol. But it brings the cervix WAY down, and makes the strings reachable (for me at least).

Safety:  Is it pretty safe?

Possible IUD side effects include expulsion, perforation, and infection.  While serious problems with the IUD are rare, you must report problems to your clinician right away to avoid further complications.  Click the Planned Parenthood link above for more information on these side effects.

Insertion pain:  My question was about how painful you made it seem to have it put in.  I am terrified of pain and wonder if you know of others who have had less painful experiences, maybe you can encourage me.  (This reader also disclosed that she has not had children.)

Anyone I've heard of who had little or no pain during insertion has had children.  During insertion, the cervix opening must be quickly widened and the IUD popped in.  My doctor did this in mere seconds.  And those seconds were extremely painful.  So yes, it hurt, but yes, it was super quick.  The pain that came after was painful cramping - which hurts but isn't the same thing by any stretch.

Anecdotally speaking, stories I've heard of difficult insertions seem to always be about Mirena insertions (I have a Paraguard IUD) or from women with uniquely shaped cervixes.  It would definitely be worth it ask your doctor specifically about insertion into your cervix and if he anticipates any difficulty.

Skin Breakouts:  My main question is I noticed you said your skin freaked out when you got the IUD.  I was curious about this because I've been dealing with birth-control related acne for months and I would not want to get an IUD if it were to cause me to get acne.

I believe that my skin freaked out as a result of suddenly having a regular cycle again after years of being on birth control pills.  Even when I went off birth control pills, my cycle did not return to let's call it "high school levels."  Now, I have a full 7-day period and my body has absolutely calmed down with the skin breakouts, but for the first few cycles it was rough.  I also wasn't prepared with any idea of appropriate skin care, so that didn't help the situation either.  Note that I have a Paraguard IUD which contains no hormones, so in my case, there weren't any artificial hormone factors at play.

Weight Gain:  I just wanted to know if you have gained any weight from the iud?

Well, I certainly have gained weight since I got the IUD, but then, I was also gaining weight before I got it.  The only actual connection I can see is that maybe because I have a regular cycle, I definitely get the munchies certain times of the month.

Mood Swings:  And also are you very moody?

Hm.  Again, just the normal cycle stuff, which I've become expert at detecting when it's going on, which helps me manage it.  Painful periods, particularly the first few months after insertion definitely didn't leave me happy, but then I wouldn't call that moody, I'd call that "in pain" and that has completely gone away for me.

On the plus side, going off birth control pills and having a regular cycle has also increased my libido, which I suppose definitely qualifies as a mood!

I would reiterate that the IUD takes a few months to settle in.  Definitely at least three months, and I saw a marked difference and improvement after six, and again after twelve.  Since my Paraguard IUD lasts ten years and is hormone-free, that process of settling in was definitely worth it for me.

Finally, here's another great online resource for more IUD discussion and advice:  IUD Divas on LiveJournal.

I'm pill-free, because I have an IUD

I have never liked birth control pills.  For one thing, they make me nauseous.  Because of this, I took to taking my pill at night.  Because of that, several times a week, FOR YEARS, I would have to get back out of bed to go take my pill.  Or I would take two the next day.  Not good for *several* reasons.  One of which was even worse nausea.

Then there's the fact that when I'm on the pill, I often don't get my period.  This is considered a plus, and believe me, it has its obvious benefits for sure.  Unfortunately, it also completely removes the monthly confirmation that you are indeed, not pregnant.  I'm pro-choice, but I'm also pro being on top of these things so that they can be taken care of promptly if that's your choice.  No period equaled a home pregnancy test every few months, FOR YEARS. 

And they're a monthly expense by themselves.

But most important to me, the idea of taking hormones every day really rather bothers me.  I went off birth control pills twice in my life.  Both times I can only describe it as having a dampener lifted off me that I wasn't even aware was there.  Everything felt a little sharper.

It felt like, when I was on the pill, the angst of PMS was spread out bit by bit throughout the month.  So that, I never had PMS when I was on the pill, but I never felt as good - as clear - as I do most of the time without it.  It was always a huge relief to not be taking them.

This last time was soon after I moved to L.A.  I think I knew I had a long life-adjustment phase coming, and one day, I simply wondered why I was taking them.  I certainly wasn't having sex, and I wasn't in any position to deal with dating either.  And I was broke.  And I hated them.  So I stopped.

This time, as the veil lifted, I realized, I didn't want to take birth control pills anymore.  Ever.  There had to be something else, and in the back of my mind, was a thought of getting an IUD.  Which I researched on the Internet, reading websites and bulletin boards.

IUD is an intrauterine contraceptive device.  It is a small T that is inserted into the uterus through the cervix by a doctor (it opens into a T after insertion).  A microfiber string remains out of the cervix so that you can confirm that it is there and in place.  You can't feel a thing unless you're trying to.  The kind I have - the one on the right in this picture - is wrapped in copper and provides the most effective form of birth control, without hormones. Yes, it's more effective, and clearly more reliable than the pill.  And it works for up to 10 years.  Hormone free.

Lest the picture seem too rosy, it turned out that getting an IUD in America was a Herculean task for several reasons.  Firstly, IUDs are not popular in the states because of a faulty IUD in the 70s, the Dalkon Shield, which caused several deaths.  Basically, IUDs have a bad rap in our collective memory.  And because they're not popular, finding a doctor that carries them and does the insertion is a bit of a trick. It was covered by my insurance (completely), but I had to find a doctor who wouldn't charge me up front because he had them in stock already. But now, my birth control is in place, and my monthly expense is $0.

In addition to that, there is a serious concern if you engage in unsafe sex.  Because the IUD goes into the uterus with a string that hangs out the cervix, if you get an STD, the chance of pelvic infection increases greatly.  The cervix ceases to be a natural barrier.  And a pelvic infection can mean that you can't have children.  Because of this, doctors in the United States adher to guidelines that IUDs are not recommended for single women, or women who have never had children and would like to.  If you engage in unsafe sex - ever - an IUD is not a viable choice for you.

It's hard to argue with doctors about this concern.  It's true, and it's serious.  I had to be firm that I - a single woman who had never had a child - wanted an IUD, and I wasn't taking no for an answer.  I don't engage in unsafe sex, but being cheated on definitely enforced their concern and made me feel like a fool for how confident I'd been when insisting on it.  I didn't do anything wrong - in fact, I did everything "right" - and there I was, waiting to find out if one lying man had left me sterile.

It was life-shaking.  But I still knew the IUD was the right choice for me.  Even though I'm not having sex at the moment, it's something I like knowing is there.  Decided.  Covered.  My choice.

One great thing about it is that if I decide I want to have children, I can go to the doctor and get it taken out and could potentially get pregnant that night.  There's nothing that has to leave my system.  There's nothing in my system that could harm a baby or me. I like that.

Also, removal is - I hear - much less invasive than the insertion.

The insertion - which I thought would be a breeze - was a little taste of giving birth.  The doctor opens the cervix for a split second, the IUD goes in, and although many woman (particularly if they've given birth) feel nothing, I felt the single most exucrutiating pain of my life.  And then I was horribly cramped for the next 24 hours.  Like I could only lay in bed and groan, and I REALLY should have had someone there to drive me home.  I had thought I was going to make my salsa lesson that night!  Not so much.

It takes three months for your body to adjust and accept the IUD. It's hard to imagine, but it is particularly susceptible to falling out during this time.  I also had THE WORSE PERIODS OF MY ENTIRE LIFE.  And my skin went crazy.  It was like puberty on crack.  For months after I had really bad periods (definition of careful what you wish for), and I thought that they would simply be like that forever, but coming up on one year, I can now report a complete absence of any monthly cramping. Though I am still having a very "healthy" cycle to be sure.  And I get PMS, usually one to two days a month, although sometimes it's worse, and then the next month, no PMS.  I'm pretty good at telling that that's why I feel crappy, and I just try to lay low if I can.  Or I just work through it.  The PMS is really a function of not being on the pill, though, as opposed to being a result of the IUD.

And once, the month that I got the IUD, I had a small uterine contraction during yoga class.  Yeah, that was disconcerting!  But apparently, just my body adjusting and perfectly normal.

I'm sharing this, because I think that IUDs are a really great form of birth control.  I went through a lot to get to this point, but I now have a method of birth control in place that effects me not one bit and costs me not one cent and lasts for years until I choose to have it removed.  It's not for everyone, but it is an option.  A good one.

If you have any questions I can answer about my IUD experience, I am available to you.  If you live in Los Angeles, and you're looking for a doctor, I know a great one in Glendale.  Simply e-mail me.   

UPDATE - I've started an IUD FAQ here.

Tag:  iud, birth control