Birth control pop quiz: what’s small, not just for women who have previously given birth, and covered by most forms of health insurance?
It’s a bird, it’s a NuvaRing … no, wait … it’s … an intrauterine device (IUD)! Quick, Robin, to the contraception mobile!
Maybe you’ve heard, but there are loads of different contraceptive options out there. You don’t have to be limited to the dynamic pill and condom duo if that isn’t what works best for you — although, if you’re not using a barrier method, you’re not going to be protected against sexually transmitted infections. I know you know that — just putting it out there. Make sure you have the Robin to your Batman, that’s all I’m saying. Everybody needs a sidekick.
But I digress. If you are a sexually active individual with a vagina who has encounters with individuals with penises every now and then, you’ve probably given some thought to a form of birth control that you can control yourself. One of the options that has been rising in popularity over the past few years is the IUD. I’d like to demystify the IUD a bit. It had a bad rap in the 70s and 80s in its prototype years, but modern IUDs are actually overwhelmingly safe.
First, the briefest of rundowns for those of you who are less familiar with IUDs. An IUD is this little, flexible, T-shaped plastic insert which chills out in your uterus and helps protect you from unplanned pregnancies. It can be removed at any time by a gynecologist. There are two different types: copper IUDs and hormonal IUDs. With the copper IUD, also known as ParaGard, you’re covered for 12 years, but you may experience worsened period cramps and bleeding. Of the hormonal types, there are four options: Liletta, Mirena, Skyla and Kyleena. Depending on which of the latter you choose, you can tailor your coverage from anywhere between three and six years. Have I mentioned that they’re more than 99 percent effective at preventing pregnancies?
Which leads us to the question you almost don’t want to ask: pray tell, how does this T-shaped piece of plastic get to the opening of my cervix?
To help me answer that question, for this week’s article I had the chance to sit down and chat with someone who recently got an IUD. I had heard a range of reviews from different people about their insertion experiences, from, “it was like a pinch, a looong pinch, but no big deal” to wide eyed, head-shaking, “let me tell you…” sagas. So, as an interested party who basically almost faints every time I get a shot, I wanted to talk to someone who I knew wouldn’t sugarcoat the truth for me. What follows is a frank discussion about the process of figuring out the right contraceptive option for you, a few ludicrous nicknames for medical tools, my friend’s insertion story and her recommendations for anyone considering getting an IUD.
DISCLAIMER: This is just one person’s experience with IUDs and birth control and doesn’t represent the range of all birth control experiences. Your birth control decisions should be made with your doctor, and should be tailored to your own body and lifestyle. The following interview is not for the squeamish, nor for those who fear terminology surrounding the female reproductive system.
(Setting: Swem, the massage chairs, a cool spring evening. As night falls, a soft mist settles on the ‘Burg. Cue atmospheric saxophone music.)
Q. Why did you choose to get an IUD?
A. Well, I was on the pill for 2 years and I had really weird cyclical anxiety problems where for 2 to 3 days of every month I’d get really bad anxiety. My doctor recommended that I switch to an option without [added] estrogen and that I switch to another pill.
(When she proposed switching to an IUD, her doctor agreed and said that was what she recommended right off the bat to most women who come to talk to her about birth control.)
Q. What would you say are the IUD’s pros and cons for you and your lifestyle?
A. It’s been a great choice. No more anxiety! I lost 15 pounds [due to the transition from the former estrogen supplemented pill], I don’t have to think about it and check like with the pill. And if I get nervous about the IUD shifting, I just feel around for the strings.
Q. And the cons?
A. I had bad cramps for two days, it was doable with Advil.
Q. What was insertion like? Was it painful?
A. The pain is not negligible. But, it was not a long enough painful experience to deter me from doing it again. The actual insertion did not take very long, and my doctor paused to let me collect myself between steps.
Q. So, what exactly was the process?
A. Well, first there’s the speculum which, I don’t find super pleasant tbh like … wow, that’s kind of uncomfortable … I was not feeling in a particularly amorous mood toward you, speculum … hmm, chafing.
(Speculums are basically hinged, hollow cylinders inserted into the vagina to dilate it to examine the pelvic area.)
Q. And then?
A. Well, next she showed me, to my eyes, what she was going to use [for the insertion]. I really appreciated knowing what was going to be used. It felt consensual, haha. There was this big-a— Q-tip, a big-a— pincher thing and the box with the Mirena in it. Next, I got in the stirrups, and my doctor took the Q-tip and blotted the cervix. It wasn’t pleasant, but not horrifying. Like rough sex gone bad.
Q. Then the giant pincher clamp device?
A. That was used to pull on the cervix to get it to open.
Q. Um, Pull?
A. The doctor gave the ‘little pinch’ warning, and I said something like, ‘Ow that really hurts, ow that really hurts, ow that really hurts, ow that really hurts, ow that really hurts, ow that really hurts.’
Q. Six times?
A. And the doctor said, ‘There will be 3 big pinches … ’ and that was the first one was like if a monster lobster came to snap your, I don’t know, pelvis in half?
Q. The second pinch?
A. The uterus measuring stick. They stick it through your cervix until it hits the top of the uterus. This was the most painful part for me. But, fun fact, my uterus is seven inches long. My doctor said it would make good cocktail party conversation. We briefly discuss the possibility of a rising trend of uterus envy with the increasing usage of IUDs among women.
Q. Okay, okay, but what happened after the uterus measuring stick?
A. The pain of the ruler disappeared as soon as it was removed, so that was nice. After that was the IUD insertion device, which looks like a really long tampon inserter with an IUD on the end.
Q. The third pinch?
A. Yup. It hurt for maybe 30 seconds. Once it was there and left in, the cramps started. Personally, I had a ‘vasovagal’ reaction: sudden drop in heart rate and blood pressure, you know, the symptoms of fainting? Which is pretty common. Then my doctor snipped the strings, which look like fishing wire, and removed the pincher things, and took out the speculum. She gave me a super-strength Advil and let me lie there for a while.
Q. Anything after that?
A. That’s it! I went back one month later for a checkup to make sure everything was still in its proper place.
Q. How did you spend the rest of the day after your IUD insertion?
A. I went to my favorite restaurant to treat my boyfriend for coming with me to basically hold my hand for 10 minutes. I highly recommend having someone there with you. After the Advil kicked in, the cramps were fine. I’m a girl, I can deal with it. Afterwards, I purchased an extra-large heating pad, which I can also highly recommend.
Q. How long would you say it took for you, and your body, to adjust to your IUD?
A. Well, I’ve only had it for three months. I get spotting, randomly sometimes, usually pretty light. I was very regular on the pill, like to the hour. Now I get spotting on the day I would get my period. It took me about two weeks of spotting for my body to sort of get into any sort of a cycle. Psychologically, it took a while to adjust to the concept of ‘there’s this piece of plastic shoved up inside me, semi-permanently.’
Q. Any final things you’d like to share with readers about your IUD experience?
A. If it’s the move for you, don’t let the pain freak you out. If it’s not the move for you, it’s your choice.
Elizabeth Barto is a Behind Closed Doors columnist who’s demystifying IUD myths.