If you happened to read last week’s post about That Thing We Never Talk About, you’ll know I had an IUD insertion on Friday.
I think now’s the time to actually talk about that — I know I would have liked a single place to look for all the information I could get about what it would be like. So here it is. If you’re considering or are interested in intrauterine devices, this is for you.
I was originally on the pill (Alesse) for quite a few years before I decided to try the NuvaRing. I had been missing pills too much, and it was getting stressful. I originally went to the doctor asking about IUDs, but she recommended the NuvaRing as it’s less intrusive: NuvaRing just goes into the vagina, will the IUD is inserted through the cervix, into the uterus. (Sounds fun, right? Whoopee!)
But that didn’t work very well. I used it for a about sixteen months before realizing that my complete loss of sex drive and emotional instability was probably a result of the NuvaRing. It was barely noticeable, I think because it happened over such a long period of time. Plus, I had been experiencing a lot of personal difficulties over that same period of time, so it didn’t really cross my mind. I just thought it was emotional trauma.
This past summer though, it suddenly hit me. I was so annoyed with myself too — how could I not have realized? No wonder the depression was hitting me harder than it used to. It wasn’t like me to feel the way I did — it was kind of everywhere in my life. Nothing was really happy, because the numbness was beneath it all. I hadn’t even noticed, but thank goodness I finally did.
Since I was working away from the city I’m in now, I wasn’t able to get the IUD right away.
They need to do follow-up, so they recommended I wait until I went home. In the meantime, I switched back to the pill, and voilà! Sex drive was back, and normal me was back. What a relief. I was sure happy to know that it was just hormones. I only used the pill for two months though — as soon as I could get into the doctor’s office to ask about IUDs, I did. And I did my share of research, too. A close friend of mine is using the copper IUD, so I asked her tons of questions, and I read all over the internet, avoiding the horror stories of course.
Despite all this, there’s very little information on what it’s actually like to have it inserted and what happens to you afterwards.
Maybe because reproductive rights is a touchy subject… but let’s not get into that for now.
So here we go! I settled on the Mirena, the hormonal IUD. The copper one can cause heavier periods and worse cramping, which is not an option for me. My cramps can be pretty terrible even when I am on birth control. Plus, the Mirena has the same hormones as Alesse (and most birth control pills) so I knew I wouldn’t have the reaction I had with the NuvaRing.
The doctor gave me the prescription, told me to go buy the IUD, and book an appointment one of the last couple days of my period. Apparently, the cervix is more flexible and relaxed around then, so it’s the best time for insertion. That was a fun discovery. Another fun discovery was how cheap it was: with my insurance coverage covering 70%, it only cost me $109 for the Mirena! Well worth it, considering pills can cost $60 for two months.
On the day I went in, I took two Advil tablets about forty-five minutes before to help with the pain.
Since I have a tilted uterus, I suspected I’d be experiencing more pain than most women and though I like to brave things without drugs, this was one that I was absolutely fine with preparing for.
The doctor had me get all ready, cover myself, butt at the edge of the examination table, feet in the stirrups. She asked if I wanted her to talk through everything, which of course I did. (I’m the type who watches when they take blood for testing. I don’t like to be surprised by the prick.) So she told me she was going to have a do an internal exam with her hand — and before I could ready myself, bam there was a giant hand in my vagina. That was a little surprising since she didn’t exactly warn me when she was going to do it, but it wasn’t too bad. No cramping here. She said she was trying to feel how far back my cervix was, and this is when she confirmed I have the tilted uterus.
“Don’t worry, that just means it’ll be a little more… don’t worry about it!”
You’ll recognize that line from That Thing We Never Talk About. It’s too funny to not re-state.
Anyway, then she said she was going to have to clean my cervix.
To do that, she used I believe a speculum, same as when they do a pap, to open up the vagina so that she could see the cervix. She did three short swabs, which I barely felt, and that was that. The material they use is brown in colour, and she said I could expect to see some on my underwear — be ready with a pantyliner!
Then she had to measure the depth of my uterus.
I’m not sure what the instrument was called, but it was thin. She prepared me by telling me this time when it was going to happen (thank goodness, seriously) and then she did it. This did hurt — it was like a sharp cramping, a lot like menstrual cramping but more localized and sharp. It lasted only a few seconds.
This was interesting — I knew what to expect at this point, so I was ready. One thing that is comforting is that you don’t actually feel it going inside at all. The only way I knew she’d done it is from the cramping. I didn’t feel it touch the back wall of the uterus, and I didn’t feel it really enter either. Just the cramping.
As soon as she was done, she told me to count to sixty and then we would be done, IUD inserted. At this point I was breathing deeply, trying to calm myself and just focus on breathing. If you get an IUD, I highly recommend doing this, it really helped. I didn’t scream or swear or anything, just breathed a whole lot. It was easier to focus on breathing than actually count to sixty, too.
She used whatever the term is for “cervix clamp” to make sure the uterus doesn’t move while she inserted the IUD. This part probably hurt the “most,” but it was different. It wasn’t the same kind of sharp as the measuring part, but it was sharp, and a bit more intense. Still localized, but less so. I didn’t actually feel anything going inside, again. Just the cramps. (Intense cramps!) Breathing, breathing, and it was over.
She told me to relax and stay lying down, let the cramping slow down.
It took a few minutes, but once it did I sat up. There was some blood, but not very much — I mean, I was on my period and she just stuck something in my uterus. There was bound to be some.
And that was that.
So basically, it’s a bit painful, but even with a tilted uterus it wasn’t too bad. It was just like period cramps, but sharper and a little more localized — the nice thing too is it goes away pretty quickly.
I was sore for a few hours afterward, so I spent the day lazing on the couch. There was a point about an hour and a half, maybe two hours after the insertion that suddenly cramping really hurt and I couldn’t focus. I took a couple Advil and that helped.
Naturally, I was worried about perforation, but there was no more bleeding other than a little spotting, which the doctor said to expect. Apparently spotting can happen for up to six months, the only real drawback in my mind. But five years of not worrying about pregnancy? I think six months and a little pain is worth it.
The doctor had told me to expect cramping for only a couple days, so once I was on the third day and still having cramps, I was worried. I called the pharmacy, and they told me cramping can happen for 3-4 days. As long as it’s mild and there’s no bleeding, I should be fine.
On the sixth day of cramping I went the doctor again.
She did an internal exam, pressing on spots to see if they caused cramping, and they didn’t. She said I was fine, but gave me a requisition form for an ultrasound if I get worried. She also told me not to worry too much about the “strings,” the tiny metal pieces that you can feel with your fingers near your cervix. They’re supposed to be a measure of whether the IUD is falling out or perforating, based on the length of the strength, but my doctor told me that checking can cause anxiety. She recommended that if I really want to check, to check once a month, but especially with my tilted uterus it’ll be hard to feel.
So basically, only if you still feel the type of pain you had at insertion should you really worry.
For me, right now, there is still minimal cramping. I’m basically fine, but it does come a couple times a day. I’m expecting to be fine by the end of the weekend though. No side effects either — just spotting, a bit of an upset stomach (as per usual – my stomach is overly sensitive).
I hope that this provides some comfort if you’re thinking of getting an IUD. I know it probably sounds a little scary with the detail, but really it wasn’t too bad. Of course, always talk to your doctor first, especially if you’re on other meds or hormones. And be your own judge — you know your pain tolerance. I know I have a pretty decent threshold for pain, but I didn’t know what to expect. I hope this gives you an idea!