IUD 101
graphic by Zoe Gigis
The idea of getting an IUD was always one that terrified me. I distinctly remember being in my sophomore year of high school and having some girl in my P.E. class describing it as the most horrifying experience of her life - hence the reason I decided to stay on the pill for almost five years. That was until about three months ago when I finally decided that it was time for me to get one, mainly because I was tired of trying to remember to take the pill at the same time every day (which rarely happened), and I was tired of having to drive down to the pharmacy every month. Both of those reasons sound pretty minor, but after doing it for five years, it gets pretty old.
Before I finally called and made the appointment to get my IUD put in, I did as much Google searching as I could. After actually getting my IUD, I found that Google didn’t completely prepare me for what the process was actually like. Here I have gone into detail on some of the most prominent questions about IUDs, and I have also conducted a small survey in order to give you an idea of what having an IUD is actually like.
Let’s go over the basics...
How does it work?
IUDs work differently depending on the type you get. If you decide to get the non-hormonal copper IUD, it will work as a spermicide because copper is toxic to sperm. If you get a hormonal IUD, they release progestin which causes your cervical mucus to thicken, blocking the sperm from reaching the egg and also possibly preventing your egg from being released from your ovaries. It can also work by changing the way your fallopian tubes contract.
What will the procedure be like?
There were a couple of things that I felt like the internet didn’t prepare me for when going into the IUD procedure. First of all, it isn’t just one painful sensation, but it is three separate ones. The first one is usually the least painful, and it is caused by the doctor inserting a device called a “tenaculum” that is meant to hold your cervix in place during the procedure. The second one is caused by a tool called a “sound” being inserted into the cervix which measures its length and depth; my doctor told me that this was the most painful part for most people. The third is the physical insertion of the IUD. Overall, this procedure is quite uncomfortable and I would consider it to be one of the most painful things I have ever done, but according to one survey done on 89 women, only 5% of them experienced severe to moderate pain.
How much does it cost?
IUDs can cost from $0 to $1300, but thankfully they tend to be on the less expensive side with most American health insurances.
How long do they last?
It depends on the type of IUD you get. The copper Paragard IUD may last up to 10 years, while the hormonal IUDs range from 3 to 7 years.
How do they compare to other methods of birth control?
When looking into other methods of birth control, the other two I was considering were the implant and the depo-provera shot. Out of all the birth control methods I found these two to be the closest in lifespan and effectiveness to the IUD. Yet, I still found that the IUD seemed like the most logical choice. It can last from 3-10 years, unlike the implant which lasts for only 3 years, and the depo-provera shot which is recommended for 2 because it can cause osteoporosis and other long-term complications.
Out of all three of them, the IUD is the most effective with a 99.9% effectiveness rate, while other birth controls range from 91-99%. It all depends on your body and what you’re willing to try, but overall the IUD lasts the longest and is the most effective form of birth control (coming second to a full-on tubal ligation).
What are the side effects?
There are plenty of lists of side effects for all types of IUDs...again, it all depends on your body. Personally, I found that I have gained some weight and become really bloated at certain points during my cycle - my period also became pretty irregular just two months after insertion. Some of the more common side effects are cramping and spotting, but it’s not the same for everyone. Thankfully, most people find that their side effects ease up after about 3-6 months, and they tend to be fairly mild.
Can your partner feel your IUD when you’re having sex?
Saving the most important question for last (lol), the short answer is yes, sometimes. Over time your IUD strings will soften and they will be harder to feel, but depending on where your cervix is your partner might be able to feel it. But don’t worry, it isn’t anything to be too concerned about. If it ends up being a big problem, you can always ask your doctor to trim the strings, but sometimes doing that causes them to poke out even more, so in some cases it might be best to wait for them to soften.
With that in mind, I took a small survey through Instagram just to show how drastically different everybody’s experiences can be with their IUD - every body is different and there isn’t a way to 100% predict how your body will react to getting one.
First I asked everyone to rate their pain of insertion on a scale from 1-10, 10 being the most and 1 being the least:
Next I asked if the whole IUD experience was worth it, 5 being that they plan on getting an IUD again and 1 being that it wasn’t worth it at all:
I then asked them to describe their healing process over the 1-3 months after getting the IUD inserted:
“I did not have any issues, slept for 3 hours after insertion. Then I took some ibuprofen the next day and the day after that I went to Yosemite and did a 12 mile hike, so overall it did not cause me any problems.” - Riley, on Mirena
“Irregular cycle ending in no more monthly bleeding, irregular hormones, acne, and weight gain.” - Kenzi, on Kyleena
“The first day I nearly passed out from cramping... do not drive yourself home from insertion appt. The only side effects that were noticeable were more painful cramps and a heavier flow.” - Camille, on Paragard
I then asked them to summarize their overall experience with their IUD:
“I loved my doctor and felt very comfortable, so my insertion experience was great. Even though it was painful, it was only for a second. I had good support after (when I was in a lot of pain) and after a day I was hiking and felt pretty normal. Spotting for 2 months was kinda annoying but I just used a liner and was never in any pain. Overall I have been very happy with my experience. For me, 2 months of spotting is well worth no pregnancy for 5 years.” - Alex, Kyleena
“It was okay for the first year, but I developed acne, lost weight, then at a year and a half I started having random severe cramping. I eventually had to get the IUD removed because the cramping became so bad I almost passed out and couldn’t move at all. It was the most pain I’ve ever experienced. The second they removed the iud all my symptoms and pain stopped.” - Connie, on Mirena
“Previous to Mirena, I was missing up to two work days a month from cramps and heavy bleeding during my periods. While the first three months were wildly uncomfortable, I have had no spotting, no cramps, and no periods for two years. The insertion process, because of complications, was nothing short of traumatizing so I will probably be asking for some heavy anti-anxiety meds if I get another IUD.” - Hali, on Mirena
Finally, I asked them to provide any advice they had for those considering getting an IUD:
“It will be the best decision of your life. I have had friends forget to take their pill, lose their pills, and get pregnant while taking pills. Getting an IUD will change your life and give you peace of mind that you won't end up getting an unwanted pregnancy . It is the most effective form of birth control and is worth the minorly uncomfortable process of getting it, especially if it will last you a decade.” - Payton, on Mirena
“Do your own research on the types of implantable birth control and the pros/cons of each. Work with a doctor you trust and have SEVERAL open conversations with them about what you want from your birth control. Begin taking Motrin a few days in advance to insertion, make no plans the day of or after, and get yourself a good heating pad.” - Hali, on Mirena
“Listen to your symptoms and your body! Doctors don't always know everything, ESPECIALLY around uterine health and birth control. If something feels wrong you're probably right.” - Melina, on Mirena