Thinking about getting an IUD? Read this Q&A on what it was like and what to consider.

We asked Ayesha* about her experience choosing birth control.

Q: Hi Ayesha, can you tell us a bit about yourself and why you were considering birth control?
I’m 23 and just recently became sexually active. I had sex for the first time 5 months ago, which is another story altogether. But, before we did anything, my boyfriend and I both got tested, and during the first 2 months of having sex we used condoms and I was taking “the pill”.

Q: Okay, so you were on the pill. What happened?
Well from the beginning, I knew that “the pill” wasn’t something that I really wanted. I’m terrible at making sure I take it on time, even with alarms, so I had begun researching different options and talking to friends. Although “the pill” is generally quite safe, I also knew there are potential risks and common side effects that I wanted to avoid. So I booked a doctor’s appointment, and my boyfriend and I went to discuss different birth control options.

Q: What did the doctor tell you?
She spoke to us about “the pill”, the IUD (intrauterine device), “the shot”, and the implant. Out of all the options I was most interested in the IUD — it seemed like it would suit me best. But I decided to start the pill in the interim and do a bit more research, and then see about getting an IUD.

Q: Out of all the options, what drew you to the IUD?
My boyfriend and I had discussed that neither of us wanted kids right now so we really wanted to make sure we didn’t get pregnant. I learned from my research that with typical use, the IUD and the implant are some of the best options with about 99% effectiveness. “The shot” is very effective, but one problem I was worried about is that if you can’t tolerate it there isn’t anything you can do except not get it again in 3 months’ time. That seemed a bit risky to me. I didn’t want to go the implant route because I just really didn’t like the idea of an object under my skin. I also preferred having hormones act locally rather than throughout my whole body¹. Side note — my boyfriend thinks it’s bullshit that there aren’t more male contraceptive options available (hopefully one day!). So, I ultimately decided that an IUD seemed like the best fit for me.

Q: What are some risks of the IUD?
There is currently no form of contraception that will protect you 100% from STIs. Therefore, if you have multiple partners it’s important to make sure you get tested regularly and use condoms because they are the best option for STI protection that we currently have. If you do contract something, it is important to get treated right away and tell your partner(s) to get treated as well because otherwise it can progress to something more serious. It’s also important to know that STIs can be passed orally, anally, and vaginally. Many people don’t show any signs of having an STI even if they have one, which is why you should get tested regularly. I highly recommend you discuss STIs and HPV with your doctor before and while you discuss contraception.

It’s also worth mentioning that IUD insertion can be extremely painful, and many women get spotting that can last 3 months or longer. A less common risk with the IUD is that it may perforate the muscular wall of your uterus and require surgical removal. If this happens you could develop Pelvic Inflammatory Disease (PID), which is a serious complication and if it isn’t treated effectively can lead to infertility.

Q: Did you consider a copper IUD?
I knew that I didn’t want one because I’ve heard those tend to increase cramping and increase the heaviness of blood during menstruation and I already have very heavy and painful periods.

Q: Once you decided on an hormonal IUD, what happened next?
I was referred to a gynecologist by my family doctor. I was only able to get an appointment a week and a half before my flight to go back to my school abroad. Since we were a bit pressed for time, things were done a bit unconventionally and I had the Mirena with me for my first visit with the gynecologist. Normally you would see the gynecologist for an initial discussion about contraception options, then if you decided an IUD was what you wanted and there weren’t any reasons you couldn’t get it, you would be prescribed the IUD to bring to your next appointment for insertion. I sort of combined those two visit into one, which really isn’t ideal.

Q: Did you do anything to get ready for your gyno appointment?
I asked my mom to come with me for support and to have another set of ears to help ask questions I may not have been able to think of in the first place. Before the appointment I took painkillers (one Tylenol extra strength and an ibuprofen) since I knew the insertion is often quite painful, especially if you’ve never given birth before. This is because your cervix is more tightly closed if you’ve never given birth and the IUD needs to be pushed through the cervix.

Q: How did the appointment begin?
The gynecologist ran through my birth control options again. I would have switched to “the ring”, but since I was going to be studying abroad in Australia and didn’t have the same kind of access, I stuck with my decision of getting the Mirena IUD². The gynecologist asked why I wanted an IUD and why I chose Mirena instead of Jaydess. What I’ve read is that Jaydess was designed for younger women who haven’t had a previous pregnancy as it’s smaller (although the Mirena looks small it’s actually about half the size of your entire uterus), has less hormones, and lasts 3 years instead of 5. Honestly, I was probably being a bit stubborn because I was thinking about how it was going to last me 5 years so I would be less likely to need to buy a second one anytime soon. Also, because of the progesterone hormone, I know most women get much lighter periods that have no cramps with Mirena. However, with Jaydess it is unlikely that you will lose your period completely. Personally, I would prefer not to have my period anyways so I’m hoping I get that “side effect.”

Q: Alright, tell us about insertion!
So it’s better to get the IUD put in while you’re on your period because your cervix is naturally a little more open. Unfortunately, I was not on my period when I got my IUD inserted. First, the gynecologist used a speculum to open up my vagina so that they could look inside. Next, he used a device to clamp and grab hold of my cervix so that he would be able to prevent the opening from moving while he inserted the IUD. This step was agony! I took lots of deep breaths while I held my mom’s hand and just focused on trying to stay as relaxed as possible. I also used some grounding techniques like trying to focus on the feeling of my body connecting to the table. After a bit, I thought okay, things should be done soon. Then he inserted the IUD which was the most painful experience. It felt like there was so much pressure in my abdomen and I was severely constipated and had lots of bad cramping! It took longer than I expected but the grounding technique helped. After he put it in I had to take a minute or two laying on the bed before I got up.

Q: What happened afterwards?
I had lots of cramping… the worst cramping I had ever had. I was also very gassy and kept feeling that sensation that I was severely constipated and needed to poo. When we got home my mom did some brainspotting for me which helped me process everything and really helped to reduce the pain. I also took some more ibuprofen and for the next three days, did yoga specifically for when you’re on your period from “Yoga with Adriene” on YouTube. By the 4th day I was feeling much better and well enough to do activity that was normal for me. I had spotting continually for about 2–3 weeks after the insertion. But I think the brainspotting and yoga really helped speed up my recovery.

Q: So how long has it been? How do you like your IUD now?
It’s been about a month and a half and I think it’s really great! I don’t need to think about anything. I don’t get cramping anymore but since it is still early, my periods are not quite back to my normal yet. Overall, I’m really happy that I decided to get an IUD! But remember contraception is a very personal decision. What worked for me may not work for you. You should talk to your doctor or practitioners at a local clinic about your options to see what would suit you best!

Thank you so much for sharing your experience with us Ayesha!

Ayesha also gave us more details about the options she considered:

  • The “pill” contains hormones that you take daily to prevent pregnancy.
  • An IUD is a T-shaped device that is squished into a rod so that it can be passed through the cervix to open into its T-shaped form, to sit at the bottom of the uterus. There are a few different IUD options: there is copper or hormone (progesterone-like) based ones (common brands: Mirena and Jaydess).
  • “The shot” an injection that lasts for around 3 months (common brand: Depo-Provera).
  • “The ring” is a rubbery ring you insert into your vagina and place against your cervix. You can keep it in for 3 weeks straight then take it out for your period, then put a new one in. This option has fewer risks and potential complications than an IUD and is almost as effective as one (IUD, and Implanon have the highest effectiveness of preventing pregnancy with typical use) (common brand: Nuvaring).
  • The implant is a small matchstick-like object that gets implanted under the skin, usually in your arm. Implants are not currently available in Canada (Common brands: Implanon, Nexplanon).

Footnotes:
¹Your body is all connected so hormones in your uterus can still affect the rest of your body.
²All countries have different access to birth control options, so if you’re in a similar situation, check with a provider in that country to see what is available.

Long-acting reversible contraceptives (LARCs): methods of birth control that provide highly effective contraception for an extended period of time without requiring user action. Once a LARC is removed the user is fertile again, although there may be a short delay.

Pelvic Inflammatory Disease (PID): is an infection of the upper part of the female reproductive system namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. PID is usually caused by a sexually transmitted infection (STI), like chlamydia or gonorrhea, and can be treated with antibiotics.

More Information
Bedsider — IUD specific page | Bedsider — Condoms
Bedsider — Explore All Options
Sexandu — STI information
Yoga with Adriene — yoga for cramps and PMS
Brainspotting

Services in Toronto
Planned Parenthood Toronto — Cheapest in the city and you can pay with cash!
Teen Health Source — Directory of all clinics in the TGTA by service
New Youth — Clinics for newcomer youth, multiple languages, services for those without a health card

Help
Call 1–888–642–2725 For information about sexual and reproductive health, including pregnancy options, and for referrals to clinics and hospitals that provide reproductive health services, including abortion, anywhere in Canada, please call the 24-hour toll-free information and referral line.

* All names have been changed. This is a personal story and is not a substitute for professional medical advice. We have tried to make sure that the information is accurate, however all readers should consult with a physician or other healthcare provider if they are not sure they understand the information being provided.

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