I am not a doctor, obviously. I’m just a fourth year university student choosing to exercise my right to control my reproductive and sexual health. Everything I’m about to share with you has been learned through my personal experience with getting an IUD, talking to my family doctor, school doctor, and my local public health clinic doctor. Yes, I visited 3 different doctors to make sure this was the right option for me before proceeding. This article will be long and thorough, but I’m writing it for anyone who has no idea where to even START when researching alternative birth control options, and to hopefully answer any question you might have along the way. I’m just going to warn you now, I’m not holding back any of the good bits, so prepare yourself for ALL the dirty deets.
What is it?
An IUD or intrauterine device is a friendly little contraption that is inserted inside the uterus (by a doctor) that works to prevent pregnancy and/ or sometimes lighten the flow of your period. The little T-shaped device sits inside the uterus for an extended length of time, slowly releasing hormones (or copper) that make the uterus unfit for an embryo to develop. This option of birth control is SUPER low maintenance, since it can last up to 5+ years, doesn’t require taking a pill every day, and is incredibly effective.
How effective is it?
All 3 of the doctors I visited informed me that IUDs are the most effective method of birth control on the market for those who are sexually active (ie. Not choosing to remain abstinent for any reason). Every infographic and chart I was presented with by a doctor listed IUDs as over 99% effective in preventing pregnancy, and Planned Parenthood states that fewer than 1 in 100 women will become pregnant while using an IUD.
How does it work?
After insertion, the hormones or copper from the IUD work in a few different ways. The first measure of defense is thickening the cervical mucus to prevent sperm from even entering the uterus. Second, they thin the lining of your uterine walls so that if a sperm and an egg were to meet inside the uterus, it is very unlikely that it will be able to find a cozy spot along the uterine wall to settle and start developing into a baby. And, as an added benefit, the IUD starts and stops working immediately as it is inserted or removed, respectively. Woo!
Are there any risks/ side effects?
Like almost anything, yes, there are risks. My doctors were all fantastic at ensuring I was aware that while risks were unlikely and uncommon, they were still present. The biggest risks were perforation of the uterus and infection. Again, while uncommon, it is still important to know what the risks of an IUD are, which is why I recommend doing a little extra research here.
The side effects, however, aren’t all that scary in my opinion. Seeing as while I was using oral contraceptives I experienced symptoms such as depression, anxiety, acne, and weight gain (while these could have been influenced by other factors in my life at the time, they are not uncommon side effects of oral birth control pills) the side effects of my IUD don’t bother me at all.
Strings. What? Yeah, it has strings. An IUD has strings which hang out of the opening of the uterus and can be felt inside the vagina (but are trimmed by the doctor during insertion). These are important so that you can regularly self-check to make sure your IUD is still in place, and so that your doctor can easily remove it once you’re ready for it to come out (emphasis on your doctor removing it!!!!). In addition, since the IUD is thinning the lining of your uterus, your periods should get lighter and potentially even stop altogether, since there might not be anything for it to shed! Woohoo! Imma save some SERIOUS money on tampons.
Can you… Feel it?
No. Well, yes. Kinda? The actual IUD is approximately the length of a fingertip. As pictured above, the hormonal version (left) and copper version (right) are very similar in size, but every type of IUD is just a little bit different. In real life, the difference in size is seriously so small that you wouldn’t even be able to tell once it’s inserted. To be honest, you will be able to feel it at the point of insertion (we’ll get to this later) but once it’s in, you shouldn’t notice it, even during intercourse. The only awkward situation that I can foresee would be getting it on with a partner who doesn’t understand what an IUD is, or that you have one, and potentially touching one of the strings which might freak them out for a hot second until you reassure them. Honestly, I would probably warn them before hand as you are both enthusiastically expressing consent and your preferred method(s) of protection. When it comes to penile penetration however, the IUD should remain discrete and not cause any pain.
What are the different types I can get?
So, I live in Ontario and I was presented with 4 options for IUDs. There might be others available, depending on where you’re reading this from, so be sure to check with your doctor or local health clinic before telling them you want one of the following:
1. Copper (Paragard) – Nonhormonal, works up to 10 years
2. Jaydess – Hormonal, works up to 3 years
3. Mirena — Hormonal, works up to 5 years
4. Kyleena – Hormonal, works up to 5 years
Something important to note (that I wasn’t aware of until speaking with my doc) is that even though most IUDs do contain artificial hormones, they pretty much only affect the ~vagine~ locally, whereas many people experience side effects from oral contraceptive hormones throughout their entire body. This was my main hesitation; prior to deciding I had chosen the Paragard, however this crucial piece of info changed my mind and I ended up going with the Mirena (as recommended for me by my doctor).
It costs…….. How much?!
Whoop—there it is. They can be costly. However, here is what I think you should consider before ruling out this option due to price point. Check your coverage! Whether it’s through a parent, employer, or your school, check to see if you have coverage for IUDs.
In my experience, I was told that the Mirena could cost about $4-500 without coverage. To help rationalize this upfront cost, think about how much you spend a month on birth control (pills, condoms, Plan B, etc.) over the course of one year. According to the Halton Region Public Health website, under Sexual Health, the average cost of birth control in Ontario is $0-25 per month. At (an estimated) $500 up front without coverage and lifespan of 5 years, IUDs can work out to cost about $8 per month for reliable protection and secure peace of mind.
*Bonus for Ontarians: As of January 2018, the Ontario government will be launching OHIP+ for everyone 24 years old and younger up until your 25th birthday (no sign up or eligibility required – just a valid health card). Through OHIP+, the government will be covering the cost of over 4,400 drug products and medications. Luckily, I did notice right here that the Mirena IUD is covered, but others are not.
Additional things to consider
As of right now I’m still new to my IUD, however there are a few final things I think you might want to know…
1. It might take a while to get an appointment.
You usually have to visit your doctor to express your interest in getting an IUD, in which you’ll probably discuss most of what I’ve shared with you in this article. Then, you might be asked to schedule another appointment to be tested for STDs/ STIs, pregnancy, and/ or have a pap smear if you haven’t recently had one. Your doctor will probably want to ensure optimal reproductive health before agreeing to insert the IUD in order to prevent the risk of introducing or spreading infections from the vagina into the uterus during insertion. And lastly, if your doctor doesn’t perform the procedure themselves, you may need to wait for a referral to an OB/GYN to have it inserted. Keep in mind, these specialized doctors are often very busy dealing with pregnant women and their cute lil’ babies, so scheduling an IUD insertion for you might not always be their most pressing concern, and it may take a while to book that appointment. Another option would be to visit your local public health clinic and see if they’ll do it so you can expedite the process!
2. Prepare to be asked to schedule a checkup 4-6 weeks after insertion.
While some spotting and cramping at the beginning may be expected due to your body learning to adapt to a foreign object which is now a part of you, extreme pain, bleeding, and any other major concerns should be brought to the attention or your doctor ASAP!
3. You’ll eventually still feel like you’re getting your period, just without the bleeding.
If you have a heavy flow, most IUDs (with the exception of the non-hormonal copper one) should help with that. Symptoms of PMS, however, will probably still occur normally, so you will still be able to tell when you’re ovulating and track your period – if you’re into that sort of thing.
4. Some clinics may actually want you to be on your period for insertion.
When I told my friends about this, they all thought it was weird and kind of gross. However, it makes sense that when you’re on your period the cervix is a teensy bit dilated, making insertion slightly easier for the doctor and slightly less painful for you.
Let’s Get Physical – The Insertion Procedure Step-By-Step
Before:
It’s appointment day, and I will admit I’m pretty nervous. The only things on my to-do list are go to work, go to class, eat a substantial meal, take an Advil a couple hours before, and head to the clinic. I was advised to not plan anything too physically demanding for this afternoon, since you’ll probably experiencing some adjustment pain and cramping.
During:
Here we go. It’s time. Realistically, all they have to do is measure the length of your uterus so they know how long to cut the strings, pop that sucker in, and send you on your way. The entire thing is supposed to take less than 20 minutes, and my experience was even shorter. If you’ve ever had a pap test (which you should if you haven’t!!) it starts off very similar, but soon, for about 2-3 minutes, you’ll feel pain identical to that of one of the worst period cramps you’ve ever had. The doctor will probably encourage deep breaths, but it goes by quick and before you know it you’ll get to rest for about 5-10 minutes just to see how your body reacts. Then, once you’re feeling up to it, you’re free to go!
After:
Thankfully, while uncomfortable, the whole procedure only took about 15 minutes and most of that was spent waiting/ setting up. To be honest, yeah, it hurt. I would give a pain rating of 7.5-8/10, but it only lasted for about 3 minutes. While I was capable of driving myself home, I was very glad I had asked a trusted friend to come with me for moral support. I’ve had friends tell me they felt like complete garbage after, including symptoms such as pain, nausea, cramps, etc. As I was leaving the clinic and driving home, I just felt like I was on my period. No major cramping or bleeding, but I feel like one of the rare cases to have had such an easy and mostly painless experience. As I was leaving, the nurse told me that some cramping and bleeding is normal, however extreme pain or anything else that seems weird to you could call for a trip to the clinic or hospital. If you’re feeling like this contraception method could be right for you, make sure to carefully listen to all the guidance and precautions your doctor gives you!
Alrighty folks, there you have it. Every single detail I can possibly think to tell you about getting an IUD. Hopefully I didn’t leave anything out. If you do have any more questions, be sure to reach out to your doctor for further guidance and advice. Also, note that everybody is different so, while this may be the best option for some people, it might not be right for everyone and that is OK. Just like oral contraceptives didn’t work for me, an IUD might not work for you. The solution is to always practice safe sex and find the method of protection that works best for you and your habits.
Love always,
xx