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Much like everyone’s “first time” story, women’s IUD experiences are often completely unique. Some insertions feel like just another annual exam. For other women, it’s the worst pain they’ve ever felt.
Granted, no one birth control is right for everyone, but the T-shaped IUD has certainly been gaining traction. According to Planned Parenthood, the number of patients using intrauterine devices has increased 91% since 2009. “It’s so effective and convenient,” Vanessa Cullins, MD, vice president of external medical affairs, says. “We quote less than a 1% failure rate for the IUD, whereas we usually quote a 5-7% failure rate for birth control pills.”
In fact, if you look at this recent New York Times article about birth control effectiveness, the Mirena (or Levonorgestrel IUD) is actually more effective than female sterilization — that is, getting your tubes tied.
Right now, there are three types of IUDs on the market — with a fourth on its way. The copper IUD, or ParaGard IUD, is the only form of temporary birth control that doesn’t use hormones, and it lasts up to 12 years. “The copper itself causes some of the inflammatory spermicidal response that prevents the sperm from being able to fertilize the egg,” Dr. Cullins says, and the lack of hormones means you won’t have to worry about mood swings, weight gain, or other hormonal side effects. The downside? “It will oftentimes result in periods that are a little heavier and may have a little more crampiness.”
Meanwhile, hormonal IUDs release low doses of progestin — much lower than what might be in the birth control pill — and no estrogen at all. Mirena IUDs last for five years, with doses that can lighten or stop your periods altogether. Skyla and Liletta are both smaller IUDs that last for three years. “These last two may be better tolerated by a young woman who has never been pregnant, but Mirena and ParaGard can also be options for women who haven’t been pregnant,” Dr. Cullins says. “It’s a myth that you have to be pregnant before getting an IUD.”
So, how do you choose the right IUD for you? “You have to think about how long you would want to use it, whether or not you are having problems with heavy bleeding during your period, whether or not you’ll be okay with not having a period over time,” Dr. Cullins says. But, it’s also important to talk to your provider and see what he or she has experience with. “The insertion technique is a little different for each of these IUDs, so they need to be trained or experienced with the one that you want,” Dr. Cullins adds. And, while you’re at it, Planned Parenthood recommends calling your insurance to ask which specific IUDs are covered without a co-pay.
Ahead, nine women (two with a copper IUD, seven with hormonal) divulge what it was like to get it inserted — and whether the IUD worked for them.
Correction: An earlier version of the article stated Liletta is not yet on the market. It was released on April 13, 2015.
“I decided to get an IUD after my second child was born in September 2009. Before then, I was perfectly happy on the pill — I had been on the pill all through my 20s before I had my kids, and I had gone back on the pill after my kids were born. But then, I just found I was forgetting the pill, even though I had been taking it for the better part of 15 years.
“It’s been six years; I’m on my second Mirena. The insertion process hurt like hell, both times, but it’s very brief — just 10 seconds. I would liken it more to your worst menstrual cramp, since it was over that fast, and the labor experience was totally different. I was on a lot more painkillers during labor. My understanding is generally an IUD insertion is significantly more painful if you’ve never given birth; I had given birth twice.
“It’s not for nothing that I joke that I would basically be a spokesperson for the hormonal IUD. I literally have a T-shirt that says #teamIUD. I’ve had no cramps, and zero period since getting it. When I go in and they ask, ‘When was your last menstrual cycle?’ I have to say, ‘I have no idea.’ I was happy on the pill, but I dare say this is better. Had I known more about it at 18, I would’ve opted for it at 18, 23, 28 — until I was ready to have kids. I’ve been blissfully happy.” — Rachel, 41
“Right after the insertion, I was sensitive for maybe 30 minutes, but then I was totally fine. I remember going to a happy hour for work that day, and I could have sex the next day. I did have some spotting on and off, but it was once every three weeks or so, and the mood swings I was really worried about didn’t even happen. But, I have to say my body is fairly insensitive to hormones; I was on a pretty high hormone pill before, and I’d taken Plan B before and felt totally fine.
“[The insertion itself] just felt like a really terrible cramp, but a lot more sudden. It was mostly a lot of weird sensations — I don’t love the feeling of the speculum.
“I loved the IUD. I was really, really bad at taking the pill at the same time every day, so the IUD seemed like a good option. But, I had to get it out six months later because my partner could feel it. He said it felt like a wire was poking him in the urethra, which sounds awful, and even after getting the string nipped it was just as bad. I kept it in there for five months, thinking it would soften over time, but it wasn’t getting any softer. My OBGYN said that some men are a little more sensitive, and if he’s going deeper than most men he might feel it, so it’s not for everyone. I loved it, but my partner wasn’t getting used to it, so that’s just sort of the way it is. Luckily, getting it out wasn’t as bad; I didn’t even realize she had it out when she did.” — Elicia, 24
“I went to Planned Parenthood, and they were very friendly. They gave me a pill to dilate my cervix, so that probably made the IUD easier to go in. They also told me to take an ibuprofen beforehand.
“The worst part wasn’t getting the IUD; it was when they were measuring my uterus. It felt like very intense cramping, sort of a spasm, and afterwards they made me lie down and drink grape juice because they thought I was going to pass out. On the drive home — my friend drove me home — I felt like I was going to throw up, so my friend set me up on the couch with heating pads, Netflix, ibuprofen, all that stuff. The next day, I had mild cramping, and the day after I went for a run, and everything was fine.
“I was hoping my period would go away because that happens for a few people, but I still get it. Still, it’s so much lighter. I used to have to take an Aleve every month for my period cramps, and now I don’t have to. So, I’m such a huge fan; it’s fantastic. I would get it even if I were never going to have sex again.” — Samantha, 28
“I had been on hormonal contraceptives in the past, most recently the ring and the pill, but I was really feeling the side effects pretty heavily. I have a personal history of migraines, and birth control pills can really elevate your migraines. I also gained a lot of weight when I was on the pill, and I found myself having really erratic mood swings. So, I just stopped hormonal birth control after that, maybe four or five years ago.
“I decided to try an IUD at the end of 2014. I’m not someone who really wants to parent, ever, so preventing pregnancy is very important to me. So, I had a Mirena IUD inserted earlier this year, in January, and I decided to live-tweet my IUD insertion with the hashtag #TurkosIUD. I’ve worked in sexual and reproductive healthcare for the past five years, and the destigmatization of healthcare services like this is important to me. It was a great way for me to share my story and experience.
“I had heard some very negative IUD-insertion stories and was very nervous, but it was the exact opposite of that. It was nothing but a positive experience for me. I had it inserted while I was menstruating, and I took 600 milligrams of ibuprofen before the process. I took a lot of deep breaths, and it was over in less than a minute. It felt very similar to an annual internal exam. I went out that night, had some pretty heavy period cramps the next morning, and since then I’ve felt really awesome. I haven’t had any weight gain, any mood swings, and I’m even feeling more like myself. And, one of the great pluses that comes along with my IUD is that I know no matter where I am or what I’m doing, I’m in control of my reproductive health. It’s like my new best friend.” — Alison Turkos, 27
“I have a blood-clot condition, so [at first] I thought all IUDs were off-limits, but since the hormonal IUD is surprisingly gentle on your body and has less hormones than the pill, I thought I would try it.
“It basically felt like going in for your annual exam; you go into your old position, and at first it feels like a pap smear, but then you feel a really big pinch, almost like getting your ears pierced. Really intense, and really quick. Getting it implanted was not as bad as I was expecting. It was the three months afterwards that were not enjoyable.
“Everything I had read about what might happen afterwards came true. For three months, I would have random, intense pain, worse than my period cramps, and random spotting. It would happen randomly, like I had been punched, or like someone was pinching me in the ovary for a few minutes. I remember being miserable and thinking, This is crazy. Then, at three months, it was like a light switch. Everything stopped. I literally haven’t had any issues. I haven’t had one cramp — nothing. It’s been flawless ever since.” — Amy, 27
“I started on the pill when I was 16, and it was fine, but after a while I started to feel like I wanted to get off hormones. Friends told me the IUD would be really good for me. I heavily debated whether I wanted to get on the Mirena or the copper one — the benefit of the Mirena is that you get a lighter period, or don’t get a period, which sounds awesome. But, the reason I was getting an IUD was to get off any sort of hormones, so I got the ParaGard.
“The insertion was a lot more intense than I expected, and I felt really ill afterwards, like I had chills and a fever, but by the next afternoon, besides cramping, I pretty much felt fine. My body adjusted almost immediately [other than] a little spotting… My periods have always been on time. They are a little bit longer and heavier, and my cramps start earlier, but they’re not more painful. I’ve heard of women bleeding through tampons, but my period was always light to begin with. Other than that, I’ve had no problems. It’s wonderful to feel like I can take control of my birth control, and it’s really nice to have no worries about what I’m putting into my body. A day of pain was definitely worth a natural form of birth control that can last 12 years.” — Zoe, 29
“I decided to get an IUD when I was at Planned Parenthood for my abortion meeting — I took the RU-4-86, where I just bled out over a couple of hours. They were like, ‘Would you like to prevent this from happening again?’ I said yes. I wasn’t on birth control before, because I am afraid of hormones — since I already have erratic mood swings and am deathly afraid of gaining weight. So, I scheduled to get the copper IUD for my following appointment.
“They told me I was going to feel a slight pinch and some pain, but I had never experienced so much pain in my entire life. It was like searing, horrible pain for a few seconds; they told me that’s what a contraction feels like. It hurt more than the abortion — you can put that in.
“I remember I was on the subway afterwards, trying to figure out whether I should sit down or stand up — which one would be less painful. I had really bad cramps afterwards, and I still get them, even though it’s gotten better over time. But, my periods are worse now. I used to not have any pain associated with my period, and now I have a ton of pain. All things considered, though, I’m still glad I did it, and I’m not taking it out.” — Sarah, 26
“I had been on the pill since I was 15, and I noticed that when I was off it, I had a stronger sex drive in a way that I enjoyed. This is going to sound crunchy-granola-hippie-tastic, but I wanted to experience my emotions and sex drive in my natural state, and I knew the hormonal IUD had about a 10th of the hormones in the typical pill.
“I had to go in twice; the first time didn’t work. The first time, the pain was really over-the-top. It was the kind of pain where part of your brain says, Is this really happening? I just had to focus on my yogic breathing, and then I heard my gynecologist say, ‘I’m going to try one last time.’ And, my heart sank.
“The second time, my gynecologist set me up with a different doctor, and she used an ultrasound first — which would make it possible for them to figure out what was going on with my uterus, more or less. The doctor was like, ‘Oh! I understand what happened. Your uterus is upside down and backwards.’ It wasn’t a problem, it’s just a normal variation — like having curly hair or straight hair. So, it took less than 30 seconds the second time for the IUD to be inserted, plus because of my last experience the doctor decided to administer some local anesthetic. I got like, 20 ccs of lidocaine or something like that.
“I had cramping for a couple of hours, so I just napped and read, and I had sex the morning after. There hasn’t been a lot of time yet to see if the IUD has an effect on my sex drive — I haven’t ovulated yet, and that’s really when it peaks for me — but I’m hopeful that it will be different.” — Katherine, 23
“I only found out the IUD insertion was going to hurt right beforehand, and it hurt more than I thought. If you’ve ever doubled over with sharp, shooting pain, it’s that same feeling — but also throbbing. I imagine that’s what a small pregnancy contraction feels like.
“The one thing I can say is that six years ago I took the abortion pill, which completely contracts your uterus, and the IUD pain was comparable. But, it was much easier to endure the IUD insertion, because it was only a minute.
“Afterwards, my uterus cramped for maybe three minutes, and then I had a bit of period cramping, but I was fine walking around. Eventually, my period went away after three months, and I really liked it. It felt foolproof, pregnancy-wise — more effective than me remembering to take the pill. I took it out a little less than a year ago to try conceiving, and it was really quick. They just use the speculum, tug on the string, your uterus cramps for a minute, and that’s it. I am now pregnant, and I’ll find out if the insertion hurts as much as contractions in about two months.” — Katie, 32
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