If we’re being honest, most people do not want to talk about small plastic (or copper) Ts being inserted through a woman’s vagina and into her uterus. The concept of an IUD or IUS, (intrauterine device/system, respectively) is enough to scare people of any gender—regardless of whether you have the uterus required to use them. Today I’m here to open up this seemingly uncomfortable discourse by sharing my (ongoing) experience with the Mirena IUS, and hopefully inspire more women to consider this form of birth control. If you’re thinking about getting Mirena and want to know what you may expect, I’m writing this for you.
First of all, the only difference between an IUS and an IUD is it’s material. The copper IUDs often increase period length, discharge, and pain, but are generally cheaper and last for up to 10 years before needing to be replaced. Hormonal IUSs differ, but generally decrease length and side effects of your period, are more expensive, and need to be replaced every 3-5 years. Hormonal IUSs like Mirena and Jaydess are often referred to as IUDs, but in this article I’ll be calling them their proper name. I should also point out before I begin that both IUDs and IUSs are ineffective against STIs—therefore, wearing a condom is still important unless you’re with a long term partner and you’ve both been checked out already.
I got my IUS because I was told I couldn’t take classic pill birth control. From time to time I get migraines with “aura”—essentially visual hallucinations, such as lines across my vision— and when I went in for a birth control consultation the doctor told me this meant I was likely stroke-prone. He recommended not continuing with any birth control that adds estrogen to my system— namely, the patch, the ring or the pill. With my three preferred methods of birth control off the table, I was pointed towards non-estrogen options—I could use a mostly ineffective Progestin-only pill, a somewhat sketchy “implant,” a quarter-yearly shot, or an IUD/S. After much research I went with the IUS, mostly because of it’s effectiveness rate—the Mirena IUS is 99.9% effective in both the “actual use” and “perfect use” categories—higher than Tubal Ligation, aka the female version of a vasectomy, which is said to be 99.5% effective in both categories.
So, let’s get into my experience. From here on out, this will not be a research article—if you want to learn more about Mirena, or any other IUD/S, please do some research and make the decision keeping in mind that everyone experiences them differently.
Pre-Appointment
After extensive research into what type of IUD/S I wanted and where I wanted to go for the procedure, I settled on a small local women’s clinic. I filled out a form online, booked my appointment for the next week, and was told to call in to confirm two days before. On this call I was instructed to take 1-2 Advil an hour before the procedure, get enough sleep, eat a good meal beforehand, come with someone to drive me home and bring a sanitary pad for afterwards in case of spotting.
Then I had to get my IUS prescription from my family doctor and pick it up. The Mirena usually costs around $400, but because I’m under my parent’s extended health insurance I had a significant discount and ended up paying under $100. All I had to do now was go to my appointment.
The Procedure
Let me just start by saying that the psychological idea of getting the IUS is WAY worse than the physical procedure. I was terrified going in—as I walked in and filled out my forms, being told to wait in the waiting room with other young women, some crying, was like a death sentence to me. As time went on I calmed down and tried to focus on the fact that I was in the hands of professionals who inserted IUD/Ss, I later learned, around 15 times every day. I was called in for a urine sample so they could ensure for themselves that I wasn’t pregnant, waited a bit longer, and was finally called into one of the rooms to sit down with a doctor.
My doctor was a sweet middle aged woman who began by asking me if I had any questions. I didn’t, (I had done a plethora of research beforehand) so I was told to take off my bottoms and lie down on the table with a sheet over myself, my feet in the stirrups. The word “stirrups” might scare you but believe me, the doctor has seen this so much that you’re the only one who thinks this is uncomfortable. If you’ve ever had a pap smear or a swab STI test, the set up is very similar.
The first thing that happened to me after this was the insertion of a speculum, just like in a pap smear/STI test. Speculums might seem intimidating, but if you relax and remind yourself you’re in safe hands they really aren’t a big deal at all. All women have to go through it eventually and it’s for a very short time so is almost always worth it. Next came the ultrasound, which wasn’t painful at all and was necessary for the doctor to make sure my uterus was a compatible size for the IUS. However this is when the psychological aspects of what was about to happen hit me, and I started crying. The doctor, who had been telling me what she was doing the whole procedure, asked me if I was okay and I over-enthusiastically responded “yes!” in the hopes of somehow making her not notice the tears. She had clearly experienced this response before, and took a couple seconds to reaffirm me and tell me it was going very well.
Next she numbed by cervix, which is an absolutely terrifying sentence, but wasn’t actually a big deal at all—I felt a slightly uncomfortable pricking feeling and then a mild cramp. Turns out the mild cramp was her inserting the IUS—I barely felt it and I didn’t realize it was over until she told me! She checked to make sure it was in the right place with the ultrasound one more time, removed the speculum, and sent me to a recovery area for 5 – 10 minutes just in case I fainted (which is totally normal). The one thing that really stayed with me was how fast it was —the whole procedure was less than five minutes long, and at worst was a weird pricking feeling and mild cramp. Knowing that it was over, and I wouldn’t have to worry about taking a pill every day, made me incredibly happy—and I left the clinic in a good mood.
Post-Procedure
For the rest of the day I had mild cramping but no other symptoms. For the first week after my procedure I had mild cramping when standing up, and little to none when lying down; I found that adding heat really helped. I used a hot water bottle, and when the pain eventually got worse, (spoiler alert: a lot worse) I began using a heat pad behind my back as well.
I got my first period about a week and a half after my procedure. Aaaand now it’s time to remind you that you clicked on an article called “MY IUD Experience,” not “THE IUD Experience.” Other women I know that have IUSs and IUDs have had very different experiences than I had.
That being said, let’s go into the awful time that was my first period with an IUS. I had pretty bad periods to start with—long, painful, etc.—and on top of that, the doctor had told me to expect my first three months to be all over the place in terms of my pain levels and bleeding. For me it started like a normal period with worse-than-normal cramping, and progressed to debilitating pain and bleeding that lasted just under a month.
The constant pain was hard to deal with, especially because I was working and needed to be able to spend long hours on my feet. I definitely debated not going to work a few times, but I settled for painkillers because I personally don’t have an aversion to them. (Side note: if you do prefer to avoid medications, there are other routes you can take to ease the pain—notably: heat, exercise, and distraction. Additionally many women don’t experience the pain I did and don’t have any after the procedure!) If you’re going to use painkillers, the biggest thing to avoid is overdose or building a tolerance. I ended up alternating between various kinds, (Ibuprofen, Acetaminophen, homeopathics, etc.) in order to go easier on my body, and regulated my use. I tried not to take them until the pain was unbearable, and even then ended up using them regularly for around three weeks. If you choose to use painkillers to help with post-procedure pain, remember to do some research or consult your doctor to make sure you’re doing so safely! It’s easy to develop a reliance on them so always lean towards not taking them if you can.
Despite taking medication, pain woke me up several nights in a row and I ended up calling 811 (the BC non-emergency nurses hotline) a few times. I got the same answers every time— “The first three months are hard,” drink lots of water, exercise, take two Advil and get some sleep, which is good advice except sleeping and lying down had begun to make my pain worse! I would literally pace through my house with a hot water bottle in order to avoid my bed. After around two weeks of this, I went in for a checkup, where they used the ultrasound again and told me everything was looking fine. The doctor answered my questions in person and gave me some reassurance—they told me it’s normal to get worse cramps for up to a month after insertion, and to only worry about something being wrong if the pain doesn’t feel like cramps. If it’s heavy “normal-feeling” period pain, it likely won’t be any issue with the IUS/D dislodging or puncturing anything; it’s just the body getting used to it. Your uterus doesn’t like the foreign object, and is trying to push it out to protect you. Don’t be scared about this —IUD/Ss are designed to make this process impossible. Around 2-4% of IUD/Ss may be expelled, so it’s relatively unlikely, but if you’re in severe pain and suspect expulsion definitely call your doctor or go to the hospital just to be safe.
After almost a solid month of the period from hell, the pain started to lessen and my period finally stopped. I had spotting for another month and another (late, but not abnormally painful) period, and I can now say that I’ve been period-free since August! Most women with Mirena find their periods getting lighter after 3-6 months, but some are lucky enough to lose them completely and I’m very thankful to say I fit into that category.
All in all, my IUS experience sounds a little scary. The pain and discomfort I experienced for that one month sound like something that might’ve changed my mind about IUSs, but I’m really happy I made the choice to go this route. Even when I was in pain I knew I’d made the right decision for me. I haven’t had any pain in months, and I haven’t experienced any other potential side effects like bloating or nausea… plus I’ve been free of worry about getting pregnant or having to take a pill at the same time every day! The girls I know with IUDs and IUSs have all had better experiences than me – little to no pain, no period from insertion on, generally the heaven that is hoped and prayed for by all women considering the IUD/S route. All women have different bodies, so my experience with Mirena is not definitive; however, I can say without a doubt that I would recommend IUDs and IUSs as a safe, effective option to young women considering their birth control options. If you think this might be a good route for you, talk to your doctor and do some research! IUD/Ss aren’t as scary as they sound and they might just save you some pain down the road.