Today I Got an IUD and It Ruled

Note: I know that many people get squicked out by reproductive health stuff.  I understand that, but I also think that sex ed in this country is uneven at best and straight up inadequate at worst, including its treatment of reproductive mechanics and contraception.  Our best chance at having children that are wanted and born at a time when their parents can adequately care for them is to educate our public so people know what their options are and exercise them.  This information is important for men as well as women.  It is for this reason that I post about things like this from time to time, and if you think I'm being hyperbolic about the lack of sex ed, I invite you to tune in to Maury* any day of the week to listen to the abject ignorance spouted about why one person or the other can't possibly be the father**.  I am not kidding.

I started taking birth control when I was 15, mostly because I was rocking epic pizza face and the hormones in birth control pills force you on a regular schedule, i.e. one that does not encourage pimplestravaganzas on your face.  The first kind I tried was Ortho Tri-Cyclen, which is the Great Grandma of birth control pills. It is a progestin and estrogen combo pill, in which you take 3 weeks of active pills and one week of sugar pills (while your body is allowed to do its thing and have a period).  My acne did get much better, but I also got quite moody.  When I went to college, I switched to Ortho Tri-Cyclen Lo, which works in much the same way, just with a lower dose of hormones.  While the drop in hormones did help even out my mood a bit, I did gain about 20 pounds almost overnight.  I suspect I would have seen a similar or greater gain when I went on Original Flavor Tri-Cyclen had I not been playing sports and running around like I was at the time. 

When I was a sophomore in college, I started hearing a lot about Nuvaring, which is ring that you insert into your vagina that releases the same hormones as the Tri-Cyclen family.  My immediate reaction was "...dude, that's gross."  The whole concept of putting a piece of plastic in there monthly just weirded me out, so I ignored it until one of my good friends came home from school absolutely RAVING about it.  I did some research and what really convinced me to make the switch was the perfect use statistics.  When you see information about effectiveness in birth control, those figures are usually based on perfect use, which means, for example, that at 8:00a every single morning, without fail, you take your Pill.  Most people don't do that, and when you don't, effectiveness drops - not to zero or anything, but definitely down from the way-high-nineties you usually see.  With Nuvaring, you basically have less chances to screw up; it goes in once a month and comes out once a month.  I made the switch around 2004 and have used it ever since, and it has been awesome!  I would definitely recommend it to anyone, particularly if they are busy and have an irregular schedule that might wreak havoc on their Pill-taking plan. 

Earlier this year, my Grad School Safety Buddy got an IUD and was raving about it (number one rule for getting good contraceptive advice: have awesome friends).  While it had been a little crampy to have put in, it had been free and was super comfortable, and did not need to be taken out until the end of its useful life. I started doing some homework on it, and really liked what I read.  First of all, it's one of the most popular forms of contraception in Europe, despite having kind of a bad rap here in the States; not sure why that's the case.  There are two kinds of IUD: hormonal and copper.  A hormonal IUD releases hormones (sound familiar?) to keep you from getting pregnant, and is good on average for about 5 years.  Mirena is one example of a hormonal IUD.  A copper IUD - ParaGard is the copper variety - lasts about 12 years and signals "no pregnancy!" to your body simply with its presence, and it also partially blocks the fallopian tubes so no sperm can hike up there and cause ectopic pregnancy.  I liked the idea of the copper IUD for its lack of hormones, and I liked that it was good for so long!  IUDs do carry specific risks, like dislocation or rejection, or perforation of the uterus (which can vary in serverity).  I decided to take the plunge, so I made an appointment with my local Planned Parenthood in Worcester, MA.

I went in to the beautiful new facility at about 2:50p for my 3p appointment.  My Mom drove me.  They suggest that you go with someone, because the cramping can be overwhelming, to the point that you shouldn't be driving.  They also suggest that you take a fairly large amount of Ibuprofen an hour before your appointment.  Now, I started my period on the day I was supposed to have my IUD put in, so I called to ask if that was a problem (besides being kind of awkward), and I was surprised to hear that having your IUD put in during your period can actually make the process more comfortable, since your body's already in a "hey, no pregnancy here" mode.  I did the obligatory paperwork stuff, and my appointment cost $20 with my Harvard Pilgrim insurance.  (Note: I paid $30/month for NuvaRing.  $30 x 12 months = $360 x 12 years = $4320.  So today, I saved $4300.  YOWZA.) 

After I got all that stuff worked out, I got called into the exam room.  The room has one side where you get your vital signs taken and your interview done, and another with the chair with the stirrups and all that hoo-rah.  I thought the interview was really well done.  Not only did they give me a really complete description of the benefits and risks of the IUD, but they also explained how the procedure was going to do.  They also asked for a profile of your sexual and relationship health, including whether or not you had a good support system and whether you'd ever felt abused or coerced in any relationship.  These are important questions that don't often get asked, so it was really great to hear them incorporated into a medical questionnaire.  During this intake process, they also took a prick test for chlamydia and gonorrhea and urine for a pregnancy test, which they do for everyone. 

Once all that was squared away, I undressed from the waist down and got in the chair with those damn stirrup things, and then the nurse practitioner came in.   Here's how the process goes.  First, she inserted a speculum and sprayed some kind of topical numbing stuff on my cervix.  Then, she had to open up my cervix, which she did with some other "-ulum" tool which actually looked like a giant, horrifying pair of pincers.  I was glad that she didn't show me those until the procedure was done.  Yikes!  When she inserted those, I did feel some pretty significant cramping, but she was awesome and kept talking to me so I was distracted.  Once that was all set up, she took the IUD, which is loaded into a tube with the little arms down, inserted the tube, and pushed the IUD in.  The whole thing took about a minute total, and for me the cramping stopped almost completely the moment she took the cervix "-ulum" out.  My GSSB said her cramping continued for some time, but I did not have a problem with it.  For the next couple hours I felt cramping, but it was not exceptionally bad - no more than I would experience in a regular period. 

IUDs are often given the side-eye, but I found the process to be relatively painless and I think the savings and effective use stats will more than make up for today's moments of cramping.  Your mileage may, of course, differ, and you should always consult your doctor before going in for any kind of procedure, but I have to say that so far I'm very impressed.  I hope that the rest of my time with the IUD proves equally rewarding!

*I like having noise in the background while I read and crappy daytime TV like Maury and The Steve Wilkos show have the maximum rise and fall of noise.  STOP JUDGING ME.


** For example: "We only had sex three times," "I don't make boys/girls," "she started birth control the day after we had sex," etc. It gets to be fairly sad because so many of these people clearly have no idea how sex and pregnancy work, much less how to present it.  This is "jump up and down after sex" territory.