The ancient Greeks wrote a good bit on the topic of birth control.

Knowing that the procedure should be painless, even for women who have no kids, I would wholeheartedly recommend it.

Really the only downside I saw to the IUD was that I could -feel- it. if I got too excited I’d bump into the bottom of the T and it was rather uncomfortable to do so (ramming the tip of your penis into something sharp and hard very unexpectedly at the height of copulation). This actually limited sex positions as well – certain positions made it almost impossible to enjoy without jabbing the thing repeatedly. There was also some sort of cord attached to it (presumably for future removal) that came a bit further out and was detectable-by-penis-shaft.

It wasn’t the end of the world, but it did lead to a few annoying moments over the years we used the IUD.

With the IUD, there’s also just a lot of concern among people from my generation about problems for the mother’s health – I’m glad to hear that the newer ones are usually a lot safer, but it’s interesting to see comments from people who’ve had both positive and negative experiences with them.

I also agree that the copay should be covered 100%.

Best part was picking up the pill that is used to prepare the cervix and uterus for insertion. The pharmacists gave me the “BABY KILLER” look. B/c it’s one part of  what’s used in a chemical abortion. So ladies, prepare to be judged by The Pharmacists Who Know All.

Do not allow the IUD filaments (like a nylon line) to be trimmed back too far right away after placement. The IUD often settles a bit after placement–often higher up in the uterus. Too short = cervix fangs. Ouch. (Not to mention difficulty removing the IUD later on.) They can always be trimmed back later.

I have placed dozens of Mirenas and fewer Paragards (the copper one) over the last 10 years and most women are satisfied, although a few have had problems (cramping or unsatisfactory pattern or level of bleeding), but you cannot beat the efficacy. IUDs are definitely underutilized in the US–mostly because of bad PR, but I think that it is changing. My wife had one placed after each of our 4 kids (1 copper, then 3 successive Mirenas.)

Uterine perforation is a risk, but the risk decreases with the experience of the practitioner. The GYNs I work with have inserted literally hundreds of IUDs and never had a perforation. What’s more common is an IUD being expelled (the uterus contracts and pushes it out) and sometimes people don’t notice. Of course, there are no 100% effective methods of birth control (not even sterilization), so we always tell patients if they have symptoms of early pregnancy to go to their doctor and get tested. And use condoms to protect against STDs, of course. 

Here’s what getting an IUD is like if you’ve never given birth:

You go to the GYN who takes some urine to make sure you’re not pregnant. She (or he) performs a basic pelvic exam to make sure all is in working order and also swabs for gonorrhea/ chlamydia (if you prescribe antibiotics when the results are back, it prevents the bacteria from proliferating in the uterus.) Then she puts 1-2 fingers in your vagina and presses on your abdomen to feel what direction your uterus tips in. It can be neutral, forwards, or backwards. That helps with “aiming” the IUD. 

Then she numbs the cervix with lidocaine (sometimes, depends on the GYN). Then  she puts a tenaculum, aka a clamp, on your cervix to hold it in place. She dilates your cervix with a plastic rod. Then she has to measure your uterus, which is often the most painful part, to see how deep the Mirena will go. The “sounder” has to touch the top of the uterus, which makes it cramp. Then she inserts the Mirena with a little inserty-plastic-tube thingie (the medical term) and you are done. She’ll trim the strings and tell you to come back for a check.

There are three painful points- dilation, measuring the uterus, and the Mirena insertion. If you can get a Vicodin/ Percocet and/ or Ativan it helps, but in the clinic we use mostly ibuprofen and the teens do fine. 

For 1-6 months you’re in for some spotting and cramping which is worst the first day and gets progressively better. Then after 5 years you do it all over again (7 for the Paragard.)

If you’ve given birth before, you’ll barely notice it because your cervix is wider and stretchier.

Ta-da. The Mirena. Highly recommended. 

I can’t predict what your experience will be, but mine has been virtually painless. Insertion was uncomfortable, but the pain lasted no longer than two minutes and subsided immediately upon removal of the speculum. Occasionally, I’ll spot and cramp more in between periods than I had before, but my periods are no longer or heavier than they once were. I’d experienced nothing but trouble with other methods of contraception, from bacterial vaginosis to intense mood changes. Nothing like that with Paragard.

Viva la IUD! When you get yours, be sure to name it. I’ve dubbed mine John Constantine, because he’s my personal demon slayer.

Birth control would be pure awesomeness even if it didn’t do shit for anybody’s  health.

Thankfully, the pregnancy went well, and I found a wonderful open-adoptive family for my son, who is now 3mos old. They waited 10 years to see their baby dreams come true, so my unexpected pregnancy turned into a win-win. :)
I would advise any woman with a Mirena to be cautious about pregnancy-testing if they lose their period with the Mirena. I just barely knew about my pregnancy in time to have been afforded the option for an abortion (if I had wanted one).