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Why I Switched to an IUD

What’s an IUD? This oblique little acronym stands for intrauterine device. (I’ll wait for the guys to frantically close the window as if they just clicked a NSFW link.)

This is a little more personal than I expected to get, but I think birth control is an important environmental topic that everyone’s just a little bit uncomfortable talking about. And I hope I’m somewhat more mature than I was in high school, when I was terrified people would see the tampon hidden in my bag.

My doctor actually recommended an IUD to me. I was on the pill, and she told me that she’d had two patients around my age with blood clots in the past year, so she wanted to make sure that everyone was on the lowest dose of hormones possible. I’d wondered about other options for a while, ever since I’d read about hormones being found in drinking water. The estrogen and progestin in the pill are endocrine disruptors, like the BPA in water bottles that we’ve heard so much about lately. Municipal water facilities aren’t able to filter them out, so they make their way into our environment. The effects aren’t entirely understood, but over time they could interfere with reproduction and children’s development. The less I’m contributing to that, the better. Here’s what I learned.

There are two types of IUDs to choose from: ParaGard and Mirena.

ParaGard has absolutely no hormones and only has to be replaced every ten years. It’s basically a little plastic T that’s inserted into your cervix, with copper wire wrapped around it and a string hanging from it. Apparently copper kills sperm, or at least makes them weak enough to prevent them from joining with eggs.

Mirena is shaped the same, but it gives off a targeted, low-dose hormone and is replaced every five years. I chose this one because I felt like the hormone gave me added protection, I liked the idea of a lighter period, and I wasn’t comfortable going ten years between replacements.

The benefits of Mirena include:

  • Fewer Hormones – The pill I was on (lo-ogestrel) contained both estrogen and progestin; Mirena only has progestin. And since the hormone is localized, less is needed, so there’s less chance of blood clots, and less is flushed into our water supply.
  • No “Feminine Products” – No tampons, pads, pantiliners, nothing. I’m told this isn’t true for everyone, but your period does get lighter, and in some cases (like mine) it goes away entirely. That creates a lot less trash (not to mention hassle). 
  • Less Expensive – My mail-order birth control’s copay was $10 every 3 months. The only part of Mirena not covered by my insurance was the copay for the two office visits, which totaled $30. Tampons also used to cost me $21 every six months (through Amazon Subscribe and Save). That adds up to a savings of $380 over five years!
  • More Effective than the Pill – Mirena is one of the most effective birth control options out there, right up there with sterilization. (Seriously.) The effectiveness of other birth control methods is subject to human error, but because you don’t have to remember to do anything with this, the perfect results are the typical results.

The drawbacks of Mirena include:

  • Uncomfortable Insertion – The actual insertion caused some really bad cramps that lasted for a couple of hours. Since then I’ve sometimes felt bloated around my “period,” but not crampy.
  • Occasional Spotting – I only had some breakthrough bleeding in the first week, but I’m told it can happen periodically.
  • No Reassuring Period – I’m not terribly paranoid, but I do have a friend who used a pregnancy test when she didn’t feel well, just to be sure.
  • More Dangerous STDs – If you become infected with an STD like chlamydia, it can travel up the string into the cervix, potentially making you infertile.
  • Higher Chance of Ectopic Pregnancy – If, by chance, you do become pregnant, there’s a higher than average possibility of that pregnancy being ectopic (the fertilized egg growing outside the uterus).

Another potential drawback: my friend had to go to Planned Parenthood to get her IUD; her gynecologist refused to insert it because she hadn’t yet had children. My doctor told me that a decade ago that was the prevailing wisdom, but now most gynecologists would offer the option to all their patients.

Of course, what type of birth control you use is a very personal choice. What’s great for me may not be for you. But if you’re interested, it’s worth talking to your doctor. Three months in, I think this is the best choice for me, and I wish I’d done it sooner. Who knows, maybe when I replace this one in five years I’ll become a complete hippy and switch to copper.


Comment from Joy Ribisi
Time October 27, 2009 at 7:54 pm

I was actually just talking with my friend this weekend (who works at Planned Parenthood) — she has the Mirena IUD and suggested that I should also get one. I have been very interested and have discussed this with my doctor in the past. I do have endometriosis and I have heard that the Mirena IUD may increase the occurrence of cysts on the ovaries. So I’m still weighing the options…I do not like taking birth control pills but I’m also a semi-fan of my monthly moon cycle occurring. Hmmm…

Comment from jenn
Time October 27, 2009 at 8:36 pm

I have one, too. I think in the packaging for the Mirena it actually claims to be MORE effective than having your tubes tied : ) Also, think of all the resources “saved” by not bringing more kids into the world! (ok, so I know there are a lot of people out there who are all about reproducing that would not be reassured by that idea…) I had mixed feelings about having Kaelyn, but was certain that I would not want to have another after, and Mirena GREATLY reduces that liklihood (remembering to take pills at the same time every day is hell when you have a baby who wants to be first all the time!). I had bad cramps for like a week after insertion, and have a tiny bit of spotting almost monthly (maybe every 6 weeks). I keep wondering if my period is ever gonna come back, but it has been long enough (about 8 months) that I’m considering giving away the rest of my box of OB’s – is that weird since it’s an open box? – otherwise they are just sitting around collecting dust!

Comment from jess
Time October 28, 2009 at 12:16 am

Wow, interesting. I didn’t know they were that reliable. I think not having any period would scare me and I’d probably end up spending money on excess home pregnancy tests, though.

Comment from Danielle
Time October 28, 2009 at 12:51 am

If you switch to the Paragard, I wager you will also want to buy a Diva Cup/Keeper… which, to be fair, are kind of fun environmentally friendly gadgets.

Comment from Brenda Pike
Time October 29, 2009 at 1:45 pm

It’s a pretty big commitment. I thought about it for at least six months before my doctor’s suggestion pushed me to get it.

Comment from Brenda Pike
Time October 29, 2009 at 1:57 pm

I agree! I would have brought up the environmental impact of creating another resource-guzzling person, but my friends already think I’m anti-baby. (To be clear, I don’t want children, and I don’t like strangers’ children or the general idea of children, but my friends’ and family’s children are a different story.)

Advertising it on Craigslist might be weird, but your friends probably won’t care. Right?

Comment from Brenda Pike
Time October 29, 2009 at 1:59 pm

I’m loving the no-period thing. Although, unfortunately, that doesn’t seem to mean no PMS….

Comment from Brenda Pike
Time October 29, 2009 at 1:59 pm

Fun? FUN? I tried one for a few months, but I just couldn’t. Especially in public bathrooms….

Comment from Sharon
Time October 29, 2009 at 2:48 pm

I LOVE my Mirena. I do have a period, but it’s teeny-tiny, and for me no PMS! I also like the fact that it’s very easily reversed if I choose.

Also, for the record, I had no cramping or discomfort when it was inserted. This is probably because I’d had a baby just a few months before. I think that’s one of the reasons they used to prefer to give then to people who’d already had babies–the cervix has already opened up.

Comment from Cidny
Time November 3, 2009 at 5:46 pm

I tried to get a Mirena, but the gynecologist couldn’t insert it. The attempt was really danged painful enough. (I haven’t had children; I’m sure that didn’t make things easier.) I was pretty disappointed and went with the Implanon (a rod inserted under the skin). Haven’t been entirely happy with that one, either–made my face really oily. Sigh…

Comment from Brenda Pike
Time November 3, 2009 at 6:42 pm

I was worried about that myself! That’s why I considered it for so long. It seems like Mirena is really convenient if it works perfectly, but really uncomfortable/invasive if it doesn’t. Statistically, a person is much more likely to experience the former, but that doesn’t really matter to them if they’re in the latter category.

Comment from Brenda Pike
Time November 3, 2009 at 6:43 pm

You’d think they’d make two sizes: one for people who’ve been pregnant and one for people who haven’t.

Comment from Emily C
Time November 5, 2009 at 1:48 am

Found you through the Festival of Frugality. For anybody considering friendlier methods of birth control, I’m a huge fan of FAM (Fertility Awareness Management). My body does not tolerate extra hormones well, and it’s been a good solution for us.

I also know two women who in the last six months have had issues with ovarian cysts, that after having IUDs removed have resolved themselves. My doctor swears it’s much more common than the pharmaceuticals will admit.

Comment from Brenda Pike
Time November 5, 2009 at 11:01 am

I didn’t know that the rhythm method is considered as reliable as condoms, according to this chart by Planned Parenthood. Weird. But it looks like they both vary wildly, depending on human error. Personally, I don’t think I could live with a 15-25% chance of getting pregnant. (To compare, simple withdrawal is supposed to be 30% effective.)

Pingback from Looking Back at 2009 « Pragmatic Environmentalism
Time January 4, 2010 at 9:07 pm

[…] IUD – My IUD hasn’t been any trouble at all, and I still haven’t had my period since I got it six months ago. […]

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Time January 18, 2011 at 2:48 pm

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Comment from Alicia at
Time February 26, 2012 at 10:44 pm

Have to say, I’m a HUGE fan of my IUD. No period and very reliable birth control.

For those interested in the Diva Cup, my sister just did a review on my blog for one she tried out. She wrote the review after having it for two cycles. It is a very popular post on my blog (maybe I should have her write more!)

Comment from Brenda Pike
Time February 26, 2012 at 10:56 pm

I tried the Diva Cup once and I never quite got the hang of it. Luckily I don’t have to anymore. Aren’t IUDs great?

Comment from Mirena intrauterine device
Time May 31, 2013 at 3:01 pm

There are a lot of reasons that women choose to get an IUD, but the most common reason is that it is believed to be the most effective and cost-efficient contraceptive choice than any other currently in the US. Although it still remains as the least popular due to a surprising number of factors, that has not stopped experts from recommending it to most women, including teenagers. They have garnered some negative press from lawsuits over their complications, but they continue to be marketed to women.

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