T O P I C R E V I E W
Member # 57605
posted 05-10-2013 07:43 AM
Ack! This got much longer than I was expecting. Thank you for reading through it. There's a lot of freak out, and this is my shortest draft. Sorry about the length.
Halloween 2012 I got the Mirena IUD at my mother's urging. I was on the Pill earlier, but she was worried that I'd forget some doses. We went in to see the gynecologist a couple of times before the insertion to get information to see whether it'd be the right choice and which IUD (hormonal or copper) would be better. I was under the false impression that the difference between the copper IUD and the hormonal one was that the hormonal one lasted half the time (5 years) and completely stopped your periods. The gynecologist said nothing to counter that, and when I directly asked her what the difference was she said that the Mirena was hormonal, it lasted 5 years rather than 10, and it completely stopped your periods after 3-6 months. She asked me which one I would prefer, and I told her I wanted the Mirena and specifically mentioned that I wanted to completely stop my periods. She did not ask me if I had had any previous pregnancies or if I was in a monogamous relationship. I filled out my marital status on a form as single. I can't remember whether she asked me about the type of birth control I was using at the time, but I was using the Pill. I was taking extra doses (only stopping one week every 3 months) with my PCP's permission. She told me that there would be moderate cramping during the insertion, and that for 3-6 months after there could be light spotting before my periods completely disappeared. I came in the week before the actual insertion to try to get it in, but my cervix was not dilated enough. I was experiencing a lot of pain from just using the speculum. She seemed very impatient with my discomfort, and kept telling me to relax. Eventually, she gave me some medication to dilate my cervix and rescheduled for October 31 when I did get it inserted. The insertion was the worst pain I've ever felt in my life by far. I drove myself to the clinic because I wasn't expecting so much pain. (She said there'd be moderate cramping.) I had no idea I was supposed to take a pain reliever before I went. They provided me a pain reliever, and I had to sit down for an hour after before I drove home (thankfully a short drive) in excruciating pain. Then I had bleeding for 40 days straight. It wasn't heavier than my normal period, but it was definitely not light spotting. I called her twice to ask if it was normal. She said it was fine, but the second time she sounded annoyed and asked if I wanted to take it out. I declined because I didn't want to go through all that pain for nothing. I went to one checkup a month after the insertion to make sure it hadn't perforated. I was told that was the only checkup I had to do for the entire 5 years. Since then I have been getting regular periods much to my chagrin. I have not been tracking them because I expected them to go away eventually. It wasn't until recently while browsing through this site that I discovered that I was not only misled but in fact lied to. The Mirena is recommended for mothers in monogamous relationships. I have not had any pregnancies nor was I in a monogamous relationship. (I had just got out of a situationally monogamous relationship.) I place zero value on monogamy in my relationships, and I stopped being consistent with condom use after I started the Pill. I haven't had sex since the insertion, so I don't have any STI risk. I had no idea that the Mirena increased my risk for STIs and PID. Others on these forums have described insertion as "the worse pain I've ever had" that was "even worse than labor cramps." I find it suspect that the gynecologist would continue with the procedure when I found the speculum painful. Apparently, I am also at risk for the Mirena falling out. I was not told to check the threads, so I would've had no idea if it had indeed fallen out. The hormone fluctuation can cause additional bleeding when taken immediately after discontinuing the Pill. I had just been hospitalized for a mood disorder 2 months before the insertion, which I told the gynecologist about. I don't think the Mirena affected my moods, but that just seems dangerous as well. It does not stop periods altogether; rather it makes periods lighter and shorter for some women. I didn't have particularly heavy or long periods beforehand, and the length and intensity of my periods have not changed. Though my cramps feel similar to the cramping I had after the insertion, but less intense. I had cramps with my periods before the Mirena, but they felt completely different. I'm not sure what to do about this IUD. I want to have sex in the future, so does that mean I should get it out and switch to another form of birth control? I'm taking benzodiazepines, so I don't think I can do any of the ones with estrogen. I'm really confused about how to find another gynecologist. My insurance covered this one, but when I called about birth control earlier, they told me they don't cover any reproductive health at all. My insurance spends copious amounts of time and money trying to get out of paying my doctors for my mood disorder, so I'm not sure if I can take the risk to see if they'll cover a different gynecologist. I was only able to see this one because my mom said she'd foot the bill if the insurance didn't cover it. I've since been kicked out of my house, and I can't afford rent letalone a hospital visit. I was also getting the Guardasil shot from that gynecologist. I have already done two, and the next one is scheduled in June. I'm not sure if I should be worried about the previous two or if I need to get the last one from a different clinic. The nurse who administered my second shot said the first one wasn't done right. Please any advice you have on how to find a new gynecologist and what to do with my IUD would be very much appreciated. I'm really freaking out here. I can't believe she put my health in that much danger.
Member # 79774
posted 05-10-2013 08:46 AM
Someone who knows more about accessing medical care where you are should be able to help you with considering a different provider, but what I do know is that some of what you're saying about the Mirena isn't in line with the most up-to-date medical opinion.
For starters, it does sound like this provider didn't serve you well - a doctor should always address our concerns fully and with patience and compassion. The one piece of information you're reporting she said that's plain misleading and wrong is that Mirena stops periods. A reasonable number of people with a Mirena do find that their periods become rare or non-existent, but certainly not all. There's no way of predicting what each individual's body is going to do. There's no medical problem at all with giving an IUD to a person who's never been pregnant. In older medical guidance, it was less advised, for a couple of different reasons, but in current medical advice, there's no problem at all. It's no increased risk to health or future fertility and it's no less effective. The thing about "for monogamous people" is to do with the risk of STIs. It used to be thought that having an IUD would make it easier for any infection that the person acquired to be carried up and therefore make the infection more serious, but in current medical belief, there is no increased risk for a person with an IUD who catches an STI. The issue with STIs and IUDs is around insertion. If there is a reasonable belief that a person may have an STI, they shouldn't have an IUD inserted until they test negative for STIs, because inserting an IUD in a person with an STI may lead to complications like Pelvic Inflammatory Disease. A person should also be vigilant about safer sex for several weeks after insertion, and if a person isn't willing or able to do that, that would be a legitimate reason for being cautious about giving an IUD. Being non-monogamous in itself isn't a reason why a healthcare provider should have any concerns about providing an IUD. Obviously, any healthcare provider is going to recommend safer sex practices anyway, including the usage of barriers like condoms with any non-exclusive partner or any partner where both haven't been exclusive and with repeat negative tests at six months. Every person with an IUD has a very small risk of it expelling. Usually, that'll be pretty obvious if it happens, and on the occasions it happens, it's mostly fairly soon after insertion. Ideally, the healthcare provider should leave the strings long enough so you can reach up and feel them; that's mostly so the person with the IUD can have the comfort of knowing for themself that the IUD is still in place. Not being able to feel the strings isn't a sign in itself that anything's wrong: it likely just means that the provider cut them short or that they've got tucked up high. If your healthcare provider was satisfied that your Mirena was still in place and all was well at your check-up, chances are huge that it's correctly positioned and effective, and the chance of it expelling after that check-up is tiny. It doesn't sound like your gynecologist put your health in danger. It sounds like she gave you a piece of misleading information that matters a lot to you, though. It can be very, very upsetting to have something different happen with our bodies than what we were led to believe. The information you should have been given was that on average, Mirena results in less bleeding, for less time, and less pain, and that for a fair number of people it stops their periods or makes them rare. It's fairly common for a person to have spotting and light bleeding throughout the first month after insertion. (Anecdotally, it sounds like a fair number of people who get a Mirena don't like the effects for the first month, but then like it a lot.) At insertion and sometimes for several hours, some people do experience considerable pain. Changes from the Mirena can continue to happen beyond 6 months after insertion, and if they happen, those changes are usually toward less bleeding and less frequent periods. There would be no way of predicting what would happen to your individual body, though, and a minority of people continue having periods every month. How do you feel about the effects you've had, in the light of this information? Obviously it wasn't what you were hoping for, but is it something you might feel broadly ok about, or not ok? You could certainly choose to change to a different method of contraception, but there are no guarantees about how your body will react to those, either. As you said, you'd also need a procedure to remove the IUD if that's what you wanted. Healthwise, it doesn't sound like there's any concern with your Mirena, so it's really up to you whether it's a method you want to carry on with and whether you feel ok or not about the effects on your body.
Member # 3
posted 05-10-2013 09:42 AM
Redskies said all I'd say here.
The only thing I'd add, per facts, is that the issue with STIs and IUDs is an issue, known to be this way through study, for around three weeks after insertion or before insertion. In other words, if someone already has an STI at insertion, or contracts one within around three weeks after an insertion that's when we're talking about increased risks of PID associated with STIs. And that's why monogamy OR safer sex, to the letter, is advised with IUDs for those getting them around the time of insertion. (Mind, PID is always a risk with untreated STIs, with or without an IUD.) I'd also add there is no method of BC that stops periods altogether by design. There are methods, you're using one, which can make them more rare, or lighter, but if you wanted a method that was guaranteed to cease your periods, there isn't such a thing.
Member # 57605
posted 05-12-2013 03:51 PM
Thank you! I feel much calmer about it now. I guess the information on your Birth Control Bingo article is a little dated. The Wikipedia page and Mirena's own website corroborated with some of the out-of-date stuff that was scaring me, and the forum posts I looked at here were a couple of years old. I was terrified I'd narrowly escaped PID or pregnancy by not having sex. If she hadn't told me my periods would've gone away, I would've believed her over Wikipedia for all the rest of the stuff. It just seemed like all this scary information fit my experience better than what she was telling me. But I'm glad I don't have anything to really worry about. Thank you so much for being such an awesome resource for sexual health!
Member # 3
posted 05-13-2013 08:51 AM
Well, I don't know that it is: just looked at it now for you and it seems perfectly up-to-date to me, and also doesn't say the things I've heard you saying here, like that IUDs are only for people who have been mothers or that your periods will go away, etc.
But for sure, if you're looking at forum threads that are many years old, you may well have seen outdated information there, especially if it was posted by users, not staff. You're welcome, though, and I'm glad to hear you're feeling better about this. [ 05-13-2013, 09:04 AM: Message edited by: Heather ]