The Devil’s in the IUD-etails: Dispelling Fear of Intrauterine Devices

Over the past year, I’ve struggled with migraines, and by the summer, I had to seek the advice of a medical professional. I walked into my family doctor’s office, expecting to discuss potential medications or eyesight testing, but my doctor said the last thing I expected: I needed to come off my combined birth control pill – almost immediately – as migraines increase the risk of stroke to an unacceptable level.

I thought about the months I had put off consulting a doctor. Migraines are common, especially for women. According to the American Migraine Foundation, 17.5% of women experience migraines. Despite this, I had no idea the serious health risk they posed when combined with my birth control. My next thought was pure panic; I’d been on the pill for years, and the other options did not sound good. The progesterone-only pill requires extreme diligence for efficacy: taking the pill at almost the exact same time, every day, without breaks. My family doctor suggested injections, or an arm implant, but as she read out the potential side effects – infections, ovarian cysts, hair loss, depressed mood – I felt the impending doom of the final option: an IUD.

Getting into the IUD-etails

I’ve always been terrified of the IUD, the abbreviated form of intrauterine device. Like so many experiences unique to living as a woman, IUDs aren’t usually openly discussed in common conversation. My knowledge was limited to hushed, second-hand horror stories: “My friend got one, and she said it was the worst pain imaginable, and it was so horrible she had to get it yanked right back out”. I couldn’t believe migraines were forcing my hand, making me confront this boogeyman-esque birth control method. I had a friend or two (the kind you can overshare a little too much with) who I asked, but they didn’t have any firsthand experience.

Naturally, I turned to Reddit for experiences of everyday women. Unsurprisingly, this led down an anxiety-inducing rabbit hole. I felt more alone trying to figure out what I’d signed up for.

I did get an IUD. And it sucked. But, it was not a horror story. I just wish there’d been someone to walk me through what it was going to be like.

So, here’s what I wish I’d known beforehand (based solely on my personal experience):

1. Importance of a trauma-informed medical practitioner.

   I got so lucky with the clinic that placed my IUD, which happened to specialize in trauma-informed care. My doctor told me everything that was going to happen before it happened, and explained everything she was doing as she was doing it. She understood the effects of trauma on someone’s body, and how that might make an IUD placement scarier and more painful.

   
   

2. There are several pain management options.

   My clinic offered two options. One was a local anesthesia, which they offer with all their placements. The other was an inhaled anesthesia, which I could’ve picked up from a local pharmacy. I went with the former, and my doctor explained it reduces the pain by about 30%.

   
   

3. Give yourself proper time to recover.

   It’s painful, and the pain lasts longer than I thought it would. The insertion itself sucked. I wouldn’t say it was excruciating, but what I didn’t expect was to be in full-on pain for the next hour or so. Nor did I expect to be on my couch, with a heating pad, for the rest of the day. There was no way I could have gone to work. Luckily, I had the day off.

   
   

4. You might feel a bit dizzy or faint after.

   As I was leaving, I almost fainted, which I was really embarrassed about. The clinic staff let me know this is an incredibly common response. Take it slow when leaving, and bring some water and/or a sugary snack.

   
   

5. It is okay to bring someone in with you, and it’s very common.

   I brought my mom, and she held my hand the whole time. I thought it was silly, but my doctor told me that more often than not, people bring in someone to hold their hand. Make sure, at the very least, to have someone to drive you home.

6. Your body may adjust to the IUD in odd ways.

   Afterwards, I had my period for an entire month, which felt very concerning. I emailed my clinic, and they said it's possible to bleed/spot/cramp intermittently for 3-6 months after. Since that first month, I’ve only had light spotting.