This Is What It Is Actually Like To Have An IUD Inserted And Removed


*Sends link to every single person who has ever asked me*

Posted on April 04, 2017, 00:37 GMT

I’m a 24-year-old
Australian and I don’t know anyone else my age with an
intrauterine device, or IUD.
@joannintransit/Instagram
/ Via Instagram: @joannintransit

Hormonal IUDs are inserted into your uterus where they
release a small amount of progestin (a synthetic version of a
naturally-occurring hormone progesterone) which thickens the
cervical mucus, making it a hostile environment for sperm, so
they can’t get up there to reach the egg.

First up, here are
some things you should know before getting an IUD.

People are often confused (“Is that the female condom
thing?”); surprised (“I thought only mothers could get
one?”); and desperate to know more about the actual insertion
process (“ON A SCALE OF ONE TO A LOT, HOW MUCH DID IT
HURT?”).

This isn’t so surprising, because Australia is
seriously lagging behind the rest of the developed world when
it comes to long acting reversible contraceptives
(LARCs).

In fact, hormonal IUDs
make up just 1.9% of the contraceptives prescribed by GPs
in Australia, while oral contraceptives account for 68%.

In Australia, to “have a lark” is to muck around or get up to
a bit of cheeky mischief.

So this is the story of
how I got a new LARC so I could safely have a lark!

So why did I get my first IUD?

I know plenty of women for whom the contraceptive pill has
been, if not a cruisy ride, at least relatively bump-free.
But for me, it was a winding road of expensive trial and
error, with each different brand bringing its own fun side
effects: acne; ridiculous changes in breast size; and
unpredictable mood swings.

My gynaecologist suggested a hormonal IUD for me in 2013.

I haven’t thought about my contraception – au revoir pesky
“PILL” phone reminders – since it was inserted
four-and-a-half years ago.

My periods all but disappeared, but I was technically still
having them. The hormonal IUD
doesn’t actually stop you from ovulating so I still got
the typical ups and downs of a regular menstrual cycle, but
with a lighter (or non-existent) period. Most women get a
spotting between periods that lessens over time.

So now, four-and-a-half years later, it was time for a new
IUD. Here’s how it went.

I chose to have my IUD removed and a new one inserted by my
gynaecologist, but family planning clinics and some GPs also
offer the service in Australia.

My GP prescribed the most popular hormonal IUD,
Mirena, which lasts up to five years.

Off I went to the pharmacy to fill the prescription.

The packaging is perfect
for people who don’t have time to pen an article but really
want to tell the entire world about their contraceptive
choice.

Gina Rushton/BuzzFeed News

Seriously, the packaging is about 10 times the size of the
actual 32mm device. I’m not here to speculate but there’s a
fair chance the Mirena package designer is in cahoots with
whoever decides on the snack-to-air ratio in chip
packets.

Gina Rushton/BuzzFeed News

“Don’t worry, the actual thing inside isn’t that big!” the
pharmacist reassured me.

What land mammal comes with a uterus that vast?

The Mirena is a T-shaped white plastic thing, reminiscent of
a dental flosser. Or, as a male editor put it: “A fishing
lure!”

It would make a snazzy Monopoly piece.

The Mirena was $38 and I also bought painkillers and a heat
pack for the incoming cramps.

You’re advised to take a few painkillers before the insertion
but I am incredibly tough (and forgetful) so I didn’t.

At the gynaecologist, I was told to take my knickers off,
cover my legs with a white sheet and lie back on the clinic
bed.

OK, so I’m going to get
specific about what happened next so if you’re squeamish or
whatever then log off.

The nurse applied lignocaine – a medication used to numb
tissue – inside my vagina and I chilled out for the next 10
minutes while it did its thing.

Then in came my gynaecologist Thierry Vancaillie, who runs
the Women’s Health and Research Institute of Australia in
Sydney and is also a gynaecology professor at the University
of NSW.

He had a very calm and
reassuring presence, which was great, because the next thing
he did was insert a scary looking device called a vaginal
speculum into me.

If you’ve ever had a pap smear, you’ll recognise it.

That bit didn’t hurt at all, but you feel a growing pressure
as the prongs widen.

It was time for my existing IUD to go into retirement but
before I had time to pass a gigantic gift card around,
Vancaillie used another tool to pull the strings of my Mirena
and guide it back out of me, where he placed it in a dish.

It was a very
uncomfortable and slightly painful sensation but it didn’t
last longer than 10 seconds.

I silently thanked the IUD for its unfailing service as it
pinged into a steel dish.

Now it was time for the insertion. I reminded myself that
however painful this felt it would hurt less than five years
of period cramps.

It is definitely worth mentioning here that when you first
get an IUD inserted, the doctor might ask you to make sure
you’re on your period during the insertion.

When I was a very self-conscious 19-year-old I thought this
was unjust, but it is so the physician knows you’re not
pregnant. In fact, they will probably make you take a
pregnancy test.

It is also because your cervix opens up a little bit while
you’re on your period so insertion is easier.

Vancaillie asked if I
was ready and then pushed the Mirena “inserter” into my
vagina, through to the opening of my cervix and into the
uterus.

Gina Rushton/BuzzFeed News

“I need you to give me a big cough,” he said.

As I coughed the device was released into my uterus and he
pulled out the “inserter”.

The pain feels like an incredibly intense period cramp, but
further up in your uterus, where it pierces for a good 30
seconds.

“You basically cough it into place yourself when the muscles
contract,” he said.

Gina Rushton/BuzzFeed News

The height of the pain was in that moment, however, a less
severe cramp began to spread from my uterus through to my
back and, eventually, down to the top of my thighs.

Vancaillie trimmed the removal strings and left with a
comforting pat on my arm.

The nurse then conducted an internal examination via a
vaginal ultrasound to check the Mirena was in the right place
because at that point all I wanted was another device in my
front bottom.

I could see the tiny Mirena sitting in my uterus on the
screen.

She gave me a pad and said I was free to go.

I stood up to leave and as I walked towards the door my
peripheral vision darkened and my knees went weak. Sweat
beads formed on my forehead and I suddenly felt lightheaded.

“Whoa, can I lie down
for a bit?” I muttered as I stumbled back to the bed.

The nurse covered me with a blanket and I tried to keep my
eyes open but I was overcome with exhaustion.

Vancaillie returned and placed an ice pack on my forehead.

He said I had been hit with a “vasovagal response” which
meant my vagus nerves – those responsible for controlling
heartbeat, breathing and blood pressure – had been
overstimulated and caused a sudden drop in blood
pressure.

It sounds like it is
something gynaecological but actually, anyone can have this
response at the sight of blood or during an overwhelming
emotional event.

Gina Rushton/BuzzFeed News

“Probably between about 2% and 5% of people have a vasovagal
response and it makes you feel weak and woozy, and some women
even completely pass out, but it just means you have to wait
a little bit until it is over,” Vancaillie said.

Within 15 minutes my energy had returned. I paid for the
insertion, which cost $330; the Medicare reimbursement was
$109.

Gina Rushton/BuzzFeed News

So all up, including the cost of the device, if I have this
IUD for five years it’ll work out at roughly $4.30 per month
for contraception, or $2.15 as I split the bill with my
partner.

The rest of the night was painful but bearable. The heat
pack, pain killers, corn chips and ice cream all helped and I
woke the next day feeling fine.

Vancaillie said a quarter of his patients who had an IUD
fitted went under a general anaesthetic which really bumped
up the cost.

But “almost all” women who went to a family planning clinic
or GP had an IUD inserted without even a local anaesthetic,
Family Planning NSW medical director Dr Deborah Bateson told
BuzzFeed News.

Family Planning clinics charge around $80 for the insertion,
$12 for the numbing cream and extra for a local anaesthetic.

Bateson said hormonal
IUDs were among the most effective forms of contraception –
apart from not having sex – but that Australia was lagging
behind the rest of the world.
@housewifeinheels/Instagram
/ Via Instagram: @housewifeinheels

“[In] northern Europe, and even the US, [they] have LARC
uptake rates between 15% and 25%, and we’re just at 10% here,
but we’re catching up,” Bateson said.

Other
research has shown that 23% of French women using
contraception use an IUD as well as 27% of Norwegian women
and 41% of women in China.

Bateson said every
person needed to find the right contraceptive for them, but
that it was important to dispel myths about LARCs so everyone
could make an informed choice.
@sewfreshandsewclean/Instagram
/ Via Instagram: @sewfreshandsewclean

“Women who haven’t had children can still have an IUD – it is
just easier for a woman who has had a child because the
cervix expands during pregnancy and childbirth,” she
said.

“Some women are concerned about their partners being able to
feel the strings during sex, but if that is a concern we can
always cut the strings a little shorter.”

Vancaillie said that 30% of his patients who have a hormonal
IUD inserted have it removed within the first couple of
months as they don’t like the initial blood spotting.

“It is generally [able to be used by] everyone, but I guess
if I have a young patient who hasn’t had kids I will do an
ultrasound and measure the uterus to check it will go in
fine.”

He said a good place to start a conversation about
contraception was at the GP.

So if you’re a uterus
owner and considering inviting an IUD through your cervix to
be at your service, make an appointment.
@missfatbird/Instagram
/ Via Instagram: @missfatbird

Still have questions? Here are a few more
things to consider before getting an IUD.

Gina Rushton is a breaking news reporter for BuzzFeed News
and is based in Sydney.

Contact Gina Rushton at gina.rushton@buzzfeed.com.


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