It is now almost 2 years to the day since I first got my IUD (copper coil) fitted. I cannot recommend it enough.
There are downsides, of course there are. Everything is a compromise of sorts. But the downsides pale in comparison to the huge positives it has brought to my contraceptive experience.
So why do I love my IUD?
To explian this, I probably have to start at the beginning. My first experiences of contraception. And I’ve had a few.
Condoms. Goes without saying.
The Implant. The hair pin sized implant that usually is inserted on the inside of the upper half of your non-dominant arm with local anaesthetic. Having it removed was pretty unpleasant too, but if it had worked out for me then I would have thought it worth it.
Seems unpleasant and extreme so why did I go for it? Well for starters, I was never great at rememering to take tablets at regular intervals. Secondly, it lasts for 3 years and works without me having to think about it. Thirdly, I had always had stressful (read heavy, painful and upredictable) periods and there was a chance this would stop them completely.
Did it work? Initially, yes. My periods soon dried up and I didn’t have one for about a year and a half. My skin was slightly worse but nothing unbearable by way of side-effects. The only issue was that because I never got periods I would get paranoid that I might be pregnant and not know so I would test every few months just to be sure. Then about a year and a half in my periods came back. They were heavy, painful and longer/more frequent than ever. Rather than remove the Implant, they put me on a combined pill as well to help manage the side effects. Woooo double the hormones.
The Pill. So there I was on the Implant and the Pill until the Implant’s time ran out, and then I just continued on the Pill. Actually, without the Implant providing extra unneccessary doses of hormones, this Pill was great. My skin got better, my periods became (mostly) regular and lighter and everything was fantastic. Then I moved to a different country and was told that that specific Pill was blacklisted there and I would have to change type. They tried to find me one that was a similar ratio to the combined pill I had been on before. The Pill can take a few tries to get right. The first one I had been on was Progesterone heavy and that was the route they went down.
Having tried two further combined pills on their recommendation that I really didn’t get on with (one so bad that aside from my back being a blotchy mess, I kept crying and I was aware that I was not myself; it was scary, I could feel it’s effects on me, and I could feel that I wasn’t right) they decided to go for the progesterone-only mini-pill. On a New Year’s Day when I had been bleeding constantly and heavily for over a month and had spent most of the festive season curled up in a ball with hot water bottles, I got fed up and stopped taking it.
Pill withdrawal isn’t something people tend to talk about all that much but having gone through it a few times, I can tell you that it can be brutal. Your body is confused. Suddenly it has to remember how to produce hormones that have been supplemented for so long, it has to fight to get production back up and your body in balance. Meanwhile, periods, skin, weight, sleep, temperature, literally everything goes out of whack. The withdrawal affected me differently depending on which pill I was coming off but it was never especially pleasant…
The IUD (Part 1). About this time, utterly fed up with hormones screwing up my system both when I took them and when I came off, I decided that finding a hormone-free alternative was probably a good idea. The IUD is an immensely successful hormone-free contraceptive, in fact I think it might be the most reliable form, not least because you don’t have to remember to take anything at specific times.
Of course the insertion process is pretty unpleasant, but for 5 years of hormone-free contraceptive protection, possibly a reasonable trade-off. However, the first time, I made a mistake. I went to my local GP to have it inserted. GPs are great for many many things, but fitting IUDs is not easy, and with that age-old maxime practice makes perfect, they simply don’t get enough practice. It also doesn’t help that my cervix is apparently at a weird angle. Anyway, they tried to fit it. It was excruciating. I fainted. It didn’t get fitted. I vowed never again.
The Nuava Ring. I had an American friend visiting not long after this disastrous event. She turned me on to three things. DIVA lipstick and lip primer by MAC, Mooncups (seriously, they’re amazing, and also great for the morbidly curious who like to know just how much they’re bleeding each month, I don’t know about you but in my case it’s way more than a teaspoon or whatever the so-called standard figure is) and Nuava Rings. The first two have become massive parts of my life, but the Nuava Ring didn’t stick.
I got one at my local sexual health clinic. They didn’t seem to get many requests for them but at least they stocked them. Basically they look a bit like a really big elastic hair-tie but made out of silicone. The silicone somehow contains hormones. Every month you have to change your ring, but for 3 out of 4 weeks of every month you leave this ring inside your vagina where it emits constant low level hormones. You can have sex with it in but if you want to remove it you can take it out for an hour or so. To get it in, you twist it and just pop it in and you can’t feel it.
In my head, the fact that it was emiting homones in my vagina that were designed to only impact upon my reproductive faculties meant that it wouldn’t affect the rest of my body. I seemed to have momentarily forgotten that blood was a thing, and that it goes all around your body. So it did just that, carried hormones everywhere, and once again the side effects were more than I wanted to handle.
The IUD (parts 2 and 3). I found myself back in the gynaecologist’s office at the local sexual health clinic. She broached the subject of IUDs. I explained my unpleasant previous fitting experience, and she did what she could to allay my fears. She said she fitted them multiple times daily, that she had been doing so for years, that coming to someone who knew so well what they were doing would make a huge difference to the experience. She told me how they worked and showed me one (it was like a tiny white plastic T with fine copper wire around the stem and long dark wires hanging at the base) which she placed in a plastic model uterus (honestly they’re about the same size and it was a little scary). They work in two ways, the copper acting as a natural spermicide, and the sideways spokes of the T sitting against the edges of the uterus, preventing anything from implanting.
She sent me away with reading materials and videos to watch and urged me to seriously consider it because having witnessed my side-effects to hormonal contraception she recognised that it wasn’t really an option for me. She booked me in provisionally for an appointment in a month’s time and told me I could cancel if I decided against it.
A month later, having done lots of research and decided that whatever my fears it really did seem like the best option, I was lying on a bed, with my legs in stirrups and an anaethetised vagina, having an IUD fitted. For me, the discomfort over the next few days was considerable, and I was taking back-to-back pain killers and wedged between 3 hot water bottles with many Disney films and I didn’t leave the flat, but weirdly the worst bit was using pads. I have never used pads in my life and given how heavily I bleed, using them was horrible. I had to get one of my female friends who used pads to take me pad shopping because I had no idea what to look for. I had to wear really absorbant ones because of how heavy my periods get, but they chaffed the insides of my legs, and felt like wearing nappies. I was terrified that someone would see the outline of them through my jeans. And it wasn’t just for the first few days, it was for a month. I couldn’t use my mooncup, or even tampons, for a month, obviously I didn’t need them all the time but whenever I did, then pads.
It was a challenging adjustment period. I had to get used to checking my wires regularly to make sure it was in place. After the first month I had to be especially careful whenever I put in or removed my mooncup so that I wouldn’t dislodge my IUD with the vacuum it creates. My periods definitely got a lot heavier and were more painful, to the point that I was eventually put on other medication to help manage them, but for whatever reason, they actually started to come more regularly, and my period app finally started making sense again. And two years on they have actually settled down, back to a point where they are managable in terms of how much I bleed and sometimes I can even manage the pain without painkillers.
While I still use condoms with partners, I don’t have to worry otherwise about contraception for 5 years. I have to pay attention to any time that I am late on my periods and test pretty quickly (IUDs can slightly increase your risk of ectopic pregnancy so you need to know ASAP if you are pregnant). I have definitely had ups and downs with coils – I managed to dislodge one last autumn and had to have it removed in A&E before going through the delights of having a new one fitted. FYI, having them removed is nothing like as traumatic as having them fitted, and the second time even the fitting wasn’t so terrible. This time I knew what I was getting myself in for. I knew it wouldn’t be comfortable, but I knew it would be worth it. The first night was pretty bad and I took a hot water bottle and pain killers to work the next day but compared to the first fitting when I didn’t leave my flat for 3 days, a considerable improvement. I was even prepared (although definitely not happy) for the pads this time around.
So yes, I love my IUD. It has changed my relationship with contraception but also with my own body. Even before my periods settled down, the trade-off of heavier periods was one I was more than willing to make. I had always had heavy painful periods. This made them worse, sure, but it exacerbated an existing issue rather than raising a new one, and for everything else that the IUD has done for me, and for how much better I am not stuffing my body full of fake hormones, I am so grateful.
But the moral of this story, if indeed there is one at all, is that there are many many contraceptive options out there. The coil certainly won’t be for everyone, but there will be something that works for each of us. If your contraception is really messing with your body or your emotions, then there are alternatives out there. One that I would definitely be trying if it wasn’t for the fact that I don’t like being told that there are days I can’t have sex, is the Natural Cycles app that was launched recently.