What do you do when two is enough?

About a year after our second child was born,  we started thinking in earnest about birth control.  I'll be honest: we were never good at addressing birth control.  We didn't have any real good "method".  The array of hormone-based options out there right now is pretty expansive: Depo-Provera - the injection every 12 weeks; Norplant - the surgically inserted progestin lasting 5 years; Ortho-Evra - the weekly patch; The Pill - the daily dose of hormone ; and Mini-Pill / POP (Progesterone Only Pill) - apparently suitable for nursing moms.  Despite all these options, there was one thing I knew for sure - I didn't want to do the hormone thing.

So, then there are the barriers: Diaphragm, Cervical Cap, the Sponge.  Condoms, of course, are condoms.  Cumbersome and inconvenient.

Then, there was one other thing I had always heard about but never thought too hard about: the IUD.  There are two IUDs: a hormonal IUD called "Mirena" and a copper IUD called "Paraguard".  I was intrigued.  My doctor walked me through the IUD process.  Insertion was relatively easy, but the uterus usually responds angrily with the insertion of a foreign object.  So, "expect really, really bad cramps for a day or two after insertion," she said.  With Mirena (the hormonal one), users tended to have fewer and lighter periods.  WIth the Paraguard (the copper one), users tended to have more intense periods.

Well, if I couldn't persuade my husband to do the *snip-snip* (and since we weren't even sure if we were really done), I decided to give the IUDs a try.  It sounded great.  Worry-free sex!  Leave it in for 5 (the hormonal Mirena) or 10 (the copper Paraguard) years!  I was so very apprehensive about the low levels of hormone that the Mirena emits in the uterus, but my doctor convinced me that the levels were so low and trasmitted very locally (and not systemically like the Pill, Depo, etc).  So, I chose the Mirena, also because of the period-supression.  Worry-free sex AND a period-free life!  Sounded too good to be true.

I guess it was too good to be true.  After about six months, my body started changing in very small ways.  If I wasn't so hyper-sensitive, I may not have noticed.  I had a dull pain in my lower back and I felt ever-so-slightly bloated everywhere.  One night, I googled the heck out of "Mirena side effects weight gain" and found several message boards where women talked about Mirena's negative side effects.  I think Mirena has few and far between negative effects, but some women did experience similar things that I was experiencing.  So, the next morning, I made a quick appointment to get the thing out.  It was easy.

That was about 4 months ago, and we've been practicing our haphazard birth control.  And, I am finally going to bite the bullet and try the Paraguard.  I know, I know.  They say you get earth-shattering, god-awful periods.  But, everyone is different.  They said I'd love the Mirena.  And, I didn't.  So, I'll try it.  I always said I'd be willing to try everything once.  My appointment is Monday.

Finally, I leave you with some insight given to me via email from a [male] OB-GYN friend:

The Ortho-Evra patch is a great invention.  It's probably the most commonly prescribed birth control these days - it's taking over the pill.  It works just like the pill in terms of hormones, and the advantage is that you only have to change the patch once a week.  Yes, once a week.  It stays on your skin, surprisingly, despite taking baths, swimming, etc.  You put it on once a week for 3 weeks and the 4th week is patch free (when you have your period - like the placebo week of the birth control pills).  The side effects are similar to the pill - some breast tenderness, a bit of nausea (yet less than the pills), but NOT weight gain.  Also, because it's a patch, the most common side effect is local redness where the patch is placed.  Overall, women LOVE this because of the ease of use.

The IUD (intrauterine device) is quite good as well.  This is for monogamous ladies who want longer acting contraception.  There is a 10-year IUD (Paraguard) and the 5-year IUD (Mirena). Basically it's placed into the uterus, an office procedure, and there's little pain involved and it's quick.  The advantage of this is that it provides over 99% protection from pregnancy without needing to take a pill, a shot, etc.  It's low maintenance.  The side effects of the Paraguard IUD is that the periods can initially be longer than usual and this may last for many months.  Also there may be a clear discharge from the vagina - many women love this as well.  The Mirena IUD is a bit different - not only because it lasts 5 years but it's actual realeases hormones, progesterone-type, in the uterus.  (vs. Paraguard which is made of copper) This only acts on the uterus and has very minimal effect on the blood - essentially none.  Women love this because after one year of use, your period decreases by 80-90%.  Yes, I said 80-90%.  Some women even stop having their periods.  We use this device for women who are bleeding too much and don't want surgery.  Anyways, those who WANT a period will not like these "side effects" of Mirena.  Most people don't want their period.

Both are great.  If you're looking for something longer term, easily reversible (can just pull the IUD out and there's no delay in trying to get pregnant) and low maintenance then the IUD is a great way. But it's all preference.

Comments

[Monica]

What about the boy being snipped? My husband has volunteered. I was worried, but it actually is reversable (not 100% of the time, but most of the time from what I have been told...) if ya'll change your mind and is not a big scary procedure. Ask your OB about it if your honey is open to it.

[Monica]

Oops, sorry.. you mention that you aren't sure you are done.. :) Must pay closer attention!

[Cityslicker mom]

Wow. Such great info. I too, don't wanna do the hormone thing at all. I did it when I was in my early 20s for 5 yrs and that was enough! The caveat on the commercials is enough for me: "may cause stroke or heart attack or blood clots in some women". That's all I need to hear. Plus the fact that all those synthetic hormones give me headaches. Your post has some really useful info!

[jj]

FYI...there was a new warning about blood clots last week - http://www.cnn.com/2005/HEALTH/11/10/patch.warning.ap.ap/index.html - so i don't think that'll be an option for us. the mini-pill is supposed to be good, like you said, for nursing moms, but you have to take it at the EXACT same time every day for it to be truly effective, and i know that i'd never be able to do that.

[bodhi]

Thanks for your post. I am really curious to hear how the Para Gard works for you. I got it about a month ago and the verdict is still out. It is really nice to be off hormones! The downside is that I have been feeling kind of crampy in between periods, but I am hoping that it all settles down.
Good luck!

[jj]

Any updates from the Paraguard mamas? I'm still on the fence about which, if any, IUD to get. I'd love to hear more about them from those of you who use them!

[Heather]

I loved my Paraguard (had it out recently after 6 months use). I had been on the pill for YEARS and started getting serious migraines every pms week, and my dr said my body was reacting to so many years of hormones. Getting the Paraguard in was a little painful, crampy, but an advil knocked it out and after that it was great. It made my periods a little heavier and an extra day or two, but otherwise it was great for me. The only reason I got it removed is that we decided to have another baby.

[Kristen]

I have a Paraguard and also love it. My husband and I are also on the fence about a third. I have had it for about 4 months now and my period was defiantly heavy and lasted a day or so longer. But these were also my first periods since I got pregnant with my son a 1.5 years ago. My only problem now is I can't find my strings. (You should check your strings are there after every period.) I went to the Dr last week to get an ultrasound to see if it was still there and it is. Man, that would be a bummer! But the dr still doesn't know what to do if I can't check the strings every month. I'll update when they come up with some thing.

[olivia]

I think the Paraguard is as good as it gets, second only to the snip-snip. I like that the Paraguard is non-hormonal. I never have managed to figure out how to check the strings. Periods are definitely more abundant than I have ever known. Aside from that, I can't think of any other major side-effects. Paraguard gets my vote.

[Queen]

I just got my paraguard on July 27th. Everything has been fine. But I started bleeding this week, at first very light. But now, I feel like there's a fountain between my legs!!! I'm not cramping at all, but I;m bleeding something awful. I also want to know from other users: has anyone felt very bloated since the Paraguard??

[olivia]

I have the Paraguard (now, but formerly the Mirena) and fountain flow is now the norm. This time around, though, we didn't have the same sort of torrential downpour. But, they say that's the side-effect: crazy abundant periods. Not painful, just abundant. I may feel a bit bloated, but I have to say I felt more bloated with the Mirena. I am glad about my choice with the copper stuff.

[betsy]

What about length? Are your periods longer than before with the Paraguard? (After I whelp out baby #2 this fall, we'll need to do some thinking). And does insurance cover it like any other prescription bc?

[Tammy Hodge]

I am getting a mirena fitted because I have severe migraines but, I am frightened it may not work. I have tried many migraine perscibed tablets,health tablets and other alternatives but nothing has worked.Just the mention of the mirena freaks me out,I would prefere to be asleep.Has anyone been in my position?I am eager to know if there is someone out there like me.Please help me.

[Snow]

My husband and I used condoms for many years because I just hated the pill...it made me feel queasy and bloated and pissed off. I also ended up developing an allergy to latex so we had to use the super-expensive and kinda yucky non-latex condoms. Anyway, as we got more to the stage of feeling like it wouldn't be terrible if we had an accident and ended up with a baby, I started using Ortho Options Conceptrol gel - it's in a handy little injector thingy and although it takes a sec to put it in it really isn't too bad. My husband loved it, I liked it a LOT better than condoms and we didn't get pregnant for over two years. We actually started to think maybe we couldn't have a baby since I didn't have that much faith that the gel on it's own was good protection. Well, I stopped using the gel and was pregnant in a month! So, I guess it worked and I would reccomend it for anyone who doesn't want hormones or metal things in their body...although I doubt it's as bullet-proof as an IUD or patch.

[catherine]

I have had the paraguard for over 10 years and I'm due to get it out. It has been great. Maybe I'm lucky, but other than the unpleasant pain during the insertion my periods have been normal and I've had no side effects. I'm supposed to get a new one and my doctor has suggested the mirena but I'm not sold on the progesterone. Some studies suggest the paraguard can last longer than 10 years but I hate to be the guinea pig.

[Amy]

I've had the Paraguard twice, once before kids for 2 years, once after my first child for 2.5 years. I had increased cramping for a few months and my periods were definitely heavier, especially if you compare them to being on the Pill. I tried EVERY brand of the Pill and got tired of my docs telling me there was no way low-dose hormones could cause weight gain and mood swings. I would go off the Pill and lose 5-10 pounds in a week! Plus I was moody. I just couldn't stand the Pill. I just had my second child and will now get my 3rd IUD. I don't recommend them for women who have never had a child, as my periods were painful when I had the IUD before having my kids. However, even though my periods were heavy, they were not painful after the first couple of months. It's worth it to not be moody and stay thin.

[barn mom]

Wow, I got a Mirena inserted today. This site is neutral on it compared to some of the boards. I’m really concerned that I’ve made a big mistake. I didn’t ask enough questions. My doctor didn’t give me all the risk info. She even went so far as to say that she’s been curious about Mirena but she is on the pill. I didn’t really think about that statement until I got home. The pamphlet has only a partial list of side effects. I’m trying hard to resist the urge to dash to her office to have it removed. Stroke runs in my family, as does breast cancer, and who has got time for migraines, mood-swings, acne or weight gain etc.? Has anyone had a positive experience with Mirena? I will be really disappointed if my Ob steered me wrong on this. I know, my responsibility to do the do diligence, still very disappointing.

[littlefoot612]

I got mirena in the fall of 2005, after being on depo provera for about a year.I'm pre menopausal and was having extremely heavy periods. The depo worked for about 10 months then the bleeding started again. I had some bleeding and spotting for the first 6-8 weeks after the mirena was inserted. After that, I had a light period (more like a day or so of spotting) every 4 or 5 weeks. It's now late march 2007 and I haven't even had spotting . I was booked for a follow up visit about a month later to check that it was still in the right place and then had the mirena checked again after a year during my annual physical.
I was informed by the Doctor before I chose the mirena of what to expect in the first few weeks, Irregular spotting and some heavy cramping when it was inserted and for a few days following. Those were exactly what I experienced and none of the other side effects she had discussed with me.
I visited one of the mirena side effects sites too. Some of the comments alluded to there being little information accompanying the product. Perhaps U.S. regulations regarding the disclosure of such information differs from Canada's because I found no lack of information with the product at all. Both common and rare side effects were listed and nothing I read on the complaint sites was news to me.
I tend to take some of those sites with a grain of salt. If you scroll down and look at the sponsors and donators of one site in particular you will find a list that is full of Homeopathic and Alternative Remedy companies. Their products are in direct competition with those of the pharmaceutical companies.

[littlefoot612]

Addendum...I will be 49 in a couple of months. My Doctor's intention was to find something to relieve the extremely heavy periods I was having and provide birth control. The mirena was her initial recommendation but I chose the depo. I'm glad I switched to mirena and it should see me through menopause.

[lauralye]

I got pregnant on the pill and with the patch. I am using Mirena now, and I have no problems at all. Since, I am still breastfeeding, I haven't even had a period.

I can "feel" it once in awhile, but that's all.

[melanie]

I've had the Mirena since my 19mo old daughter was six weeks old. LOVE IT! Like others, very mild periods, more like spotting for a day. I've not had any weight gain, acne, or any other side effects. It's been the perfect choice for me.

[Hope]

Have had mirena since my son was about 5 months old (my first). It's been in for about three months and I'm way less moody than being on the pill, but I can't feel the strings. Going to get it checked out this week, but I noticed others said they couldn't feel theirs either and was wondering how common this is.

[leslie]

i've had mirena for about a year now and have noticed few side effects. apparently the strings are rather, um, pokey... but mine have been missing for a while. i had an ultrasound about a month ago and found that the IUD is in place. often, the OB trims the strings to avoid that annoying (to your partner) poke, and they further recede after that.

other than that, i had normal periods for the first 10 months or so; in the last two months, they've been markedly lighter (3 days instead of 5, far less flow).

the only problematic issue i've run across is dull, achey crampiness near my ovaries when i'm ovulating. the ultrasound checked that, too, and apparently everything is fine - it's simply a side effect.

overall, i'm happy with mirena. i'm the worst at consistently taking pills, despised the patch that i tried (yucky sticky rings -think of the sticky goo your kids' stickers leave everywhere, then multiply that to small circles on your skin), and lost a couple nuva rings (still don't know where they ended up!).

we're pretty sure (well, i'm sure, but i'm outnumbered around here) that we're done having babies, so it's a perfect option for me.

oh, and one more thing. even though advances have definitely been made in the IUD world, my mom had a copper IUD in the 70s and suffered a minor stroke due to the device. that kept me as far away from the copper version as humanly possible. it's just one more thing to worry about for me, as the likelihood of it happening to me may be genetically based.

[melanie]

Hope,
I just had mine checked (and this is a new doctor, not the one who put it in) and she said that my strings are pretty short. She advises women to periodically check the strings, but she said I probably wouldn't be able to find mine because of their length. She said that's pretty common though and not anything to worry about.

[olivia]

I have also heard a few things about our parents' generation having health complications with the copper IUD. I am hoping that the modern-day copper IUD is new and improved, seeing as I did end up going with the Paraguard after a year with the Mirena.

On checking the strings: I tired and tried and tried and finally felt the strings one day. It must have taken a year of intermittent trying. More recently, I haven't been able to feel the strings, and I am just hoping that my provider can assure that all is fine during my annual checkup.

[christie]

i've been glad to find this site. i'm researching mirena as a birth control option after i give birth to our 2nd child. i had previously takent eh pill for close to 15 years and never had any problems with it; however, i've recently found out that i have a gene mutation which makes me more likely to develop blood clots...no more estrogen for me. so my dr recommended mirena as the most effective option but gave me other options as well. i've read so many message boards with horror stories about the negative side effects, and it's refreshing to read more normal sounding negatives as well as some positive experiences.

for those of you who experienced the more negative side effects for more than the first 6 weeks or so, did you also have issues with other hormonal birth control, or no?

thanks for any input...i'll keep on researching.

[Kathleen]

I had Mirena inserted five weeks ago and have had a few side effects that I was wondering if anyone else has experienced. Along with light bleeding everyday since insertion I've had "hot flashes" on and off...I'm nearing menopause yet didn't have any hot flashes prior to getting the Mirena. I was experiencing heavy bleeding every month (with no end in sight) and chose the Mirena versus having an ablation done to control the problem. Any comments would be appreciated!

[Marion]

I agree that the Copper IUD is good for people who are in a steady relationship, and the men are scared to get snipped. Or for the women who don't want to under go surgery to get their tubes tied. I've had my copper IUD for a little over two years. Everything is great other than the periods(a little longer, stronger). I have two wonderful boys. My husband would love a girl but as of right now I'm happy. The IUD gives me control of the choice, like when or if we will have one more. Besides it gives me the piece of mind that we can "practic" and not worry about getting pregnant. I recommend it to any one who has one partner that wants control over their bodies.

[ms molly]

hi, I have read all the posts. I got my mirena 8 weeks postpartum after baby #3, last ditch effort to try something reversible since I can't take the pill anymore due to vascular problems. Hubby said he'd get snipped, and is still willing to do it (grudgingly) since our long awaited baby boy arrived after two girls. I was excited about the prospect of no periods. I had a paragard before I got pregnant this last time and I couldn't stand the gushing, two boxes of super plus tampon periods and I swear I could feel the stupid thing in there just about all the time. Not anything real painful, just mild crampyness, but just constant. I always knew it was in there.

The mirena was great for about six months while I breastfed. I chalked up the low sex drive, lack of lubrication, and painful intercourse to breastfeeding and exhaustion. I had no bleeding at all for six months, but then in Jan. started spotting. Every day. Not a lot, not enough for a tampon, but enough for a pad. I buy them in bulk now. I get up every morning and start bleeding. I bleed when I exert myself or exercise. I feel mildly achy and crampy all the time. I can deal with it, I guess, if it will go away at some point, but it's been three months and no end in sight.

Any one else had this experience? I'm thinking that the constant spotting is because I didn't bleed for half a year, but thought it would let up after month #3. My libido is still pretty much non existent.

[Fab40]

Kathleen - I'm five weeks into the Mirena today. I had my period when it was inserted and I've had it every day since. I too have been experiencing peri-menopausal (I'm 40) related heavy bleeding alternating with no period but constant spotting. All in all I haven't had a blood free day since last November. After all the tests and ultrasounds it was recommended that I try the Mirena before the ablation or hysterectomy options. So far - I haven't seen any improvement in the bleeding. In fact it is worse. I expected this and was asked by my GYN to wait 6 weeks before calling. I haven't had real cramps since I gave birth to my sons over a decade ago but they were back with a vengeance for the last few days so I decided to google for similar stories. I've been on this computer for 4 hours reading comments about Mirena. I'm a little freaked out by some of what I'm seeing but haven't had any of the bad side effects others are complaining about. I have had an almost daily headache but not too severe. I take anti-biotics for acne but have noticed a few bumps more than usual but not enough to be worried yet. I haven't had any joint pain and no hair loss. I do think weight gain/bloating could be an issue. I'm supposed to start a marathon training regimen this month - partly as a challenge to lose the weight I've put on in the last few years. If I have more weight gain AND sore joints I'll go crazy. I'm going to keep poking around and will check back to postings here and some other sites for more info. I'll also definitely be following up with my doctor at 6-weeks regardless of the bleeding. A girlfried had an ablation last year. I'm meeting up with her this week for a drink and recommendation.