Written by Lily Evans
Illustrated by Sabrina Small
I was freshly sixteen years old when I asked my mother about going on the birth control pill. When we had the conversation, I told her that it was because I had very heavy periods and excruciating cramps. That wasn’t entirely a lie, but it certainly wasn’t the full truth. My mom is a nurse, and complaining about my periods was not new, so we made an appointment with my pediatrician to discuss birth control options. After a simple appointment and a trip to the pharmacy, I was a proud user of the pill!
Fast forward a year and a half to August 2017. I’m in a loving, committed relationship with the man of my dreams, and I’m having all the wild sex I could ever dream of. During a yearly check-up with my doctor, she asked how I was doing with my birth control. After admitting to her that I was sexually active (ahh yes, the dreaded moment), she instantly suggested I consider an IUD. I had very little knowledge of what those three letters meant or what they could do for my sex life. The doctor gave me some reading material as well as the names of some local OB/GYNs, and I was off.
An IUD (intrauterine device) is a small, T-shaped, plastic or copper item that is inserted into the uterus. IUDs is a long-acting reversible contraception (LARCs) meaning that while it’s in place, the chances of conceiving are insanely slim, but once it’s taken out, you can get pregnant immediately.
There are two different types of IUDs: copper and hormonal. The copper option, also known as Paragard, is right for you if you want hormone-free contraception that lasts for 10 years. Paragard is wrapped in copper which makes the uterus a hostile environment for sperm, thus screaming fuck the fuck off to anything potentially wanting to set up camp inside of you, and force its way out nine months later. What deters some women from the copper IUD is that it can make periods heavier with more bleeding and cramping.
On the other side, we have the hormonal IUD. Since it is the most popular type, there are a few more options. The Skyla and Liletta types are smaller and only last about three years. Mirena is the most popular type of IUD; it is the same as Skyla and Liletta, only a bit bigger, and it typically lasts for five years. A major benefit of hormonal IUDs is that they almost always lighten periods, and sometimes even stop them entirely! With all IUDs, the only maintenance you have to do is check once a month to make sure that the strings are still hanging out of your cervix which can easily be worked into your “alone time,” or you can have a “special friend” feel around for the strings when they’re already down there. I think that’s much more fun anyway…
When I got to college, I was still taking the birth control pill, but soon found that it didn’t cooperate too well with my new schedule. Even though I switched the time I was taking it, I found myself forgetting and snoozing my alarm too often. Still in my monogamous relationship, I decided that after a year-and-a-half of contemplation, I was finally ready to take the plunge and make an appointment for an IUD consultation with a gynecologist. I had never been to an OB/GYN before, so I was quite nervous about what it felt like to be “cranked open” (have a speculum used on me), but we’ll get to that later. My partner, had been in favor of me getting and IUD from the day I brought it up, so he was very excited to have all of the care-free condomless sex our bodies could support. Granted, the pill prevents pregnancy, but since there is a margin for human error, it is still possible and being paranoid people, we were still using condoms as a backup. (Side note: as I have mentioned, we are in a monogamous relationship and have both been tested for STIs. IUDs DO NOT protect you from STIs so be sure to use condoms if there is a chance you or your partner has something).
The next step was to call an OB/GYN and make an appointment for a consultation. I scheduled my appointment for the day before Thanksgiving so I could hopefully get my IUD put in before heading back to Champlain. I was so excited for my consultation appointment. Before the consultation, I did extensive research.
When I got to my consultation, I was brought into an exam room and a nurse took my vitals. I got to keep all of my clothes on because it was just a discussion, but I had to sit on the bench thingy with the stirrups. When the nurse-practitioner got in, she asked me about why I wanted an IUD, if I had researched them, and which one I wanted. All in all, the appointment only lasted about 10 minutes. There are a few reasons there has to be a consultation before the actual insertion: 1) the OB/GYN has to call your insurance company and do all of that technical bullshit, 2) to make sure that you are a good candidate for an IUD and have a minimal risk of complications, and 3) to discuss everything before the actual procedure so you can be in and out as quickly as possible. The only question I had leaving the consultation was when I would actually be getting my IUD. I was hoping to be able to get it two days later, on Black Friday.
About two hours after I left the appointment, I got a call back saying that my insurance was willing to cover the entire procedure and device. Also, I was able to get my IUD on the day I was hoping, only with a different provider. I was ecstatic, but this is also where the nerves began to creep in. I knew it was going to hurt, but just how badly? My mind spiraled out of control as I feared the pain I was expecting.
The morning of the procedure, I woke up with chills. I had hyped it up so much in my head that I was making myself physically sick. They had instructed me to take Tylenol before the procedure to reduce cramping, which I did apprehensively. Personally, I’m more of an Ibuprofen girl, but I followed the doctor’s orders. We got dressed and drove to the doctor’s office. It was a particularly busy morning at the OB/GYN. They had me pee in a cup to check for STIs and make absolutely sure I wasn’t pregnant. Sitting in the waiting room was fifteen minutes of mental agony and overthinking. I was clinging to my partner like a child who knew they were about to get a shot. When a nurse came and got me, she said that I was welcome to bring him back with me, which was good because I was going to regardless of if I was or wasn’t allowed to.
In the room, she took my weight and blood pressure, then asked if I had taken Tylenol (it’s like these people had been paid by Tylenol, it is seriously all they talked about). Then, it was time for the dreaded disrobing. I was asked to strip from the waist down and cover myself with a paper sheet. Let me tell you, this thing was flimsy as fuck! Sitting down, I couldn’t get it to fully cover me so I just sat there with my asscrack exposed for the world. But it’s okay because I still had my socks on, so not all modesty had flown out of the window.
The doctor came in and we exchanged pleasantries as you do with a stranger that is about to be wrist-deep inside of you. She seemed nice enough and explained everything thoroughly. I even got to see and play with a demo IUD before the procedure so I could have an idea of what would be setting up camp in my uterus for the next five years.
Ever since I found out about what a gynecologist does, I’ve dreaded putting my legs in those goddamned stirrups. When she said it was time, my heels timidly met the janky cushions. The doctor asked me to scoot my butt all the way to the bottom of the bench. I hated this position more than I could possibly put into words. The entire time, I couldn’t stop thinking to myself, I really hope she’s not staring at my butthole… She probably wasn’t but being exposed like that to a stranger is horrific. But this was just the beginning of being uncomfortable…
Next, I discovered what a speculum feels like. A speculum is a metal or plastic tool that looks like a duck’s bill with a handle. It is inserted into the vagina and literally cranked open so the doctor can see inside of you. At first, it is bitterly cold. Once it is all the way in, it feels like a lot of pressure as the doctor cranks it open. It didn’t hurt, but it was very weird. I immediately started reaching for my partner to hold my hand. The sensation was nothing like a penis, maybe because penises aren’t cold, hard, and metal.
When the speculum was in place, she cleaned my cervix with Betadine. This was super quick and it didn’t hurt; it just felt like when you have an itch and can’t scratch it.
She then inserted a tool called a “sound” through my cervix into my uterus to measure it. They do this because doctors typically will not insert an IUD into a uterus that is smaller than six centimeters. Fun fact: my uterus is about seven centimeters deep! This is about the size of an adult woman’s pinkie finger. The sound is where the real pain began. I freak out when my cervix barely gets bumped during sex, so having something shoved through it was unpleasant to say the least. This was quick but caused some pretty good cramping, the kind you get when your period is showing its full wrath. At this point, I was in a lot of pain. My partner was holding my hand and trying to distract me. He claims that he asked me a question about Christmas, but all I remember was my head writhing around while making sure not to move from my chest down.
After my uterus had been measured, the doctor stabilized my cervix with some sort of medical clamp. This made me nearly jump out of my skin in pain! When I had been doing my research before making the decision, one woman said that having her cervix stabilized felt like her butt was falling off. After actually going through it, I can completely agree with her; it felt like my butt was falling off. The best way I can describe this to someone who hasn’t been through the process is that it feels like a lot of pressure internally below your belly button and in your rectum. So. Strange.
And, for the main event, she inserted the IUD into my uterus. It felt about the same as the sound, but it lasted longer because she had to wait for the arms of the device to unfold. I accidentally yelled “fuggers” at this point. I meant to say, “fuckers,” obviously, but pain makes you do weird things. After the IUD was placed, she withdrew the speculum (which felt amazing to have taken out of me) and the ordeal was over. But I was still in a substantial amount of pain. I remember just lying there telling myself not to cry. The doctor said she would see me in a six weeks for a follow-up and that the nurse would be in with some water and Ibuprofen (finally, some Ibuprofen!!!). I was instructed to lay on the exam table until then. As soon as she left, I began crying. It wasn’t because of the pain, but because the stress of the whole event was over and I could get past being nervous. My partner comforted me and said I did an amazing job. I just laid there, but I agree, I did an amazing job!
When the nurse came back in, my partner helped me sit up so I could take a drink. I felt very dizzy so he and the nurse agreed that I should lay there for a few more minutes until I was better. I was sort of out of it for the next few hours. But since it was Black Friday, we went to Best Buy because we had been eying a Mario Kart Nintendo Switch bundle. No IUD could keep me from Mario Kart! I felt like I was in a fog. When we got back to his house, I took a nap for a few hours and felt a bit better when I woke up. For the next two weeks, I had excruciating cramps on and off accompanied by constant spotting. To be honest, I was pretty unhappy. However, after a month, I stopped getting my period. Unlike with the birth control pill, your body still ovulates with an IUD. In my case, I still get mild period symptoms (light cramps, sore breasts), but they are nowhere near as hellacious as they were pre-IUD.
As I write this, I have been two months period-free and it is incredible. Although the insertion process FUCKING SUCKED, I am now 100% team IUD. To anyone who is unsure if they want one, I would recommend you go in for a consultation with an OB/GYN so they can help you weigh through the pros and cons for your unique situation. Obviously, birth control is not a one-size-fits-all deal, so do your research and be sure to actually consider if getting an IUD is the right option for you.