To IUD or Not To IUD?

I’ve spent the last couple months or so agonizing about whether or not to get an IUD (an intrauterine device). If you’re not aware, an IUD is a little bit of plastic or copper they place in your uterus to prevent pregnancy. It’s one of the most effective birth control options out there. To be honest, I’m not entirely comfortable sharing personal details about my reproductive health choices with the Internet, but I feel like this is something a lot of people I know are going through and I wanted to add my voice to the conversation. Desperate times call for desperate measures.

I have been on the birth control pill for about 10 years. And it’s fine. I don’t love it. I don’t hate it. I have a permanent alarm on my phone to make sure I remember to take it. (9 PM, destroy all babies.) I’ve been thinking about switching to an IUD for a number of reasons. I’m curious if it will alleviate some of my moodiness (as I know birth control pills are loaded with a lot more hormones). I’m also a little worried about being on the pill for such a long time and what that might be doing to me. (Though I’m also of the attitude if it isn’t broken, why fix it? So many questions.) But mostly I’ve been constantly meditating on this because of the current political climate in the United States.

There are a LOT of dudes in government that want to take away my access to birth control. They want to make it more expensive and harder to get. The last few years I have spent zero dollars on my birth control. This is thanks to the Affordable Care Act (seriously, thank you Obama, you are the best), something the Republicans are desperately trying to repeal as we speak. Under the ACA, I get my birth control pills for free! I also, if I choose to, could get an IUD inserted at no cost to me. But I’m not sure how long that will remain an option. Because of my anxiety about whether or not to get one, I’ve hesitated. And now I’m worried it’s too late. If I got one next month, would I still be able to afford it? And if not, what will I do? There will certainly be a cost if I remain on birth control pills. Should I just do that? What if they try to take that away too? What if I can’t afford it at all? Why is this even a thing that I’m wasting valuable worrying space in my brain on?

Ignoring the mounting political chaos, from what I’ve read and what I’ve spoken to my health care providers about, there are a lot of benefits to getting an IUD. So many women sing its praises: shorter or no periods and super duper effective at preventing pregnancy (even better than pills). You set it and forget it. Wham, bam, no more cell phone alarms! I’ve heard the insertion process can be very painful, but it varies from woman to woman and the right cocktail of painkillers and anti-anxiety medication might ease that. Many, many of the stories I’ve read are women saying how much they love their IUD.

But the possible negative things I’ve read about are TRULY HORRIFYING. It could perforate the wall of your uterus and end up in your stomach and you’d have to have SURGERY TO GET IT REMOVED. It could fuse with your uterus and you’d have to have SURGERY TO GET IT REMOVED. These are very rare occurrences (about 1 in 1ooo women). That’s 0.001%. It’s very unlikely, but it does happen. And the accounts I’ve read are harrowing enough to give me pause. Also it’s very effective at preventing pregnancy but only if it remains in place. From what I understand, if it falls out of position (which is possible), you could get pregnant, so proper maintenance is key. There’s also a risk of ectopic pregnancies (i.e., when a fertilized egg stays in the fallopian tube and not your uterus) and that could potentially kill you. Again, this is highly unlikely, but POSSIBLE. I’ve read some women don’t like the hormonal ones (it made them ill or worsened their acne) and some women don’t like the copper one (it made their life a nonstop Carrie). The possible cons are very real and very scary, but also fairly unlikely (or so I keep hearing).

I’m not sure what to do. Currently, I’m looking at the Mirena, which is the 5 year hormonal option. I’m pretty scared about all the possible risks and am very afraid it will hurt horribly, but the benefits are pretty amazing so long as I’m not the 1 in 1000 women. The one thing I am certain about is that I want to make sure I have access to adequate and affordable birth control options. I take birth control not only because I want to prevent pregnancy but also because I suffered for years from difficult and extremely painful periods, something I really do not want to go back to. So currently I have a bunch of leaflets from my gynecologist and an open invitation to make an appointment, if I so choose. And I need to choose, soon.

I’d love to hear your stories and any advice you might be able to offer. Feel free to comment or shoot me a message!