Inauguration of an IUD
I wrote this piece in 2017 when I first got my IUD, the Kyleena. The first paragraph reflects the pending political environment. The ending has a general update and new political landscape.
I wanted to share my Kyleena story first as a simple review of a new IUD option. But given the recent decisions regarding the defunding of international organizations that help women with abortions—and the risk to domestic Planned Parenthoods which I support monthly—I couldn’t stop my response with my own experience. It terrifies me that something so personal yet crucial to half the population—our reproductive health and rights to options for ourselves—is reverting. The ability for a woman to connect with other strong ladies and resources, the chance to find something that makes her comfortable and proud of her body, and most importantly allows her to decide her own fate and future—are all things I want to fight harder for. I hope we all do, and I hope we all will.
I’ve had a complicated relationship with birth control and my body. Unfortunately, I know I’m not alone in this. Four types of pills, broken condoms and Plan B, no pill at all and then the fear that entails—I’ve seen a lot of it. When I moved to a new city (and started a new job with new health insurance), I knew it was time to finally get a consistent method that worked for me and was easily accessible. I had a positive relationship with Reclipsen for over 4 years but my new insurance only covered a closely related (but not the same) type of pill. Only after months of gastroenterology appointments I realized this brand was the culprit of IBS and terrible stomach distention. I went off the pill as an immediate remedy, but as a sexually active female I knew this wasn’t a sustainable option.
I booked an appointment with a gynecologist in the fall of 2016 and prior to my first appointment asked my friend Anna—who I knew was heavily involved in female health and contraception—for her thoughts on an IUD. I’ll be upfront and say that sex was not a high priority in my life at all. However, my health and being smart about my body was. I anticipated speaking with my gyno about simply starting a different type of pill; I’m extremely punctual with medication, and quite frankly thought the IUD was too extreme for my very low risk of pregnancy. The fact that it was a “procedure” intimidated me, but a lot of things appealed to me from my own research and discussions with Anna and my doctor. IUDs are localized; there was a lesser risk of the hormones affecting my digestive system or brain (don’t need any additional depressive symptoms, thank you very much). I also had heavy periods and the option of a decreased flow with time was pretty appealing, though I did enjoy skipping the placebos on the pill to solve that issue. Anna had done her thesis on contraception and her data for what was preferred by women, removed by women, etc. all pointed to an intrauterine device with low doses of hormones. I didn’t initially consider an IUD because of the potential shift in political landscape, but I was suddenly thankful I started the process before 2017 initiated.
My doctor mentioned that the FDA approved a new IUD in late 2016 that was smaller than the Mirena but had more hormones that the Skyla. The Kyleena lasts 5 years, was free with my insurance, and the risks were the same as with any IUD. Given that I hadn’t had a baby, was having adverse reactions to certain hormones, and was pretty open to a device newly on the market, my doctor thought I was a good candidate. I ordered one and waited about a month and a half before I had it inserted. The process was to be expected. I took pills to relax my cervix but it still felt like a pap gone wrong (but only for a few seconds). My gynecologist was an angel; she explained the process beforehand and shared each step as we went, prompting me when to expect pressure or pinches or cramps. She said there would be 2 major cramps, the first with the measuring device and the second for the placement. Despite a finicky speculum that caused a bit of a delay, the overall process went smoothly with minimal pain. She has an IUD herself and told me this would be the worst pain I’d feel in that region since I haven’t had a child, but it was more funky, or uncomfortable, than painful.
I’ve had the Kyleena for about 2 weeks. Spotting has been off and on, as has the cramping. I know I’ll get used to it, I don’t have any large concerns. It’s an adjustment I’m ready to make as I take more responsibility for my reproductive—and overall—health. Despite being someone who would prefer to not think about reproduction due to my lack of participation, if you will, I still do every day and in many different ways. Because as a woman, I have to. It’s part of my identity; my body is something I care for diligently that no one else should really have a say in. I’m thankful I had the resources and opportunity to find something that has so far worked well for me.
I have now had the Kyleena for almost 3 full years. The first year was a dream. No periods, no pain or spotting during the (minimal) times I had sex. As I started my second year, with a steady boyfriend, things started to change. First, I realized I would have pretty bad period-like cramps for a few days after intercourse. I went in for an ultrasound to confirm everything was in its place (it was, and always is), and was told cramping is to be expected. When you orgasm, your uterus contracts and can create the cramp. This eventually sorted itself out, until about 5 months later when I started noticing a period-type discharge but not quite what I was used to. I would also bleed, sometimes profusely, after sex. I contacted my gynecologist again and went in for an appointment. After tracking the bleeding, I've found out my period is returning. This is due to the device naturally losing hormones. I also learned I have a friable cervix given the ways the glandular and squamous cells are placed-- I have more cells that secrete blood and mucous closer to my cervix, which can be irritated during sex. I'm never in pain and when careful, I don't bleed at all. I have had 2 silver nitrate cauterizations to help with the bleeding and might have to keep up the process if it returns to the same degree. Cauterizations burn the cells to stop bleeding, and is an out-patient procedure that only mildly stings. My pap smears and blood work for STIs have been normal, so all in all I'm healthy. I now more regularly have a period, but I don’t get cramping or have issues related to the IUD itself.
I'm not sure if my changes in vaginal landscape are correlated to my IUD, but I'm still happy to have it. I'm also thankful to have doctors who can comfort me when I'm worried about my state (having a cute little device in your uterus really makes you think about your ability to have other cute things growing in there one day). Your sexual health is completely in your own hands, and the best thing to do is learn how to handle the ebbs and flows (no pun intended) the best you can.
I couldn’t post this article at the current time without bringing the GOP’s Title X changes to light. Trump’s presidency has led to Planned Parenthood leaving the Title X program, the federal program that grants low-income individuals and families access to family planning and sexual health resources. According to the PP website, Title X-funded health centers not only provided 720,000 pap smears and 4 million STI tests but breast exams to 1 million women in 2016. Starting in 2018, Trump and his cohort pushed hard to ensure a gag rule was passed making it illegal for Title X funded providers from giving patients how they can safely and legally access abortion. Given this new rule, PP opted out for funding to not follow the new rules.
Access to information and services is a human right. The PP websites below have ways you can help fight Title X. Most importantly, keep voting to ensure your priorities related to health are heard, please!
https://www.plannedparenthoodaction.org/issues/health-care-equity/title-x