Mirena vs. Paraguard vs. Nuvaring

[morleyroarly]

I have an appointment soon for insertion of Mirena, a hormonal IUD. Does anyone out there have experience with Mirena and/or Paragard (the copper one)? I know it's a good option, and cheaper than the ring over 2 years, but the whole "perforated uterus" thing and the whole "occasional spotting and really bad cramping for the first three months" thing scares me.

Nuvaring worked without a hitch for me - I would be opting for the IUD for the long-term cost savings and the decreased hassle, as well as the lower hormonal load.

Comments

[levanah.livejournal.com]

I have a paraguard. I've had it for... uh... *checks livejournal* around two years and I'm very happy wiht it. I did/do get nasty cramps, but that really isn't different. I was on Norplant for 10 years, and rarely had a period at all, so I really don't have a "cramp history" to compare to. My period is very regular now, no spotting, and normal (most of the time) cramping. iud_divas is a great place to ask questions and read abotu other people's experiences.

[ladymsruby.livejournal.com]

Hey - I love the Mirena.

Love, love, love it and have had it 5 years this month.

It sucked getting in. Hurt like mad. Take ibuprofen or something that prevents cramping. Take pain meds or have them with you. Have your man rub your feet and be good to you.

In my experience, the pain subsided the first night, the second day was crampy, but the foot rubbing from the ex-bf helped, and then now five years later it rocks to have an IUD. My periods are about a day or day and a half of spotting - nothing like a period and a side effect of the light dose of hormones. Cramps are almost nonexistent. I hear those are worse with the copper-T. And, I don't have to think about birth control and haven't for five years.

But I do recall the first few months had irregular spotting and occasional cramps. It wasn't so bad, and utterly manageable. I think the perforation risk is negligable - they say that because it's a risk in like one in a million. You're young - your uterus isn't stretched out from 10 pregnancies, which I'm led to belive has a lot to do with perforations (which I've only seen once in a woman who had been pregnant 13 times, at an abortion clinic I worked at over the span of a year. And they were doing an abortion not inserting an IUD - an IUD is not going to perf your uterus). Most of the women who work at said clinic, including the doctors, have the Mirena. And of all the women in my grad school program, the women who had the Mirena all had worked in women's health care. I guess we knew all our options and figured out that it was the best for us. And all of them really liked it too.

Anyway, ask a question, get answers.

[levanah.livejournal.com]

ladymsruby -
Had you been previously pregnant when you got your IUD? The doctor at planned parenthood, where I had mine inserted, nearly refused to insert mine when she read in my chart that I had never been pregnant. This was also the excuse [for dr's not giving me an IUD] I had heard during the previous 10 years I was trying to get an IUD and couldn't get anyone to even consider giving me one.

My insertion was perfectly simple. One try and it went in. The worst part was the clamp on my uterus. Until I got home... then it was hell for about 12 hours.

Also, let me confirm that cramps on paraguard can ****ing suck. But they are usually pretty manageable now.

I used to defend an abortion clinic. Thank you for working in one!

[buckminster.livejournal.com]

yeah, k had issues getting her's. She had to really push for the IUD, sign off that all the risks been explained, and promise that we are 100% monogamous.

[(Anonymous)]

I guess my main concern is the cramping and bleeding. I have a pretty sensitive body in many ways (lots of skin sensitivity, the tendency to faint in the Dr's office). I haven't had bad periods before - a little cramping, maybe 2 episodes per period, but nothing a little lying down or ibuprofen can't fix. I just wonder if getting an IUD is somewhat pushing my luck? Given that the ring works so well.

The pros for the Mirena include sponaneity, lower hormones, and in the long run lower cost (though there's a decent chance I would be removing the IUD right around the price break-even point, as we're potentially looking to get pregnant somewhere in that time range).

My argument for NOT getting the ring again was the lower hormone dosage. However, 2 more years of the ring wouldn't be a big difference, eh? And then the Mirena after kids?

It's just such a tough decision, and the occasional bleeding/cramping horror stories have me scared!

[buckminster.livejournal.com]

Kris, my gf, got mirena two months ago. She had a pretty easy time of it, switching from Depo. Painful cramps for a week and some random bleeding that gradually got better. None since then. We had to to be gentle with that area for about two weeks, but that was about it. Copper is supposedly more likely to be rejected by the body and can cause heavier monthly bleeding. Her doctor didn't recommend it for someone who hadn't had a kid yet. Overall feeling like she had less issues with mirena than many people.

[fuzzycoffeebean.livejournal.com]

Also check that your health insurance will cover the procedure. I was detered from getting mirena due to 1) my doctor and any one in her practice did not perform the procedure on any woman who hadn't had a full term pregnancy before (even though I know plenty of women w/mirena who have not been pregnant) and 2) my insurance didn't cover the cost of the procedure.

I've been perfectly happy with the ring for years, but wanted to switch to an iud before we moved with our plans for lots of travel (one less thing to worry about is my reasoning). I plan on looking into it here.

[(Anonymous)]

My insurance does NOT cover it - however, even without coverage it is cheaper than the Nuvaring with prescription coverage.

Mirena: $440 for the IUD, $175 for the insertion = $615. Good for 5 years, probably looking at getting pregnant before the full 5 year mark (!).

Nuvaring: $20 per month with prescription coverage = $240/year. The break-even point would thus be just about 2 1/2 years.

Nuvaring has a considerably higher dose of hormones, from what I can tell. Nuvaring releases 0.015 mg/day of ethinyl estradiol (EE) AND 0.120 mg/day of etonogestrel. Mirena releases 15ug=.015mg/day of levonorgestrel only. I don't know how these hormones compare, but I can only assume they are in a similar family and thus have similar effects (anyone with more knowledge, please jump in!). It would seem the dosage on levonorgestrel and EE are the same from Mirena to Nuvaring, but the Nuvaring adds the 120ug of etonogestrel.

I found a really rad ob/gyn doctor at the Allegheny General Hospital LifeStages program - Dr. Cathy Saunders. From what I can tell, LifeStages caters to young mothers and don't-wanna-be-mothers, particularly lower income. Dr. Saunders is 100% willing to insert an IUD despite my lack of prior pregnancy and my interest in future pregnancy. She's been very helpful (or rather, her assistant has!).

-Morley (not logged in - at work)

[(Anonymous)]

Also - you should have much better luck with getting Mirena across the pond. IUDs are far more common in general in Europe, particularly among pre-childbearing women.

[poodah.livejournal.com]

My anatomy is on the small side, so it took two tries and medication to dilate my cervix to get it in. Here was my experience of the insertion process. Despite the inital pain and discomfort, as well as the hassle of my older doctor telling me he didn't want to put one in as I'd never been pregnant--I have had coming on 4 worry free years of sex. Not one pregnancy scare, decreased menstual flow, and no cramps. It's been great. I worry a little about the 5 year mark as I have no idea how they are going to get this thing out--the little bugger floated away after 3 months and the 'string' (or piece of plastic) that use to stick out of my cervix is no longer feelable. It's been free, floating in my uterus with no punctures or problems. Having a tiny cervix, I doubt I have a cavernous uterus.