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.
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.