So we have come to that moment we get to read a rather peculiar article, of a slightly different nature from my usual topics in my blog. This one is from my friend who had been married for three years now and she decided to get herself a few more years raising her child and developing her home based business. Hence she decided to get an IUD insertion procedure done to keep unplanned pregnancy off for until she would know when. This I believe only gives one, more certainty on a their future plans and goals.
I am so grateful to her for opening up with this wonderful article. She thought (so did I) this would help thousands of other women with questions and doubts on making a relatively safer contraceptive choice.
Here goes Nisah Hussain: (Profile not linked on request by the writer)
“I am 27 and I have recently started up a home based business that I had been planning for over a year. It has just been launched and is going great. I believe I need to spend more time developing my business as well as looking after my family (I live with my in laws). As much as I would love to have another kid I’d also love to be able to decide when that would be as well. Hence, I discussed with my husband and made a decision in getting an IUD inserted for prevention of pregnancy. In this article I have shared some of the frequently asked questions which I got answered by my VOG and I have shared my personal experience as well.
To begin with here are the FAQ for IUCD/IUD :
What is the difference between the types of IUD’s?
Type 1: Copper IUD – Rs. 450 at Royal Hospital Pharmacy to be precise (valid over 5 or 10 years after insertion). Many women choose copper IUDs because they are less expensive and have no hormones. They are very effective with about 1 in 100 women getting pregnant in a year. They usually make the periods heavier, longer and more painful by about 20-50%. There are no effects from a copper IUD outside the uterus: no weight gain, mood changes, nausea, sore breasts, etc. A woman with heavy, painful periods should choose a Mirena or Jaydess if she can afford it. The copper IUD is also very effective as emergency contraception.
Type 2: Mirena – Not sure of the Price and availability in SriLanka but you can voice out and discuss the options with your gynaecologist (5 years). Mirenas work better; only 1/1000 women per year will get pregnant and the periods will be lighter and easier. The amount of hormone in a Mirena is much less than birth control pills, patches or shots so there are very few hormone side effects. Only about 5% of women will notice any hormone side effects such as weight gain, mood changes or acne. Most women get some spotting in the first month or two after their Mirena has been inserted.
Type 3: Jaydess – Again not sure if this is a norm in SriLanka. (3 years) – These are smaller and have less hormone than Mirena (8 vs 20 mcg levonorgestrel per day). They are a good choice for women who just want contraception and do not have very heavy painful periods.
Source: Willow Clinic
What do they cost?
If you do not have extended medical coverage the cost would be Rs. 1300 to 1500 just to consult your VOG first to get advice and discuss your options, followed by Rs. 5000 to 6000 (Doctor charge Rs. 2500, theater charges Rs. 2500, Drug charges Rs. 600; they dont give you any druugs but they LOVE TO CHARGE FOR THAT) to book the OR at Nawaloka Hospital for the 5 minutes procedure (in sterile conditions). This would make a total of Rs. =/- 7000 in Colombo. However, you will be asked to visit the doctor in two weeks from the date of insertion to check through an ultrasound if the placement is secure and right. This would cost you another Rs. 1500 if you choose to go to Royal Hospital where most VOGs use the scanning machine available at the consultation room. I am not quite sure about other hospitals, but they charge Rs. 4000 for the OR (excluding doctor charges if you decide to get the procedure done at Royal Hospital, Wellawatta).
My Advice here is to explore the charges to book an OR for few minutes for an IUD procedure in various hospitals before you make a choice on where to get it done. i was in a haste and I had no choice but to settle with Nawaloka. You can always discuss with you VOG on which hospital they visit and check among those.
Will the insertion hurt?
You will likely feel a strong cramp at the time of the insertion. It is recommend that you take ibuprofen 1 hour before your appointment to help with the cramping. Most women feel fine after resting for a few minutes. Some women do find that the cramps remain strong and may be given a stronger pain killer if needed. However, the pain is not excruciating to the point you will not be able to walk. You will be able to actually get off the bed and walk. 🙂 It takes only 4 minutes or so in total.
My experience: 1st the Doctor inserted the speculum to dilate the vagina. The doctor then told me to push so that she can reach out to my cervix and clean the vagina with Betadine. I imagine she measured the depth of where my cervix was first and then inserted the devise with the measurements on it. I could feel some discomfort (I breathed in and out trying to relax and not tighten up my pelvic muscles). There was definitely heavy cramps during this process but it lasted only for a few minutes. On a scale of 1 to 10 the cramps decreased in intensity from about 8 during insertion to up to 3 after several hours. I experienced spotting over the next 3 to 4 days and this was suppose to be normal. I was too scared to have a check myself and I did not check the string until a week’s time. 🙂
How long does the IUD take to start working?
IUDs work immediately. Make sure you use condoms if there is risk of sexually transmitted diseases.
How often should I get it checked?
After the first ultrasound that would be carried out in 2 weeks post insertion, you may be advised to get another one done in 5 – 6 weeks time. This consultation would help you discuss any side effects that you might be experiencing and get any medication as relevant. After that you would require to see the doctor once a year. You can also check the existence of the IUD yourself, by inserting a finger inside your vagina and feeling the string.
What should I do if I am bleeding heavier than my normal period?
Don’t worry. Expect that copper IUDs will make your first periods quite heavy and that they will get better after three months. If they remain very heavy, make sure you eat well or take iron supplements so that you do not become anemic.
What should I do if I have really bad cramps?
Ibuprofen 400-800 mg is the best for cramps. Heat (hot water bottle, heating pad, etc) and anything that helps you relax will help.
What should I do if I have a positive pregnancy test?
If you get pregnant with an IUD, check with a doctor to make sure it is a normal pregnancy.
Can I go to work after the insertion?
Most women feel well enough to continue their normal activities that day and are able to control any cramps with ibuprofen. Some women do have very strong cramps and need to rest. Unfortunately we cannot tell how it will be for you. Don’t plan any major physical activity that day (running a marathon (LOL), moving house including major cleaning and moving furniture, trampoline party 😛 none of these).
How long will my appointment be?
You will be here at our office for approximately 1 hour. You will be asked to fill out forms when you go to the reception at the Nawaloka Operation theater. Ideally you would be asked to do a urine test to make sure if you were already pregnant, in case you had doubts on your last unprotected intercourse. You will then see the doctor for the insertion. After the insertion you will be asked to stay back at the OR for up to half an hour to make sure you are alright and do not feel any abnormal pain/dizziness etc. Just to make sure you were fine!
Will the IUD affect future pregnancies?
Within one month after the IUD has been removed, your fertility will be back to normal.
Do you do ultrasounds?
Ideally the doctor will do an ultrasound before the insertion to check your uterus and then again after the insertion to make sure the IUD is in correct position. However, this did not happen in my case and I was asked to meet the doctor after 2 weeks.
Will I bleed after the insertion?
You may have some bleeding at the time of and after the insertion so we ask you to bring a pad with you. The bleeding may last for a few days or even weeks depending on how your body adjusts to the IUD. You may have spotting on and off or a day or two of heavy bleeding. This is normal and should settle down within 3 months.
Is it OK to have an MRI or an X-ray with an IUD in place?
Yes – The IUD will not interfere with the tests.
How long should I wait to book the IUD insertion after my baby is born?
At least six weeks.
Can I use tampons? What about menstrual cups?
Yes. When using your cup, just make sure you break the suction before removing it.
Will I feel it during sex? Will he feel it?
Occasionally, you may feel a twinge, but it shouldn’t hurt. About 5% of men (1 out of 20) say they can feel the strings, but it usually doesn’t bother them. If it does bother your partner, we can shorten or tuck the string up out of his way.
Is there anything I should be watching for?Yes, if you get a fever, steady pain and/or a smelly discharge, you might have an infection that needs to be treated.
How soon can I have sex?
The IUD works right away, but you might feel some pain during sex in the first few days after insertion.
What should I do if the string feels longer?
Don’t panic. Your cervix moves naturally during your cycle and when it moves down the string will feel closer to the outside of your vagina. A long string could mean that the IUD is coming out. If it stays longer, get a doctor to check.
What should I do if I can’t feel the string?
Don’t panic. Many women never can feel the strings. You might ask your partner to try because he may have longer fingers. If you are worried that it has come out without you seeing it, you can get a doctor to check.
When can I have the IUD removed?
You may have the IUD removed at any time.
How long after removal do I have to wait before I try and get pregnant?
It is not dangerous to get pregnant right away, but better if you wait for one period cycle.”