Saturday, December 23, 2017

FAQs About the Hormonal IUD (Birth Control Update)

Hello, beautiful! I mentioned in my post on my hormonal acne that my last birth control update, all about getting the Liletta IUD, was super well-received - which got me thinking about how I hadn't done a birth control update in a really long time. So, here we are!

I wanted to update you guys on my experiences with the IUD for many reasons, but the main one is that my first post about my IUD only covered why I got it and what my insertion was like. Now that I've been living with it for a few months, it's time for me to tell you what having an IUD is really like, down to every last dirty detail.

To make this more interesting, I've decided to answer some of the most commonly searched questions about the hormonal IUD from (Bloggers, this tool is a super cool way to generate ideas and titles for blog posts; for everyone else, well, it's just all-around useful!) That way, instead of giving my opinion about the IUD, I can give you guys the info and let you decide for yourselves if this birth control method is right for you and your lifestyle...

Now, let's answer some FAQs, shall we?

What is the hormonal IUD and how does it work?

Let's start with the basics: IUD stands for "intrauterine device." Some docs also call these IUCs, or "intrauterine contraceptives." 

In general, there are two types of IUDs: hormonal and non-hormonal. The non-hormonal version contains copper wire that somehow repels sperm. We still don't know exactly how the copper IUD prevents pregnancy in this way, but scientists have tons of theories that they're still trying to crack.

However, we're here to talk about the hormonal version, which prevents pregnancy in the same way that other hormonal methods - such as the pill, implant and patch - do: by thickening the cervical mucus and preventing ovulation. Even if you didn't realize it, you've probably heard of the hormonal IUD by one of its many brand names, such as Mirena, Skyla, Liletta and Kyleena. (Pretty names, amirite?)

What hormone does the IUD release?

Unlike birth control pills, the IUD releases only one hormone. That hormone is called progestin, and is a synthetic form of the female sex hormone progesterone, which regulates many aspects of your menstrual cycle. 

Progesterone is responsible for various symptoms during your period, pregnancy and even PMS. For example, without the characteristic drop in progesterone that happens at the end of the menstrual cycle, you would never have a period again! (And while that might sound appealing now, in a couple years when you're ready to have kids - should you choose to have kids, that is - you might not love it so much.)

Progestin, on the other hand, is a man-made version that mimics the role of progesterone in the body. It's because of the synthetic hormone progestin, found in all hormonal birth control from the mini pill to the IUD, that the cervical mucus thickens (making it difficult for sperm to reach an egg). In other words, you have progestin to thank for pregnancy protection when you use any kind of hormonal birth control! How cool is that?

What are the benefits of the hormonal IUD?

One reason why the hormonal IUD is popular with some women - like moi - is because it contains fewer hormones than other methods, which means women - also like moi - who are sensitive to estrogen and progesterone will probably experience fewer negative side effects than they maybe did on the pill, the patch or the shot. Think about it this way: whereas the pill has to pass through your entire body before it gets to your reproductive system, the IUD is already RIGHT THERE! So, it takes a much lower dose of hormones to "get the job done," so to speak. 

Additionally, since you don't have to remember to do anything before having sex when you have an IUD, the IUD is one of the most effective methods of birth control out, we're talking 99% effective, people. Basically, as long as you check your strings every month to ensure the device is still in place, you'll be good on pregnancy protection for the next 3-5 years. (But please remember to use barrier methods, too, since the IUD won't protect you from STIs!)

Does the hormonal IUD cause weight gain?

Personally, I haven't noticed a significant weight gain since I got the hormonal IUD - I've actually noticed that I've lost a couple of pounds in the past year or so! However, I attribute that more to my antidepressants than to my birth control method.

That isn't to say that the hormonal IUD can't cause weight gain. Basically, anything that tinkers with your hormones can cause fluctuations in your weight - including your ordinary, unregulated menstrual cycle! (Ever noticed that you look and feel fatter when you're PMSing? Yeah, that's why.)

All things considered, there's one fact I think we can all agree on: you'll gain less weight on the IUD than you will when you're pregnant. So, if you're not in the market for a baby anytime soon, I would choose a birth control based on efficacy, NOT based on whether or not it will make you fat.

Does the hormonal IUD stop your periods?

Long answer made short, it can! In my experience, I've had gradually longer cycles and lighter periods with my Liletta IUD - and hey, I'm not complaining! Considering how expensive it is to keep replenishing your tampon supply every month, who wouldn't trade in their period for some effective long-term birth control?

According to Bedsider, about 1 in 5 users of the Mirena and Liletta IUDs will stop having a regular menstrual period within the first year of use. That doesn't mean that anything's wrong with you; it just means you're lucky! 

As for the rest of us, you're pretty likely to experience lighter, less painful periods on the hormonal IUD. But, please note that this is not the case for the copper IUD - in fact, Paraguard can actually cause the opposite, aka extra-heavy, extra-painful periods. Yeah....ouch.

Can the hormonal IUD cause acne?

In my experience, YES! The hormonal acne problem is a very real, very pressing issue in my life right now - I even wrote a blog post all about it, which you can read by clicking here.

Not everyone will automatically get acne just because they get an IUD, of course, since everyone reacts to different birth control methods in different ways. That being said, if you're taking birth control solely for acne-control - and not because you're sexually-active - you're probably better off sticking with oral contraceptives than getting a hormonal IUD.

On the other hand, if you are sexually-active, it's up to you where acne figures into your birth control equation. For most people, I would say a few more zits are worth the relief that long-term pregnancy protection provides. But seeing as acne can seriously damage your confidence (and therefore your sex life), I can also see why some girls might be opposed to the IUD if they thought it would make their skin worse. 

Ultimately, it's up to you to make these decisions for yourself, but I still think my IUD has been totally worth the side-effects...yes, even the acne!

Can the IUD cause yeast infections?

For some women (like me), the answer is a resounding YUP! And it can also increase your risk for another type of infection known as bacterial vaginosis, aka BV. On top of that, it heightens your risk for Pelvic Inflammatory Disease (PID) if any kind of infection goes untreated - so, if you experience any kind of funky odor or discharge on the IUD, it's important to see a doctor and get treated ASAP. Unless you've had a yeast infection before and are 100% certain what it looks and feels like, you really shouldn't use an over-the-counter product like Monistat without consulting with your gyno.

Of all the side-effects I've experienced with the IUD, this one has definitely been the most annoying one, and the only one that really interferes with my quality of life. Since last May when I got the IUD, I've had two bacterial infections two months apart...followed by a yeast infection each time, since the intravaginal medication they prescribed me can cause them. 

So, yeah, the IUD isn't always pretty. That's why they don't necessarily recommend them for women who are at high risk for contracting STIs, such as women who engage in unprotected sex with multiple partners: because your risk of more serious complications is all that much higher. As for BV and yeast infections, there's not much you can do to prevent them - but there is some evidence to suggest that taking a probiotic regularly can help balance your vaginal flora and keep the nasty bad guys from overgrowing. (I've taken a probiotic for about a year now, and I'm still TBD on if it actually works for me or not.)

Can the IUD cause infertility?

Absolutely not. In fact, the IUD is one of the best choices for women who are looking to become pregnant within the next few years, since your fertility essentially returns to normal as soon as it's removed (unlike other methods like the pill or shot, which take a little bit more time to wear off). 

Basically, as the Huffington Post explained, there used to be this really shitty IUD called the Dalkon Shield on the market in the 60s and 70s. Not only did it cause infertility, but it also caused some women to lose their uteruses - and even their lives.

IKR? Shady stuff. But that doesn't mean you should give the modern-day IUD a bad rap! Apart from the fact that it's also an intrauterine form of contraception, today's IUDs have nothing in common with that ancient ladykiller. So, you have nothing to fear - there's no link between having an IUD and having fertility issues.

How much does the IUD cost?

I hate having to give you guys such wishy-washy answers, but again, this really depends on a couple of factors. Firstly: do you have insurance? If your health insurance still covers the IUD (#handsoffmybc), your out-of-pocket costs could drop from triple-zeros to double-digits. Between my Planned Parenthood copay and our insurance's deductible, I only had to pay about $20 out-of-pocket for my IUD.

Secondly: which IUD do you want? Mirena and Kyleena each cost around $500, plus any costs from your doctor's office for insertion and removal. Skyla costs even more than that, charging between $650 and $700 minus any insertion and removal costs.

If you can't afford to pay hundreds of dollars, never fear - you still have one option! The most affordable hormonal IUD by far is Liletta, the IUD that I have. The makers of Liletta launched a low-cost program to help vulnerable patients pay for the IUD. If your insurance doesn't cover the IUD, you can basically apply for a debit card that will allow you to pay between $75 and $125 for the IUD (not including any costs for insertion and removal) - and get your second Liletta for as little as $0. YASSSSSS, Liletta!

Which hormonal IUD is the best one?

There's really no clear answer. Since birth control is so personal to every woman, there's no one-size-fits-all approach that will suit every woman. However, you might want to consider a couple of factors when it comes to choosing the hormonal IUD that best meets your needs:

  • Availability. Your insurance may only cover one kind of IUD, or your local family-planning clinic (such as Planned Parenthood) may only carry one type. Alternatively, if you're getting it inserted by your doctor, you can usually choose which kind of IUD you would like them to order, as long as it's covered by your insurance plan.
  • Price. Liletta is the cheapest hormonal IUD, followed by Mirena and Kyleena. Skyla is probably the most expensive option - but thankfully, Liletta and Kyleena are both comparable to Skyla.
  • Size. Most women who haven't had children will receive either Skyla, Liletta or Kyleena, since these IUDs are made to be smaller than the Mirena IUD, which was originally designed for women who have already given birth.
  • Staying power. Not every IUD lasts as long as the next! Mirena lasts the longest, since it contains the highest doses of hormones. You can keep Mirena for up to 7 years (but obviously, like any IUD, you can have it removed at any point before then, too!). In second place, Kyleena can be kept for 5 years. You might have heard that Liletta could only be kept for 3 years - but luckily for me, it was recently extended to 4! In last place, Skyla only lasts for 3 years (but that doesn't make it any less effective as a form of birth control).
  • Efficacy. Good news here: all of the hormonal IUDs are over 99% effective at preventing pregnancy! Woohoo! 

What have your experiences been like with birth control? Share in the comments below or @haleymarieblog for your chance to be featured on social media!