In the last 5 months, I’ve become exceptionally intimate with my uterus and its “mood.”
Our relationship has become somewhat tumultuous at times because it’s not always happy with its new inhabitant, my progestin intrauterine device (IUD), though I’m hopeful they’ll learn to get along soon.
Over the last couple of years, I’ve toyed with the idea of getting an IUD as a form of birth control. But there was never a significant push that made me want to take the plunge.
I’d previously been taking an estrogen/progesterone oral contraceptive pill that worked well, and I always remembered to take it on time.
Then, in summer 2020, I was discussing future clinical rotations for medical school with some of my friends. One mentioned that it might be nice to have an IUD during shift work, which could make remembering to take a pill more difficult.
My friend also shared that IUDs were covered for people under age 25 in Ontario, Canada. This conversation happened 2.5 weeks before my 25th birthday. To say I was in a time crunch would’ve been quite the understatement.
I already knew I was going to lose my private insurance under my dad when I turned 25 years old, and the new plan I’d have under my school wasn’t great. This meant more money out of pocket for monthly birth control pills.
My friends were still talking, but I had already made up my mind. I quickly whipped out my phone and emailed my family doctor about IUDs.
My family doctor is excellent. She emailed me back quickly saying a hormonal IUD would be a great option for me and allowed me to do my own research to choose the one I wanted — the perks of being a patient while also being in medical school!
The two available in Ontario are the Kyleena and Mirena IUDs. Ultimately, I chose the Kyleena, since it’s smaller and recommended for people who haven’t had children yet.
I had a prescription by the following morning and was booked for a phone consult in a month’s time.
The phone consult was a standard medical history, and a focused sexual history, covering the usual questions:
- Had I had any new sexual partners in the last year? If so, was protection used?
- Had I had any prior sexually transmitted infections (STIs)?
- Was there a chance I had an STI or was pregnant?
It took another month to schedule my insertion appointment for the first week of November 2020.
Insertion day arrived. My mom drove me there and stayed in the parking lot until I was done.
I had to go through COVID-19 screening in the lobby, which didn’t take long. I was administered a surgical mask to replace my cloth one and off I went upstairs to the procedure room.
The Bay Centre for Birth Control in Toronto, Ontario, is mostly run by family doctors who have a special interest in women’s health. I had a family medicine resident taking care of me under the supervision of an experienced family doctor.
I was a bit embarrassed because I was on my period that day, but the staff assured me it’s actually easier to insert an IUD while a person is menstruating because the cervix is softer.
I was swabbed for chlamydia and gonorrhea as standard practice, and then it was time to measure my uterus and insert the device.
The measurement and insertion hurt a lot — there’s no sugarcoating it. I’ve had heart surgery, and this arguably hurt more due to the minimal pain medication. As instructed, I took one Advil before my appointment.
The insertion felt like the worst period cramps I’d ever had. But it’s important to note the pain experienced during IUD placement varies from person to person.
After the insertion was done, I laid there for a few minutes, as instructed, to let some of the pain subside. I waddled out to my mom’s car, grateful she had insisted on coming; took another Advil; and sat with the seat warmer on until I got home.
At home, it hurt for a few more hours and I lay on my bed with a heating pad, taking more Advil periodically.
For the first month, I had daily cramping similar to intense period cramps. My uterus seemed quite angry at its new occupant. Again, this was my experience — it’s different for everyone.
That first month I was often found on my bed, flipping from my back to my tummy on top of my heating pad. I was less productive with my schoolwork and less physically active.
I’m a fitness instructor part-time, so that was a bit difficult. I had to push through a couple of virtual classes despite my cramps.
After the 1-month mark, the cramping slowly decreased in frequency. I’m now 5 months in and I typically have a bit of cramping associated with my periods and once or twice over the rest of the month, more sporadically.
I’m still in the “getting used to it” phase. I do still get a period — most of Kyleena recipients do. Mine has been generally lighter than pre-IUD, a little shorter, but associated with more days of spotting. All of which is natural.
It’s been a time of adjustments for me. Along with continuing medical school via Zoom, I had a pretty big change in my birth control.
Since getting my IUD, I stopped taking the birth control pill, which means that my body no longer gets a consistent dose of estrogen it’s been used to for years.
My body is recalibrating its hormone levels and starting to go through the ups and downs associated with each cycle.
I’ve noticed an increase in my acne since I stopped taking birth control pills, which can be associated with changes in estrogen and progesterone. I thankfully haven’t noticed any other changes since making the switch.
Overall, I’m looking forward to the next 5 years with my new accessory, with hopefully a bit less cramping along the way.
Bailey Bernknopf is a second-year medical student at the University of Toronto (UofT). She obtained her Master of Applied Science in biomedical engineering from UofT and a Bachelor of Science in health sciences from Wilfrid Laurier University. Her medical interests lie in primary prevention and her desire to pursue medicine stems from her experiences as a young cardiac patient. In her spare time, Bailey is a fitness instructor, with a focus on Zumba and strength classes. She founded Bailey’s Beat in summer 2020 to teach fitness classes online. Follow her journey on Instagram.