using Cytotec to aid IUD insertion

[hexentier]

hi, this is my first post here.
right, my story is as follows. i have recently been diagnosed with Epilepsy and my Neurologist is putting me on Topamax to control the seizures. he won't prescribe it to me until i have my IUD inserted as the drug has a high risk of causing birth defects. as my family is complete, i have a daughter aged 11 and two sons aged 9 and 2, this is the best option as the topamax interferes with hormonal contraceptives and my husband won't use condoms.
last month i had two failed attempts at inserting the IUD, the first one on day two of my period and the second on day 5. i now have an appointment with the family planning clinic to have it inserted on the 9th of November, which should be day 3 or 4 of my next cycle. the doctor also prescribed me Cytotec tablet to insert vaginally the night before the insertion to soften the cervix and hopefully make it possible to insert it this time around.
i had all three of my kids by c-section, which is most likely the reason why my cervix is so tight and the cytotec is supposed to "loosen" it up.
can you please tell me if you ever used Cytotec to aid the insertion of an IUD and did it help/work? also, if you had a failed attempt when your doctor tried to insert the first time (without using Cytotec beforehand) and then the second time (using Cytotec) it worked?
i will be grateful for any replies. the first two attempts were so painful and i am dreading the thought of having to go through the pain again without the desired result of the IUD finally being in place.

[JenRN]

I had my IUD placed at my 6 week PP visit (vaginal delivery), so I have no personal experience with Cytotec in regards to IUD placement. However, I am a L&D nurse and have loads of experience with cytotec for cervical ripening inductions.

If you can reach that far, it tends to work better when placed directly behind the cervix. (Maybe enlist DH's help, as it's an awkward angle when trying to do it yourself.) Also, make sure you stay laying down for at least 30 minutes after the placement so it doesn't dislodge and fall out before it's dissolved. Cytotec can cause some nasty cramps, so keep some ibuprofen or a heating pad nearby just in case.

I know a lot of women use evening primrose oil to help soften their cervix (albeit at the end of pregnancy). Maybe that's something you can try from now until your appointment to help the process along??

[mitintraining]

I am not sure this is relevant, as I have never had an IUD placed. I would be concerned though about cytotec and the 3 previous c-section births. I am not sure on the research but I would think that it may change slightly since you are obviously not pregnant with a stretched uterus, but I would still be wary. I have used cytotec for a missed miscarriage and it was not pretty, the cramping was horrendous(not trying to scare you honestly) and I ended up hemorrhaging after I used it. I would first try the evening primrose oil, or look up more natural methods of cervical ripening. Although since you are not pregnant your body may not respond to these things. I would talk in depth with your OB about the possibility of uterine rupture and cytotec before you consent to its use. Good luck momma and I am so sorry you are having to go through this at all. Hugs and good vibes :for a safe procedure and good luck on the medicine to control the seizures.

[hexentier]

@JenRN: thanks for the tip with the correct placement as i had not actually been told where exactly to put it and i would have simply inserted it like i would a Tampon.... when you say behind the cervix, do you mean towards to back ie, between cervix and rectum or between cervix and bladder (i have no trouble reaching the cervix)
i think i will try the evening primrose but i don't actually know how i would have to use it? (i know, i'm a bit dim) is it taken as a tablet, or liquid or is it actually applied directly on the cervix and how will i know if it has worked? will the cervix feel different? (maybe i should mention that the doctor had no trouble getting the sounding devices tip into the outer cervix and that it was only the inner cervix that was too tight, how will i know if the evening primrose has worked?)

[gemasita]

I took Cytotec the night before I had my cervix dilated in preparation for an IVF cycle. (They had a difficult time transferring embryos the time before.) So I think the reasons for giving me Cytotec were similar to yours - just to soften the cervix so they could get through it easier.

I freaked when they first mentioned the Cytotec but I couldn't find ANY research on using Cytotec for cervical ripening in a NON-pregnant woman. All the concerns were related to induction because of the difference in hormones in a pregnant woman.

So I ended up taking the Cytotec with no problems. Not that everyone will have the same experience but again, I couldn't find any concerns related to using it for cervical ripening when the woman is NOT pregnant.

[AlexisT]

My understanding is that it's only an issue for induction of labor. It's both hormones and the strain on the scar from the baby, IIRC.

I had misoprostol for a missed abortion with a previous CS, and I am sure my RE would not have offered the choice if she felt it was not safe on a scarred uterus.

It didn't work for me so I can't say much about it (though everyone I know who did it successfully reported horrible cramping). You use a smaller dose for an IUD insertion than a missed abortion, though--you're just trying to soften the cervix, not start contractions. Good luck!

[SubliminalDarkness]

I had Cytotec to put my IUD in. I did some reading, and didn't feel concerned as I was not pregnant and it's not contraindicated for breastfeeding.