Originally Posted by KKmama
I'm really curious about IUDs, too. I guess I'm most curious about what the ramifications are if you have an IUD and you do get pg. Also, I'm wondering what you might know about how IUDs impact ovarian cysts and milk supply (I've heard/read negative things about Mirena, and I couldn't pin my ob down with a straight answer).
The IUD is the most effective type of contraception out there. It protects mainly by inhibiting sperm and making the uterus “inhospitable” to implantation. Studies have shown that fertilization of an egg happens very rarely, and when it does, implantation is inhibited. The Mirena also has progestin, which thins the endometrial lining and inhibits ovulation in some women. So the bottom line is that if you do get pregnant, it is more likely to be an ectopic pregnancy, because the IUD prevents implantation more than it prevents fertilization. HOWEVER, that pregnancy was destined to be an ectopic anyway, regardless of the IUD itself; it does not cause
If a woman with an IUD gets pregnant with a normal, intrauterine pregnancy, there is a 50% chance of having a miscarriage (up from about 10-20%, I think, with any other pregnancy). One of my gyn books says, “After removal of the IUD, the spontaneous abortion (i.e., miscarriage) rate decreases to about 30%.” My preceptors recommend taking the IUD out because carrying a pregnancy to term with an IUD increases the risk of infection. But here we’ve just had some stories of people keeping it in, so…I don’t know. I’m guessing you probably don’t want the Mirena in through a pregnancy because of the hormone.
As far as milk supply, the IUD is much less likely to impact supply than combination pills. As long as you start after your supply is well-established, at 6 weeks postpartum or more, it shouldn’t make a difference in supply at all. In the clinic where I was last quarter, we put it in breastfeeding moms all the time. I am afraid I don’t know that much about cysts. I see on some of the public web sites that the Mirena “causes ovarian cysts,” but I’ve never heard of that in any lectures or from any of my preceptors. I will ask this week, though. Now I’m curious.
Originally Posted by emmalola
I'm another one of those skeeved but intrigued by an iud. since i get migraines from hormonal birth control, I'm pretty limited to just the copper iud, which i hear has worse side effects. not so great. I'd love to get a mirena, but for the cost, I hate to think of having to get it removed instantly if migraines pop up again. what a waste.
It is my current understanding that combination contraceptives (pills with both estrogen and progestin) are more headache-inducing than the progestin-only types (a few pills and the Mirena IUD). Also, the progestin in the IUD has much less systemic effect; it mainly works locally on the cervix and uterus, a little on the ovaries (about 30-40% of women stop ovulating). But some women find that even progestin-only methods make their headaches worse. Do you know what type you were on?
Originally Posted by elsanne
I realllly want to hear more about how the IUD could be more effective than a tubal ligation. I don't see how that's possible. I think I'm going to get another IUD despite this experience because of all the options, that's the only one that still appeals.
Paraguard (copper): 0.8% failure rate
Mirena (progestin): <0.5% "with perfect use" in one book and 0.7% in another
Female sterilization: 0.5%
So you guys can see that I’m biased. Unfortunately no type of contraception is perfect, IMO, but this is the best of the options. I love my Mirena. Short, light periods, low risk, less systemic effects.
P.S. Hi, Lisa!!