Seeking advice about IUD for 20yr old and best docs for same

My daughter has used the Skyla, which I believe is made by the same company that make Mirena, but is a smaller size for women who have never had children. She's had it for over a year now, and has never had any problems with it.  I have had a Mirena for 3 years and have had no problems, pain, or any side effects.  I told my daughter the insertion would be painful for about 2 seconds.  Her doctor gave her a lidocaine shot on her cervix to cut down on the pain.  She tried both birth control pills and the depo-provera shots, which she said caused her to have periods non-stop.  I think the hormone dosage of the IUD is much less than either a daily pill or the injection.  I recall the doctor said her periods would be lighter with the IUD, but I haven't asked her if this is the case.  Sorry, my daughter was not living in the Bay Area when she had her IUD inserted, so I don't have a doctor recommendation for you.  

Hi there! My kids don't have their periods yet, but I have already said to myself, "I would totally put them on Mirena if they had periods like I did when I was a teenager." Obviously the ultimate decision is up to them, but to me, Mirena was absolute heaven. I had no period - or maybe just very light periods - for five years, this after a lifetime of bleeding so heavily, and with such painful, debilitating cramps, that I would end up in the ER every couple years or so. 

From what my doctor told me, the copper IUD doesn't stop your periods, only acts as a birth-control device, so fie on that, I say. The hormones in Mirena are localized so they don't go throughout your body, as they do with the pill, so that is much better in my opinion - the side effects aren't as bad. The only side effects I experienced, I am pretty sure were just me worrying / hypochondria. (I don't say that to be self-derisive; I really do just think I get in my own way with this sort of thing.) 

I found the insertion to be a total disaster - the first time it was easy bc I had just given birth, the second time? Oy vey. I ended up not even doing it the second time and going with the Nuvaring, which might be another avenue you want to explore -- the hormones aren't as localized, but you don't have to commit. I dunno. The doctor I used is an NP, Alice Cannan at Sutter Health in Albany, and she is really cool. She gave me a bunch of different preparation drugs to prepare for my second try, but as I said, I just ended up not bothering, since I'm a billion years old and pretty sure I'm going thru menopause anyway. 

When I first read about Mirena, I got so scared of those negative online reports that I put off getting it put in and, voila, got pregnant with my second child. Obviously that was totally fine and great for me, probably not so great for most other people. I think sometimes the internet is not our friend, friend. Every single nurse in my doctor's practice at the time was on it. And whatever weight i gained was NOT the Mirena, as I took it out two years ago and I'm still the same weight. yay? 

Anyway just my two cents. Mirena is a godsend if you're a heavy bleeder, but if your daughter is sensitive tell the doctor that and she will do what she can to make it easier. 

Finding the right balance for birth control while managing heavy periods and a family history of health issues is not always easy.  My family has a history of blood clots, and my doctor was able to run blood tests to rule out whether I had any of the blood clotting issues.  I wonder whether your doctor can help put your family history of breast cancer and heart disease into perspective for each of you personally with some testing?  Knowing your own risk really helps when making decisions.

As to my own experiences with birth control and heavy periods, the only option that ever really helped was the pill.  There are different formulations, and some might help your daughter feel less moody.  After I had my kids and I was over 35, it was time to stop taking the pill.  I really, really wanted Mirena to work.  The insertion wasn't too bad.  Unfortunately, Mirena caused me to have a never ending period.  My ob/gyn thought that it would get better after 3-6 months.  I waited for 8 months, and I was still having a nonstop period.  I decided to get the Mirena removed and get the copper Paragard instead.  With Paragard, I have my normal, heavy period.  That is definitely the better IUD for me (and my husband definitely agrees).

Every woman is different, and I wish you and your daughter the best as you explore birth control options.

Mirena is THE BEST. I've had it 3 times now. Once it's in, basically no periods at all - maybe a bit of spotting early but that's it. I had a copper IUD earlier and had TERRIBLE periods on it. Mirena is painful to get inserted, sure, but upon nurse advice I took 4 advils 1 hour ahead, and it hurt for max 30 seconds during insertion, then I was crampy on and off for the rest of the day. I actually just got my final Mirena - I'm almost 40 and the mirena is good for 7 years (5 in US but 7 in Europe, so my doc said 7 is fine). I won't get another one because by the time it's 'done" I'll be near menopause! Also I actually have the Mirena only for period control - I have terrible long bleeding without it these days...

After a decade on the pill (starting in high school to control heavy cramping/bleeding) and then about a year of no hormones at all (because I worried the pill was negatively affecting mood/sexual desire) I got the mirena, and kept it in for 5ish years until I was ready to start a family.  After getting the Mirena, my periods gradually disappeared (lots of intermittent spotting for about 6 months, which was a little annoying because it was unpredictable, but was way better then 3 days of debilitating cramps per month).

Retrospectively, I wish I'd known about the Mirena sooner, and I highly recommend it to others. It had much less negative effect on my moods and yet much more effect on my cramps/bleeding than the pill.

It sounds like you've already researched options, but a great overview site for contraceptives is bedsider: https://bedsider.org/methods

Another option, like a mini-Mirena, is Skyla.  We're using it a lot where I work as a slightly smaller, lower dose (but less long lasting) alternative to Mirena. https://bedsider.org/features/261-hello-skyla-getting-to-know-the-newes…

You probably already know IUD insertion is supposed to be less painful if you're on your period.  Some people find it difficult and for others it isn't a big deal - taking over the counter pain medication before your insertion appointment will probably be recommended by your provider.

Hi, I happen to notice this as a parent of adolescent girls, but I'm also the director of the UCSF Women's Options Center. Some places/MD's don't routinely use pain control measures for IUD insertion and others do, so ask when you make the appt. (I'm a big fan.) Feel free to call us. We can also give you recs for docs in the E. Bay. IUD's are the most common choice of Ob/Gyn's for their OWN contraception and there is good evidence that girls and young women usually do great with them too. Mirena is very effective for bleeding control. On average, women have 90% less bleeding than their baseline. Paragard is not helpful for bleeding and usually makes bleeding heavier. No evidence yet regarding how Skyla affects bleeding for women who need help with heavy bleeding, but it likely would help at least a little. Mirena leads to very low levels of progestin in the system (only high in the uterus) and Skyla is considerably lower. Good luck!

I have had the copper IUD for 5 years.  The insertion was relatively painless as I recall. It felt similar to having a Pap smear.  One of the doctors at the Sutter OB-GYN group inserted it; which one I can't recall.  Based on my experience, I would not recommend the copper one if you are looking to lessen the flow of your period or if you're looking for a relief from PMS.  I say this because my periods became much heavier once I had my IUD inserted.  Moreover, I now have at least one day of intense cramping, which I never experienced pre-IUD.  I have been willing to live with these side effects because I wanted to not have to think about birth control, but I am now considering switching to the Mirena.

I'm curious to hear what others say about the Mirena, as I was actually contemplating seeking BPN advice about it myself. I've had mine in for about 5 months and it has not lived up to the hype for me. I switched to the Mirena from birth control pills largely in an effort to combat my hormone-triggered migraine headaches. A few weeks ago, I had the worst migraine of my life. I am also dealing with almost constant spotting. My doctor suggested I give it 6 months, so I'm ready to call it quits if things don't improve in a month or so. 

I did not find the insertion (done at Kaiser Oakland) all that painful, and just had a bit of cramping. But I'm also in my late thirties and have been through childbirth; a young woman without kids might have a different experience. Also, for what it's worth, my friends with copper IUDs complained about extremely heavy periods, so I would not think that would be a good choice for your daughter. 

Good luck to her; I hope she finds something that works with minimal side effects.

I am 45 and have been extremely happy with the Mirena (I am on my second one). I had used only barrier methods prior to pregnancy, and after having two children, tried the pill -- I also felt that the pill affected my moods (though it's hard to separate that from the effects of being a sleep-deprived parent!), and because of that I was hesitant to try the Mirena -- but my care provider talked me into it, warning that the copper key could cause heavy bleeding. I haven't found any effects of the Mirena on my moods, and I love the side effect that my periods have basically stopped completely. There was a transition period of light and constant spotting that was a little annoying, but it has been many years now since I've had to buy tampons! Love it!

Happy with Mirena

I have no experience with Mirena but did have the copper IUD for several years. With the copper IUD, my periods were heavier and I experienced more cramping but it worked well because my periods were never heavy to begin with. Another reason why I chose the copper IUD instead of Mirena is because I didn't want any hormones and also because the copper IUD lasts longer - 10 years versus 5 for Mirena. Insertion was very painful but worth it because I didn't have to worry about birth control  afterward. If anemia and heavy periods are an issue, You might want to skip the copper option since periods can become heavier and more intense. 

My daughter has a Paraguard IUD. I don't think any doctor can make insertion less painful. The uterus cramps up upon insertion of a foreign object and that hurts a lot.  She has heavier and more irregular periods than before she had the IUD. Since there are no hormones involved, it doesn't pose those risks (increased cancer, blood clots, etc.)  or benefits (lighter periods.)  It, and other IUDs, have other risks (uterine perforation, pelvic inflammatory infection, infertility, falling out/being expelled.) Vitamin B-6 taken daily can help with PMS in terms of mood, but not heavy flow.