Delirium (n2narcosis) wrote in iud_divas,

Mirena Insertion and Implanon Removal

Today I became a Diva!

I wrote a week or two ago asking if anyone had experience switching from Implanon to an IUD like Skyla or Mirena and did not get any comments so I figured that maybe it was not something that happened a lot. I wanted to share my experience in case anyone else in a similar situation had questions.

Really Quick Background: I'm 26, no kids, in a long term monogamous relationship. Since I was 16, I have been on various name brand and generic BCP's, the NuvaRing, and most recently Implanon. Due to side effects from Implanon, I chose to switch to Mirena, which has fewer hormones that act more locally and less systemically than the hormones in Implanon do.

I did most of my research here at IUD_divas and read nearly every page of this community before deciding on the IUD. I had originally chosen Implanon thinking I'd try an IUD next if it didn't work out and at that time I already knew of this site. Now, a year and a half later, I came back to IUD divas when I decided it was time to switch as Implanon wasn't working as well for me as I'd hoped. I chose Mirena because I wanted fewer hormones, but didn't want the heavier, crampy periods from my younger years that not having any hormones could bring.

I used to find an ob/gyn in my area. I live in Boston, MA, if you need a recommendation, I highly recommend Dr. Michelle Lafornara. You can find her on and read her reviews from other patients. You can even book an appointment online. The office was really nice and even called me to let me know they were out of Skyla (Bayer is back ordered) a week before my appointment and gave me options such as using Mirena, or having them save me a Skyla when they got more in stock. The doctor herself even got on the phone and answered some of my questions! At that point she had never met me before and still took time to talk to me so it made me feel really great about choosing her for getting my IUD.

I did some research and found an article online about a study they did on oral surgery patients and pain management. I am not a doctor, so please don't take any of this as medical advice, but the article talked about how taking acetaminophen and ibuprofen can be as effective as narcotic pain meds for pain management and they work better together than either one does by itself. Because they work differently in the body, they can be taken together as long as you follow the dosing guidelines. They had a few guidelines for different amounts of pain.

In the end, I just followed the instructions on the store bought bottles I had. I had regular Advil (ibuprofen) and Extra Strength Tylenol (acetaminophen). Per the instructions for both, I took the amounts allowed for adults (2 Advil aka 400mg of Ibuprofen and 2 Extra Strength Tylenol aka 1000mg of acetaminophen). I had a normal lunch about an hour and a half before the appointment and I took the Advil and Extra Strength Tylenol 30 minutes before the actual insertion started (or about 15-20 min before the appointment time). I also do happen to be on my period, with today being the day after the heaviest day of my period.

The doctor went over all the information about the various IUD's and all their risks and effectiveness information. Basically, she condensed a lot of the info on this website into a 5-10 minute talk about my options. I already knew all of this but I was happy she went over it anyway. Then we discussed whether to take out my implant first or put in the IUD first. This is because in some cases it is possible to have trouble putting in an IUD (as many here have shared) and in some cases it is difficult to remove the Implanon. Since I would rather go with double protection than none, in the end, we decided to put in the IUD first. That way, if the insertion didn't go as planned I'd still have the implant and we wouldn't have to go cutting into my arm for it unnecessarily. And even if the IUD went in fine and she couldn't get the implant out, I would just be doubly covered until we could get it out, which is not dangerous, just more hormones than you'd likely really want.

With all the stories I read here, I would say that my insertion went very easily. I would call it a slightly more uncomfortable version of a pap smear where they do a little more poking around than normal. My doctor *does* numb the cervix, so I did feel the needle when she did that. It felt like getting a flu shot *inside* my tummy.... very weird, but not any more painful than a flu shot (2 out of 10 on the pain scale). After that she let me know when I would feel cramps, and she told me twice to expect a cramp so I assume that was for the sounding and the insertion. Both times I did feel a poke and then a cramp in my lower belly, both nothing worse than a moderate period cramp. I've had more painful cramps in my life. I knew there was something there and my body was just reacting. It didn't *hurt* it just felt like pressure and cramps. She asked me a few times if I was ok, and I was, and after the second "big cramp" she warned me about passed, she took out all the tools and the insertion was done (both cramps were around a 4 out of 10 on the pain scale)!

She said not to have anything in my vagina (Penis, Tampons, etc...) for 2 days and that I need to go back to see her in 8 weeks. She did *not* tell me what I measured at, even when I asked if my uterus was big enough, and said only that the Mirena fit without issue. I got the feeling she didn't want to say a specific number because she didn't think I needed to worry about it as long as I knew I could accomodate the IUD. I didn't really need to know the number and she was confident the Mirena is sitting fine (and the insertion was so easy) so I didn't care that she'd rather not say. My boyfriend was there for moral support and also because he finds the whole IUD thing fascinating and wanted to be there to see the procedure and he tells me the whole thing from speculum in to speculum out was 2.5 minutes. I would agree that it was super fast and the doctor was efficient and sure of herself during the whole procedure. She was really great! And that was that for the insertion!

The removal of the implanon actually took much longer than the IUD insertion and was (for me anyway) more uncomfortable. She had to inject lidocane all around and along my implant and the lidocane kind of burns so that was the worst part (3-4 on the pain scale). After that she had to make a small cut and dig around for the implant (while pushing it from the other end) until she could grab it to pull it out. It took a lot of pushing, digging, and making the cut bigger to finally get it out. Everything after the lidocane shots felt just like pressure (like she was pushing on my arm but it didn't hurt). It took about 5-10 minutes.

After that was done, I set up an appointment for my follow up visit. It was clear at the front desk that they do a lot of these insertions there because the minute I walked up and said I needed to make another appointment she said, "Ah yes, the 6-8 week follow up..." and started to put me into the computer. My boyfriend drove me home and on the way the numbness in my cervix and my arm wore off, so both started to hurt. I had mild to moderate cramping in the car that felt more like a constant cramp than sharp distinct cramps. I am now at home 3 hours after insertion and so far I've had one bad moderate cramp that happened suddenly and then passed in a few seconds and the baseline constant cramp/ache is till there. All of the baseline cramping I've had so far rate on a scale of 2-3 with the more moderately painful short one being a 4 on a pain scale of 10. The reusable heating pad my boyfriend got me is wonderful for the constant achy cramp and unless anything gets worse I don't plan to take any more medication tonight.

So that's that. Please feel free to message or comment if you have any questions. I will try to update in a month and then again at 3 months and 6 months so there will also be long term information on what it is like switching from Implanon to Mirena in terms of side effects. For now, I'm hoping the IUD stays in place and that I'm good for the next 5-7 years!
Tags: hbc, healthcare professionals, hormones, insertion, mirena

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