I've had several questions about the Mirena, so I'm just going to create a post. Disclaimer: I am not a medical professional, have never been trained as a medical professional, and do not endorse any course of treatment. Also, insertions are different for everyone, as are each person's personal threshold for pain. Take this with a grain of salt.
This will be another one of those TMI posts, so consider yourself warned.
In December 2010 I found myself in my new doctor's office at Johns Hopkins, hoping she wasn't going to prescribe yet another oral contraceptive (since clearly that wasn't working). It took about 3 minutes of me describing my worsening endo symptoms before she stopped me and asked if I would consider an IUD.
I thought she'd never ask.
She told me that in Europe Mirena has widely been accepted as a treatment option for endo, but because the FDA hasn't approved it here it is only considered birth control. She explained that the progesterone from the IUD would be released directly into the uterus, closer to the endo growths, so that it should help control my symptoms. It also keeps the hormones more localized, instead of coursing through my bloodstream as per oral birth control pills.
The plan was to use Mirena in conjunction with oral contraceptives for 3-4 months (it can take this long for the body to adjust to Mirena), and then quit the pills.
She petitioned my health insurance, who approved the insertion, and I completed my pre-insertion bloodwork. By this time it was February so I scheduled my insertion appointment for early Spring.
I've heard that many doctors are unwilling to insert Mirena if a woman hasn't had a child. If you have a similar doctor, find a new one. This is an old-fashioned approach and the numbers prove that there is no greater risk of complications, as long as you're willing to deal with the pain!
She told me she was going to give me a prescription to 'loosen my cervix' to take the night before the insertion since I'd never given birth. She didn't tell me the prescription is used to induce labor, but that's exactly what happened.
I took the medicine about 10PM and went to bed. At 2AM the contractions woke me up. It was terrible. Nothing helped - curling up into a ball, walking, laying still. It hurt no matter what. The magic of television had led me to believe that contractions come in waves, with periods of relief in between.
That's not what happens.
The contractions don't go away, they just ebb and flow in severity.
So by 8AM, my uterus was still contracting but sore at the same time. Interesting.
Brint stayed in the waiting room while I went back. I was expecting a quick in and out appointment, but later I wished I'd asked him to come with me.
She started out by giving me a shot in my cervix - I don't know if it was lidocaine or what, but it was for numbing purposes. Then it got pretty rough. She used a metal device to open the cervix, and then inserted the Mirena. It was kind of like inserting a tampon - there was a clear plastic straw that held the IUD, all folded up. The straw was inserted into the uterus, the IUD was pushed through the end, and the straw pulled out.
Easy enough, right? It was terrible. I was so certain that the contractions were going to be the worst part, but I was wrong. I got sick to my stomach due to the pain. I asked her how bad it would have been if my cervix hadn't been dilated a bit, and she just put her hand on my forehead and said, "much worse than this, dear". The doctor and nurse left me curled up in a little ball on the table until I felt better. She said I would be in intense pain until my uterus de-contracted, but that it was going to be knotted up for a while due to the IUD. I took some prescription strength ibuprofen and waited.
I wanted Brint, and he wasn't there, and I just wanted to go home, so I crawled over and put my clothes on and walked out even though the medicine hadn't kicked in yet. I was as white as a sheet from the pain, but I made it to the waiting room.
I laid in the back of the car on the way home and immediately went to bed when we got there. It took about 12 hours for the pain to subside. I bled some that day, but by the next night it stopped. After that, I would hurt erratically, usually when I tried to pick up anything heavier than about 8 or 10 pounds.
Mirena pain came and went after that. I learned that pain = spotting, and the doctor assured me this was normal. She said my uterus just had to get used to that 'thing living inside of it'.
And after about 3 months it did. It was wonderful, for about 6 weeks. Then the endo pain came back (I can tell the difference between IUD pain and endo pain - it's very different), so I never stopped taking the birth control pills. I was afraid the pain would just get even worse. Except that I took my last one last night.
Since I've been soy (and pain) free, I've gotten the confidence to finally follow the doctor's orders and see if the Mirena really will manage the pain. I'm tired of double-dosing on hormones, and I don't like what it could be doing to my body. So fingers crossed that Mirena can hold up its end of the bargain the way it did in the beginning!
