My son is now 4 years old, and after a now pretty well-documented unusual journey into pregnancy and birth, I sought out a post-partum contraceptive choice that would a) actually work, b) not riddle me with too many side effects while I was trying to wrangle a tiny person, and c) come recommended by healthcare professionals. After a chat with my midwife, my GP and my local sexual health clinic, I opted for the Mirena coil; a modern, progestogen-emitting IUD that would last five years.
IUD stands for Intra-Uterine Device. It’s also sometimes called an IUS, which stands for Intra-Uterine System. Generally speaking, the terms are interchangeable, but if we’re being exact, the ‘system’ portion of the acronym refers to the fact it actually emits hormones, which other coil options do not.
The Mirena has been an empowering experience for me. As someone who spent 17 years on the pill and had never discussed any other form of contraceptive with a doctor (despite seeing them every 6-12 months for regular checks because of the risks associated with the very medication I was being prescribed), I was understandably shaken when I conceived despite using it as directed; and in the end, continuing to use it for 6 months while pregnant because I didn’t know I was. After almost two thirds of my life blighted by the faux-chemically-induced periods the pill brought monthly, a general feeling of exhaustion and teenage spots that never ceased, the Mirena has changed my experience of contraceptives entirely.
The Mirena Coil: my experience with it in place
I, like everyone else with a phone at their fingertips and Google as the default preferential source for the world’s knowledge, searched online for other’s experiences of the Mirena. And what did I find? Much like giving birth, blogs, articles and even news stories broadcast horror stories of painful insertions, poor placement, miracle babies birthed holding coils in their hands and displacement panics. In truth, that’s why I wrote my original experience: because while it was uncomfortable, the insertion didn’t hurt me, and the side effects have been absolutely minimal.
Within a few months I had no period (a true revelation for anyone who’s ever menstruated) and while I did originally blame my new hormone balance for a patch of bad skin, I switched skincare products not long after and actually found that the blame lay with my own poor choices. Now, almost 5 years later, my Mirena is almost at the end of its functioning life (they hold approximately 5 years worth of hormones, at which point you can have it removed and a fresh one put in, if you choose) and so it’s time to have it taken out. I can honestly say that the Mirena has been the best contraceptive I have ever used, but it’s time for me, after 20+ years, to give my body a little break from synthetic hormones.
The Mirena Coil: removal consultation
I contacted the local sexual health clinic who had inserted my Mirena some 4 years earlier and enquired as to the process for removal. They were really on the ball and advised that first I’d need a consultation with a nurse, which would have to be on the phone rather than in person due to their strict adherence to social distancing and enhanced clinical safety practices due to the current monkeypox outbreak. Awesome. I mean, I love talking about my flaps, but didn’t really want to walk all the way to the clinic in my precious child-free time to do so for 5 minutes before schlepping all the way back. So we made a phone date.
Actually, in an amazing turn of events for the NHS, the nurse called early (I love you NHS, but it’s true) and we had a good chat about how the IUD had served me so far. We discussed my child, my current sex life, my current relationship, the last time I had a sexual health screening and my current and previous cervical health.
NB here: if you haven’t had a recent sexual health screening or haven’t had one since sleeping with your most recent partner, this is a good opportunity to get one done. While your sexual health clinic probably won’t refuse you service altogether, they may insist you’re screened and everything’s back all clear before the IUD is removed. Similarly, if you’ve missed a cervical screening or had dodgy results back from one without further investigation, they may want to wait a little while first.
She advised that it sounded like a simple job and booked me in for a removal the week after – in person this time, of course. We were all set. I still had time to change my mind if I wanted and had the clinic’s number to give them a bell if I wanted to ask any more questions. Good to go!
The Mirena Coil: removal procedure
I headed for my local sexual health clinic at the agreed time and date, and having asked those following me on Instagram to share their own experiences, was armed with some basic painkillers (which I dutifully necked 30 mins before the procedure) and a big pad for my pants. Upon arrival I was greeted by a very empty waiting room (thanks to safety procedures regarding monkeypox) and was asked to give a urine sample. Oh shit. I had done a pretty huge wee before I left the house and definitely did not need another. Thankfully, when I questioned the necessity of this I was told not to bother and not asked about it again – so I guess it wasn’t a must-have for me, anyway.
Within minutes of arriving I was sat opposite a nurse who offered a chaperone and chatted through my notes. It turned out to be the same nurse I’d had my phone consultation was, which was great and so with little more to cover, I took to the bed.
Bottom half off (bar my socks, I’m choosing comfort over couture every time when it comes to yet another NHS employee gazing up me), the nurse inserted a speculum and visually checked my cervix. For me, this was not painful – speculums are never the best thing in the world but a visual check is considerably more gentle than the feeling of the lengthy cotton bud you experience during a smear. With both strings of the Mirena easily visible, it was right where it was meant to be and so could be easily removed.
Making sure I was ready, the nurse counted to three and asked me to cough after the count if I consented to its removal. She counted, I coughed, and then… nothing. That was it. My Mirena was out and I had literally not even felt it. A little bewildered, I asked her to show me it and yep, true to form, there it was. A slightly mucus-y white t-shaped IUD. Out and back in the big wide world.
At this point I got re-dressed (this time with my hastily-packed pad), we had a quick chat about my cervical scarring (a lengthy topic for another day) and she advised me of effective contraception options in the meantime; but advised that I would be fertile immediately – and that if I had had unprotected sex within the last 5 days, indeed could conceive from that. We also discussed that now sexual health clinics are able to issue Mirena IUDs to pregnant individuals to take to hospital with them for immediate post-partum insertion (where medically safe and appropriate). This seems like a great way to bypass intervention later on and should help negate some unwanted pregnancies in that post-birth super-fertile period, too.
Job done. I headed home.
The Mirena Coil: removal side effects
I was lucky enough not to bleed from my Mirena removal, but that’s little surprise as it’s no secret half of my local gynaecological unit have inspected my cervix. I was prepared for, and had expected, some light spotting, but this never arrived. I did feel pretty knackered later on and indulged myself with a quick nap but… I can’t guarantee that wasn’t just psychosomatic and what I wanted to do with my afternoon.
What I wasn’t perhaps prepared for was a period just days later. Having spent so long on the pill before then getting pregnant, I’ve never really had ‘proper’ periods and have zero idea as to what’s a regular cycle for me. As a result, I’ve downloaded Flo, a period-planning/cycle-tracking app that I can log symptoms on and get advice from specialist medical professionals. It’s likely my cycle will take a few months to even out, and the app is guiding me through that, but for now (touch wood, grab lucky charm etc etc), it’s nothing too painful or traumatic.
I’ve truly loved my Mirena and it’s served me well. I’ll definitely have another inserted in the future and, if I can, keep it as my lifelong contraceptive choice – until it’s overtaken by something else with zero side effects and less intrusion. For now, I’m IUD free… so let’s see what comes next.