What Happens After You Get Your IUD Out?

Illustrated by Anna Sudit.
An IUD is deceptively simple: Once you get one all up in your uterus, you can forget about getting pregnant, taking a pill every day, and, if your IUD is hormonal, having a regular period. Yet, despite the fact that many women love their IUDs, they can come with a surprising amount of hassle for others. That means IUDs are definitely not an ideal birth control option for everyone with a uterus — including me.
In truth, I was totally fine with the Yasmin birth control pills that I took pre-IUD; my period came like clockwork, and taking the pills made my hair crazy-thick. But all my cousins were getting IUDs, so I wanted one, too. I ended up getting the Mirena two years ago because it seemed like a lazy miracle for someone who's perpetually confused about health insurance and can't be bothered to refill a pill pack every month.
But having an IUD sucked.
Although I can't say with 100% certainty that my IUD is to blame, after the insertion, I started to lose my hair, began getting crippling migraines every month (reported by 16% of people who have adverse reactions to Mirena in the US), and got gorgeous cystic acne all over my face. For me, it was clear that my IUD had to GTFO after a year of hoping the symptoms would go away.
Other people might choose to have their IUDs removed because they don't like not getting a regular period, they want to get pregnant, or the monthly cramping is too annoying. But getting your IUD out is almost as big of a decision as it is to get one in. So you should give it some serious thought before pulling the trigger — or string.
The good news: Getting your IUD out doesn't hurt nearly as badly as it does going in. In my experience, it didn't hurt at all. That's because, when you get an IUD inserted, sometimes doctors have to dilate your cervix to get it in there. But when it gets removed, "we very rarely have to do anything more than just gently pull on the strings," says Shree Chanchani, MD, a gynaecologist and clinical assistant professor in the Department of Obstetrics and Gynaecology at NYU Langone Medical Centre.
Once the freaky piece of plastic comes out, things may get interesting. Just like getting an IUD in, having yours taken out can come with side effects — whether you're on the copper IUD or one with hormones, such as the Mirena. Many women experience spotting or cramping after their IUD comes out, but that's usually normal and can be caused by the device physically brushing against the inside of your vagina, Dr. Chanchani says.
But spotting and cramping are pretty mild compared to some of the other reported side effects. If you Google "Mirena crash," you'll find endless message boards with stories from people who claim that, about two weeks after having their IUDs out, they started getting a ton of terrible side effects — from mood swings to nausea and breast swelling. Of course, any time you stop taking hormonal birth control you could experience symptoms like those associated with the "crash" thanks to a sudden change in the amount of extra hormones in your system. (The Mirena releases a small amount of synthetic progesterone, which thickens your cervical mucus to prevent sperm from meeting up with one of your eggs. Sometimes it also suppresses your periods along with any associated symptoms.)
However, despite the internet's insistence, it's still unclear whether or not these symptoms can truly be blamed on getting an IUD out. "The overall amount of absorbable progesterone is quite low with a Mirena IUD," says Dr. Chanchani, meaning that taking one out likely wouldn't have a huge impact on your body. According to her, the worst thing that could happen post-removal is that, thanks to the progesterone withdrawal, you get a period. Plus, the recent research about hormonal IUDs doesn't suggest the crash is really all that widespread.
The next thing to consider once you're IUD-free is whether or not you want to go on another form of birth control. Without birth control, there's a very real likelihood that you could get pregnant, Dr. Chanchani says, "so it is very important to have an alternative plan." If you're not planning on getting pregnant, you should start a new kind of birth control immediately after you have your IUD removed. And it's a good idea to talk to your gyno about what you want to try next before your IUD comes out so you can get started on a new method right away.
Luckily, I didn't go through "Mirena crash" or notice any side effects once I got my IUD out. And getting back on the pill was a surprisingly simple process: I was worried that my gynaecologist would make me wait before starting a new birth control pill, but the office sent me home with a script for new pills that I filled that day.
I'm still occasionally getting migraines, and I'm still reckoning with having a thinner ponytail, but it's a relief to not have an IUD. The moral of the story is that, while IUDs are highly effective and work well for many people, an IUD might not be the best form of birth control for you to be on — even if it seems like the most convenient method and everyone else is doing it. Talk to your gynaecologist about what your choices are, and really consider the possible side effects of each option. There simply isn't a one-size-fits-all birth control method. Your body is unique, and you have a right to access the kind of birth control that's just perfect for you — even if it takes some trial-and-error to find it.
Ed. note: This is a first-person account from a writer in the US – the healthcare system there is very different from the healthcare system we have in the UK. Here, an IUD refers to an intrauterine device (commonly known as a coil), which is non-hormonal. Mirena, which Cory talks about above, is a form of IUS, or intrauterine system, and works by releasing a hormone.
If you're considering birth control and are unsure which is the best method for you, consult your GP or visit your local sexual health clinic. There's also lots of handy information here.

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