vaginapagina | Post IUD - wondering if I should have waited

odetta-to-detta.livejournal.com posting in

So...I'm just kinda curious. I had my Mirena inserted Friday afternoon (yay), and after everything had settled down down there and I didn't think I was going to pass out from pain, I decided to see if I could find my strings. I couldn't, but figured it was no big deal since a lot of women can't for awhile (still couldn't today. But I also have to keep in mind that my sense of touch is sub-par. So I could be poking them and not knowing it...).

My boy and I took it for a test drive today and had sex, and while I'm not really worried, the more I started thinking about it, the more I wondered:

How many women waited until they could actually find the darn things before having sex, and should I have? I'm pretty sure it's still there (though part of my mind hates me and keeps telling me it fell out when I pooped, though I know that's unlikely), but I do wonder if what I did could be considered risky business.

Like I said, I'm not really worried about it, just curious.

And would the Mirena float were it to fall in the toilet? I would imagine so since itss a bunch of plastic, but again. Curious :) I also can't find my cervix, so if anyone has any tips for finding it, I'd love you :X

(Also? Add me to the numbers of women who didn't realize how much the pill was affecting their moods. I've been off it for a week now and I'm back to my bouncy, happy, smiley self! I was never depressed or anything while on it, but I did notice a lack of energy that's usually associated with my character. I'm now back to boucing off the walls. Yay!)

Edit: I'm also beginning to wonder about the standards of the Planned Parenthood I went to.

They didn't make me take a pregnancy test (though I was on my period, I've seen so many insertion stories where the woman had to take one anyway, despite her period, so I have to wonder), and they inserted my Mirena without checking to make sure my BV was actually gone (I was diagnosed with it on Monday, so my last treatment was Friday night, quite awhile after my insertion. It was diagnosed as a "slight" case of BV, and they were aware of it, but I still wonder about that). They also didn't schedule me for a follow-up appointment, like I've seen so many women here do.

They also wouldn't do a PAP smear on Monday because I hadn't been sexually active for at least three years (just three weeks), which while I'm cool with that and unconcerned about my cervix, I'd never heard that before.

There were other things I thought about too while I was waiting in the room for my Mirena, but I don't remember them at the moment. Do these sound like little things and thus I'm being paranoid, or would you be concerned, too?

Flat | Top-Level Comments Only

From:

frolicnaked.livejournal.com

I did wait until I could find the strings, but I found my strings the day of insertion. Also, my then-partner was out of town at the time, so sex with him wasn't really possible until several weeks afterward.

Can't tell you for sure whether Mirena floats. But ParaGard (I kept my first one for awhile when I expelled it), even though it has metal around it, doesn't go -- PLUNK! -- straight to the bottom of a container of water; it kind of makes its way down slowly. I imagine that if a Mirena did not float, it would also not PLUNK! rapidly, and therefore you'd have a good chance of seeing it in the toilet in the unlikely event that you did poop it out.

I'd only question your PP about the BV check. According to the INFO Project (http://www.infoforhealth.org/globalhandbook/book/tools/pregchecklist.shtml#checklist) from the Johns Hopkins School of Public Health, you starting your period within a week is enough for them to be sufficiently certain of non-pregnancy to insert. (Though the INFO Project also does (http://www.infoforhealth.org/globalhandbook/book/fph_chapter10/fph_chap10_who_can_use.shtml#criteria) not mention (http://www.infoforhealth.org/globalhandbook/book/fph_chapter9/fph_chap9_med_eligibility.shtml#criteria) current BV as a no-go for insertion, though it's my understanding that it's generally preferred.)

Also, for follow-up appointments, it really depends on the clinic and the health care professional. My NP requested them, for my first two insertions at least, but I know a fair number of

iud_divas members who didn't have follow-ups. As long as you can contact them if you're worried about problems, I think you should be okay there.

From:

cadetsandkings.livejournal.com

I also did not have a follow up, but they did call to ask how I was and to ask if I wanted one.

I declined since I had no problems.

From:

cadetsandkings.livejournal.com

Personally I would not be concerned. About half the time I have a bit of trouble finding my strings, and I have had my IUD for over a year!

I just refuse to let it worry me. I also would not freak out about the BV thing- they were aware of it being a mild case and you were treated, so they probably deemed it appropriate to go ahead.

What I would do is call and ask to speak to the nurse on duty, and just ask these questions- you were wondering in hindsight why they did not do those checks, because you have heard of other places doing them, and you just want to make sure you did everything right. Also ask for a bit of help maybe finding your strings.

For me, I know my cervix is up and to the left a little bit; whenever I look for my strings I find them off to the side rather than poking straight down. Also mine are really short- the doc trimmed them up quite a bit for me so I would not have to worry about them poking Simon or myself/dangling oddly!

I used a cup only a little while after the insertion and I was fine, even though I was afraid that the sucking as I took it out to change it would rip my IUD out! It is most likely just first-week paranoia. But it can't hurt to call and get it checked out!

From:

marionravenwood.livejournal.com

They also wouldn't do a PAP smear on Monday because I hadn't been sexually active for at least three years (just three weeks), which while I'm cool with that and unconcerned about my cervix, I'd never heard that before.

This is the American Cancer Society standard. There's no need to do a pap test until you've been sexually active for three years because it generally takes much longer than that for cervical abnormalities to develop. I believe there's still a standard to do a pap test before IUD insertion, which contradicts the ACS guideline, but I believe the ACS guideline is more recent.

I also don't think there's anything wrong with inserting an IUD without a pregnancy test, as long as they were reasonably sure you were not pregnant (http://www.managingcontraception.com/qa/questions.php?questionid=337):

How to be Reasonably Sure a Client is Not Pregnant

If the client answers YES to any question, proceed to

the first box directly below and YES column.

NO YES

1. Did you have a baby less than 6 months ago, are you fully or

nearly/fully breastfeeding, and had no menstrual period since

then?

2. Have you abstained from sexual intercourse since your last

menstrual period?

3. Have you had a baby in the last 4 weeks?

4. Did your last menstrual period start within the past 7 days?

5. Have you had a miscarriage or abortion in the last 7 days?

6. Have you been using a reliable contraceptive method consistently

and correctly?

Client answered YES to at least one question.

If the client answers "Yes" to any one question, and has no signs or symptoms of pregnancy, then she can safely be provided with her method of choice. It is very important that the provider trust what the client says. For example, if the client says her menstrual period started within the past seven days, the provider should accept the client's word.

From:

foureyeddarlin.livejournal.com

This is the American Cancer Society standard. There's no need to do a pap test until you've been sexually active for three years because it generally takes much longer than that for cervical abnormalities to develop. I believe there's still a standard to do a pap test before IUD insertion, which contradicts the ACS guideline, but I believe the ACS guideline is more recent.

It it more because most women's bodies are able to fight off any cervical cell changes within 18 months of exposure and infection. The 3-year wait is to give body's natural defenses time to deal with an HPV infection and spare the patient unnecessary procedures. HPV infection does not become worrisome until it is persistent and the patient's body cannot deal with it - cervices are biologically very active in young women with high cell-turnover, and while you're very likely to experience cervical cell abnormalities as a sexually active young woman, older women whose cervices are not as active are most at risk for developing precancerous changes that their bodies cannot stop. It is a policy of leaving the cervix alone because it can take care of itself.

To the OP: I wouldn't worry - I also had a slight case of BV at my insertion and no pregnancy test. Since you were undergoing treatment, and there was no reason to think you were pregnant, there was no reason to delay insertion.

From:

archangelbeth

For cervix finding... Remember that not all cervices are in the exact same place. (As, well, sheesh, you know. *grin*) Anyway, if your uterus is at all tippy, it could drag the cervix around to all kinds of spots, from what I recall the last time we got cool pictures of tipped uteri. (Poke me, and I can google them up later.) So while it "should" be up there as a firm smoothness if you just run your fingers up the anterior (front) of your vagina till you bump into a tip-of-nose-firmness, there's a non-zero chance that it might seem like it's at the very "top" of your vagina, or off to one side a little.

Luck!

From:

arularia.livejournal.com

I have to check my strings at the surface of my cervix since they no longer hang down--they've curled up around my cervix. You might have to experiment with position to find your cervix. The first time I felt mine, I was squatting down on the floor. Since then, I've discovered that it's just as easy to find while sitting down as long as I'm not sitting ram-rod straight--my hips need to be slightly forward. Sometimes I have to bear down a little (kind of like when you need to have a bowel movement).

Your cervix also changes position during the month and even during the day. I discovered that even during those times when my cervix should be low, after about 6pm, it raises up and can be hard to find. My advice is that, every few days, try to find your cervix every time you go to the bathroom. This should help you learn if your cervix has any habits for moving during the day and how it changes during the month with your Mirena. (Since you've got rather constant hormones, it might not change that much.) Just explore around a bit. Mine is slightly off to the side and tucked up a bit behind my pubic bone.