Kelly Baden, 39, the director of reproductive rights at the State Innovation Exchange, got her IUD in January of 2017 — "right after the inauguration," she tells me in an interview for Elite Daily. Working as an advocate for reproductive rights, she heard a lot about it from friends thrilled with the long-acting, reversible contraception. "I'd been thinking about it for a long time, and it really wasn't until [President Donald] Trump was inaugurated that the real threat of the [Affordable Care Act] ACA and the contraceptive coverage mandate really catalyzed me to more seriously consider getting it," she says.
But, she believes, it pretty quickly started causing her problems.
"Insomnia, to a degree I've never had before in my life, just literally up all night," she describes. "I was having increased anxiety, and my body just felt off."
She thought about what might be causing those changes and quickly came to the conclusion that it was likely her Mirena IUD, despite the fact that mental changes aren't a listed side effect. Less than six weeks later, she had it removed.
"It was immediate relief," she says. "I felt back to my usual self."
In the year following President Donald Trump’s inauguration, requests for IUD insertions rose by 16 percent from the year before, according to data from health care company Athenahealth. Around the election, the spike was even more significant — Planned Parenthood alone saw a dumbfounding 900 percent increase in patients seeking IUDs in the week after the election, according to Quartz. It was a trend many attributed to fear about what the notoriously misogynist Trump — who said that women who got abortions should be "punished," repeatedly talked about repealing the ACA (which guarantees no-copay contraception), and promised to appoint Supreme Court justices to overturn the landmark abortion rights case Roe v. Wade — might do to hinder reproductive rights.
But the talk around the IUD as a reaction to Trump can almost make it easy to forget that an IUD isn't just a way to stand against an anti-woman administration; it's also a medication that can have some major effects on your body. And like any medication, it'll work great for some people... and not as well for others.
One of the benefits of having so many kinds of birth control is that you can find one that matches you.
In 2018, the everyday news out of the Trump administration can feel like some over-the-top Handmaid's Tale fanfiction, so it's no wonder that an IUD might feel like easy protection against any threat to reproductive rights. And now, with news that Trump got to pick another name for the Supreme Court, nominating D.C. Circuit Court Judge Brett Kavanaugh on July 9, many are concerned that abortion rights are at risk and the Great IUD Rush appears to be starting all over again. As soon as Justice Anthony Kennedy's upcoming retirement was announced, social media flooded with people apparently hitting speed dial to their OB-GYN.
There's a reason so many people sing the praises of the IUD: it's kind of a birth control promised land. The IUD as a method of contraception has a more than 99 percent effectiveness, according to Planned Parenthood. It's almost impossible to not use correctly. It lasts anywhere from three to 12 years, depending on the type you get, and there are several different brands and styles which vary on what (if any) hormones are delivered into your system. Once it's in, you get to just kind of... forget about it and go about your life, as it doesn't require any upkeep beyond the occasional check that it's still in place. Essentially, your birth control could outlast any president. And while they are very expensive — running up to a cool $1,300 — under the ACA, insurance companies are required to cover the cost of an IUD device and its insertion. Is it any wonder so many people absolutely love it?
Eventually, I was just having so much anxiety about it that I was like, 'I just have to have it removed.'
But for some women, the IUD promised land is more of a mirage. Planned Parenthood's website notes there are a few categories of people who should not get an IUD, including people with a history of uterine, breast, or cervical cancer, who are inclined towards pelvic infections, or who are allergic to copper (in the case of the copper-wrapped Paragard IUD). But even if you don't fall into one of those categories, that doesn't mean you're guaranteed smooth sailing.
Like any medication, there are side effects — all five of the major IUD brands available in the U.S. warn of possible symptoms like bleeding and spotting, pelvic or stomach pain, or pelvic inflammatory disease. But though there's been significant discussion of the ways hormonal birth control may affect your mood and mental health, none of the four IUD brands that use hormones — Mirena, Kyleena, Liletta, and Skyla (the fifth IUD brand, the Paragard, does not contain hormones) — mention possible mental health effects. Elite Daily reached out to Bayer, the parent company for Mirena as well as the Kyleena and Skyla, for comment regarding side effects, but did not hear back.
Gigi Engle, 27, got her Mirena IUD shortly after Trump's election. "What if birth control becomes hard to get or becomes illegal?" she remembers thinking, as she tells me in an interview for Elite Daily. (Engle was previously an Elite Daily employee.) Engle recalls she thought she could feel her IUD inside her abdomen, and it made her uneasy and anxious. She adds that heavy exercise made her cramp and spot for the six months until she got it removed, a known side effect, but one that made Engle uncomfortable. A check from her doctor said everything seemed fine, but Engle couldn't shake the discomfort. "I was just so hyper aware that there was something inside of my body," she says. "Eventually, I was just having so much anxiety about it that I was like, 'I just have to have it removed,'" she says.
Dr. Sarah Horvath, a OB-GYN Pennsylvania and Fellow with Physicians for Reproductive Health, says that mental health issues from IUDs aren't common, in her experience. "While I appreciate the realities of the patients you spoke to and do not discount their experience, these are not side effects shown in studies," she tells Elite Daily in an email. But she also adds that different forms of hormonal birth control can have different effects "depending on the unique makeup and experiences of each patient."
"If you find that your mental health or mood is affected by your menstrual cycle, it’s important to discuss this with your reproductive health care provider," she says.
Dawn Huckelbridge, 36, who also works in reproductive rights, describes her experience to Elite Daily as "often uncomfortable," with "unexplained pain," which she attributed to her Mirena IUD. "It's hard to put your finger on [whether an IUD is the cause of discomfort], and I think doctors are reluctant to try to figure out what's causing it sometimes," she says.
These women's experiences are a reminder that birth control methods, no matter how good they look on paper, are not one-size-fits-all.
"It's not uncommon," says Dr. Kristyn Brandi, an OB-GYN in California and a board member of Physicians for Reproductive Health, when I ask how often she sees women who decided an IUD isn't right for them. "I think it's great for people to try different types of birth control and see what works for them, but I agree that IUDs don't work well for some women."
But that's the whole point, too: "One of the benefits of having so many kinds of birth control is that you can find one that matches you," Brandi says. She adds that trying to force yourself into liking it could actually make things worse.
"There’s actually evidence that shows that even though the IUDs and implants are very effective, the most effective method is the method that women are happy with and use consistently," she notes. "So you can be a great pill taker and that works well for you and you won’t get pregnant. But if you try the IUD and you hate it, there’s a very likely chance you’re going to take it out and be at risk for pregnancy."
The people who have and love their IUDs, really love their IUDs.
It should go without saying that your choice of birth control has nothing to do with how "good" of a feminist you are. But while so many people are singing the praises of an IUD, admitting you don't like your own can feel fraught. Engle, a sex educator and writer, says when she told her doctor she wanted to remove her IUD, she felt judged. Her doctor discouraged her from having it removed and advised Engle to give it a few more months, which Engle refused to do. "I think she just kind of thought I was being a drama queen," she says.
But it was also hard because of how much Engle wanted to love it. "I remember just feeling really disappointed that I didn't like it," Engle recollects. "I also just felt like I was being a baby." And while Engle's doctor's reaction might not be the norm, there are plenty of people who think that the IUD is the bee's knees.
There's definitely a culture around people who love their IUDs. Both Engle and Baden say before they got their IUDs, they'd only ever heard good things about it. "I think there is an IUD evangelism among many people," Baden says. "I had a lot of friends who had IUDs and raved about them ... The people who have and love their IUDs really love their IUDs, and they really love to talk about it, which I think is great."
In fact, all three women I spoke to — Baden, Huckelbridge, and Engle — are quick to emphasize that for those who like their IUD, it can be great, and they in no way want to discourage people from considering it.
I wish there were more resources for women and providers to share the good and the bad.
Huckelbridge attributes some of the overwhelming praise to the fact that, well, some of the options available really suck. "There's a lot of not great choices when it comes to contraception currently," she says, "so I think when women find something that they have any good experience with, they're very quick to talk about it."
For those who find or decide an IUD isn't their best option but still want to make sure they're covered, Brandi recommends asking your doctor for a longer-term birth control prescription or just to renew your existing prescription. "If you've used that method before, they're usually very happy to just write another prescription that you can just take to the pharmacy and not have to wait for a doctor's visit," she advises. She also suggests apps like Nurx, which will deliver birth control of your choice to your door, even if you don't have insurance.
"There’s so much variation in birth control and women’s reproductive goals in general," Brandi says, "that you really have to take in in a lot of different factors to figure out the perfect birth control method for the individual person."
Getting an IUD isn't a pink badge of honor for those who want to assert their reproductive rights. It's merely a choice, and one among many — after all, it's being able to decide what's right for you that's empowering, no matter what you end up choosing.
"I wish there were more resources for women and providers to share the good and the bad so that women have more information when they're weighing their options," Huckelbridge says. She says if she had known what she knows now, she "probably wouldn't have bothered" getting the IUD.
Baden, however, says though she wishes she had known the IUD wouldn't be the answer to her prayers, she wouldn't change a thing. "I have no regrets, but I wish I had known that it wouldn't be the be-all, end-all contraceptive answer," she says.
And for those ready to try it out? "Just pay attention to your body," she says, "and don't be afraid to recognize if it's not working for you."