Getting the IUD Past Your Cervix

A reader wrote that she wants to get a Mirena IUD but scared to death of being dilated. Another woman wrote she was concerned with getting an infection with insertion. Another woman wrote that she was worried that the IUD insertion pain would be greater this time, because she had an IUD already and was just getting another placed. The issue is getting past the cervix safely with an IUD, and women can feel confident that this can be accomplished both safely and with modest discomfort without any need for extra medication or special testing before hand. If the insertion is more problematic, your gyno can use tools to aid her, so gain safety and comfort are the goals for your insertion. 
In the first case of the woman who worried about dilation she gave us further information. Her goal was to get a Mirena, which is effective for 5 years. It's smaller cousin is now available, and it provides effective 4 year contraception, so that is a consideration. Her only deliveries were c-section deliveries, elective, she didn't have any labor. Although she wants an IUD for her contraception, she knows it has to be inserted through her cervix. She is therefore wondering if she would have difficulty getting an IUD, or extra pain with IUD insertion? ! In truth the cervix needs to be dilated so little with an IUD women who have never been pregnant, let alone whether they have had a delivery can have an IUD with very manageable pain symptoms. 
For most women nothing special has to be done. In women who have an abnormality of the cervix there are gyno procedures that can help get the IUD in the uterus. It is possible to image the uterus with transvaginal ultrasound and make measurements in 3 dimensions, or even to use 3-D ultrasound to see the dimensions of the uterus if necessary prior to an ultrasound. It's not usually necessary. A pelvic exam can detect active infections, but without infection the risk of getting an infection is very low (under 2%) and even with an undetected gonorrhea (GC) or chlamydia (CT) infection the risk of pelvic inflammatory disease is quite low (under 5%) so that shouldn't factor into insertion pain or problems. At Women's Health Practice it is very rare to have a problem dilating.....it's quick, and so little dilating really needs to be done....but we do whatever it takes, paracervical block to numb the cerivx , topical numbing, misoprostol before to soften the cervix, or really just using very tiny dilators... so if you want an IUD, discuss options with your gyno, but it is a great choice and you shouldn't be deterred by the fact that you have never had a baby.

Comments

  1. Nice Posting! Keep it up!!Main Problems Faced by Women Trying to Conceive.First you must determine the length of your menstrual cycle from ovulation calendar, which commences on the first day of bleeding or spotting and ends on the day before your next period starts.

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  2. WE also have posted a menstrual cycle calendar at www.womenshealthpractice.com

    ReplyDelete

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