contraception

Does it hurt to get an IUD? —Concerned

AA: We are so glad you asked, Concerned. For today’s post I’ll be writing as the content expert regarding intrauterine devices (IUDs). TL;DR: While level of pain varies from person to person, yes. There are a number of factors that inform the physical experience of getting an IUD.

SM: I’ll be the context expert for today. Some factors that can play a role include where you are in your cycle, whether or not you’ve ever given vaginal birth, your personal anatomy (i.e. the shape of your uterus, thickness of your cervix), and pain tolerance.

AA: Some of these factors you may not be able to control but there are some things that you can do to manage the pain. Pain that is experienced during IUD insertion comes from a speculum specially designed for dilating your cervix. If you have flexibility with when you are able to schedule your IUD appointment, try to aim for near the tail end of your period. During this time, your cervix is more open than at other times of your cycle.

SM: Another way to manage pain during an IUD insertion is to take ibuprofen or another NSAID approximately 20-30 minutes before your appointment. This can help reduce the pain from cramping during and after the insertion. If you do choose to take ibuprofen, be sure to not do so on an empty stomach.

AA: Studies have shown that expectations of pain can influence experience of pain. Talking with your clinician about your concerns and what to expect may have a positive impact on your experience. Here are some talking points to possibly bring up with your clinician:

  • Do you prefer to have a step by step explanation of what is happening in the moment or would you prefer less verbal information?

  • Do you have any diagnoses that may have an impact?

  • Have you experienced interpersonal harm, which may inform how much or little information is helpful, the pace at which the procedure goes, and other coping strategies?

SM: There are other things that people have found really helpful during the procedure itself, including bringing a book, listening to a relaxing playlist, bringing a friend or loved one into the appointment, practicing breathing exercises, or zoning out on your phone. After the procedure, some people find snacks, tea, a hot water bottle, or just taking time to relax can help.

AA: If you have any questions, concerns, or pain after your procedure don’t hesitate to reach out to your provider. Thanks again for your question!


Where can I get free condoms on campus? Do I have to prove that I’m a student?

AA: Thanks so much for writing in to ask this question. We’re really proud that here at Harvard we provide (for free!) a variety of types of condoms and other barrier methods, such as oral (dental) dams, finger cots, and gloves.

LM: One of the most popular forms of birth control is the external (or male) condom. In addition to preventing pregnancy, external condoms can also protect against sexually transmitted infections (STIs), because they provide a physical barrier. There is also the internal (or female) condom, which is inserted into the vagina or anus before sex.

Below is a list of places on campus you can get free safer sex supplies, as well as a map.

Houses & First-Year Dorms: Most Houses and dorms have dispensers with external (male) condoms. These are generally located in laundry rooms, gender-neutral bathrooms, or near building manager’s office.

Health Promotion Office (6th floor Smith Campus Center): internal & external condoms, oral dams, finger cots, gloves, lube, & educational materials

Office of Sexual Assault Prevention & Response (Smith Campus Center, 6th floor): internal & external condoms, oral dams, finger cots, gloves, lube, & educational materials

Women’s Center (Canaday Basement): internal & external condoms, oral dams, & lube

Office of BGLTQ Student Life (Grays Basement): internal & external condoms, oral dams, & lube

AA: In answer to your second question, nope! No questions will be asked when you show up for condoms!  If a staff person is available and you have questions or you don’t see something you’re looking for, please feel free to ask!

LM:  Thanks again for your question!





I’m trying to buy condoms but am a little overwhelmed by the options. How do I know which condom is right for me?

ML: Thanks for asking this important question! Absolutely—when purchasing condoms, there are a multitude of options from which you can choose. From various sizes to ribbed vs. unribbed, flavored vs. glow-in-the-dark, this decision may feel like a daunting one. In this post, we are going to talk through a number of the factors that impact efficacy, comfort, and personal preference that will allow for the best experience at the end of the day.

AG: One straightforward way to start getting a sense of what condoms might be right for you is to measure your erect penis. You’ll want to measure both the length (from the pubic bone to the tip) and the girth (the width of the penis which you can get by dividing the circumference by 3.14). Condom manufacturers sell snugger fit, regular fit, and larger fit condoms which will fit different penises depending on these two measurements.  

ML: In addition to the fit of the condom, there are other things to consider when finding a condom that’s best for you and your partner(s). Some of these may include: ribbing, or texturization of the condom, flavor, color, material, thickness/thinness, added sensation, and amount of lubricant on the condom or in the packaging.

AG: A lot of variation! It’s worth remembering too that though most condoms come with some lubricant in the packaging this is generally just to prevent the condom from tearing as it is unrolled and so more lube can always be added! Again, we know this list can feel overwhelming. Finding the perfect condom isn’t always super quick, and can really just be more of a process of experimentation. It can be worth trying on the condom before the sex act to ensure that it fits well enough to be effective and comfortable, but you’ll get the best sense of what works the best for you with time and through trying different options.  

ML: Here on campus, there are multiple locations at which you can pick up a variety of condoms and other safer sex supplies for free. Feel free to stop by the sixth floor of HUHS in the Center for Wellness & Health Promotion, the Women’s Center, the BGLTQ Office, or at SHARC Office Hours in house dhalls where you can also ask any additional questions as it pertains to sex and sexual health. Here’s a map that points out these places!

AG: We wanted to end by briefly noting some of the pressures and expectations that may come with buying condoms. Many people may feel that they need to use larger sized condoms. In fact, studies show that 25% of men have tried magnums (extra-large condoms) when in reality these are really not necessary for most people. The average penis size is 5.16” long while a magnum condom is made for penises that are 8.07” long...so a big difference! The truth is that sex will feel better and that the condoms will work the best when they fit your penis appropriately. For some people it can feel that others may judge their condom choices however, picking something that fits well will really result in the best and safest experience for you and your partner(s). If picking up or buying condoms in public is nerve wracking, there are also certainly ways to buy them discreetly online!

Does getting an IUD hurt?

EXPERT ANSWER:

Thank you so much for asking about IUDs (Intrauterine devices). IUDs are one of the most effective forms of birth control on the market. There are now four different kinds of IUDs that you can choose from, each meant to fit different needs. These IUDs are Paragard (non-hormonal), Mirena, Skyla, and Liletta

IUDs themselves don’t hurt while they are in place. This is a misconception. The only time a IUD user may feel any sort of pain would be during the insertion process which usually only takes a couple of minutes to complete. Most people obtaining an IUD say they feel minimal to moderate pain. There are many things that you can do to reduce any pain that you might feel. It is recommended to take 2 ibuprofen (Advil) before the procedure. Some doctors also tell their patients to schedule the appointment for during their period. The pain from insertion comes from opening the cervix for placement. While a person has their period, their cervix is already slightly opened which can aid in reducing any possible pain.

The pain (if any) usually does not last long. It can sometimes be followed by cramping which will go away within a few hours to days. I know that any sort of pain can feel very intimidating but think about the ease afterwards. Mirena can last up to 5 years and ParaGard can last up to 12 years. Having a long-lasting form of birth control can save you time, money, and mental space.

I hope that you will consider an IUD as your form of birth control.

If you ever have other questions about IUDs or other contraceptive options don’t hesitate to contact me at 617-496-2053.

Amanda Ayers, MPH

Health Educator


STUDENT ANSWER:

Thanks for the question! IUDs are awesome. They last anywhere from 3-12 years, can reduce or even eliminate periods, and are over 99% effective at preventing pregnancy. Once they’re in, you can basically forget about it other than a quick monthly self-check to make sure it’s still in place.

BUT, it’s the classic question, how much do they hurt? IUDs are inserted (by a healthcare provider) into the uterus which means they must pass through the cervix. Though the insertion is incredibly quick (only a few minutes) it can be painful for female bodied individuals who have never had children. While it’s usually done without anesthetic, like Amanda said, having the appointment while you’re on your period and taking a few Advil can make the procedure more comfortable.

Fear of pain is one of the biggest deterrents for people in choosing to get an IUD but the truth is that it’s just a few moments of discomfort (and shouldn’t hurt more than some period cramps). I’d suggest trying to convince yourself that it won’t hurt too much and trying to focus on other things during the insertion. Maybe bring a friend to the appointment and have them distract you and squeeze your hand.

After the insertion itself, you may feel cramps, mild discomfort and experience some spotting for the next few days. This should go away pretty quickly although your periods can take a few months to get back on a normal cycle.

It is important to remember that the IUD does not prevent against any STIs and that condoms should still be used if you start sleeping with someone new. However, IUDs are the highest rated form of contraception and - especially if you don’t want to deal with taking a daily pill - can be a great, great option!

AG

Student