IUD vs Permanent Sterilization

[fernweh]

I can’t believe I am having to consider this right now but here we are…

I currently have an IUD that would need to be replaced in early 2026. H and I have had conversations about him getting a vasectomy and my initial response was push him to do it sooner than planned but now that I think about it - it needs to be me. H having a vasectomy won’t protect me if I am ever assaulted.

We don’t have kids and don’t want them. I am a few months shy of 40 and obese so I’m sure if I were to have an accidental pregnancy it would be high risk for me.

I have had my IUD for almost 7 years and have been happy with it. Insertion was easy and my period stopped completely afterward. It has become almost impossible to lose weight which may or may not be related to the IUD I don’t know.

I could ask my Dr to replace now so I have 8 years in the event access to contraception gets banned under the new administration. But then what? At 48 I may still be able to get pregnant. My mom menstruated well into her 60s and her doctor told her while it was unlikely it was still possible she could get pregnant.
Do I go the route of permanent sterilization? I know there was a list of doctors that would do the surgery no questions asked floating around a few years ago but the idea of surgery/recovery gives me extreme anxiety.

I guess I don’t really know what I’m looking for here, obviously you guys can’t make my decision for me, I’m just terrified right now.

[waverly]

I am currently on birth control pills for my PMDD so that is our birth control method, but I probably have a hysterctomy in my future because I think I have prolapse anyway. I need to see my gyno for assessment.

I think it is fair to reach out to your doctor and discuss both options.

[Vespasia]

I had my tubes removed a year or so ago. MH had previously had a vasectomy but it never really worked 100%. The procedure itself was no big deal but the first few days were uncomfortable. I briefly regretted my choice a few time when having to get in or out of bed but in the end I am so relieved that I did it. As a bonus, it lowers your risk of ovarian cancer. They also found an ovarian cyst and were able to take care of that at the same time.

I was 44 and solidly CFBC. My doctor had zero hesitation on doing it but that might have been either luck or location. She and the residents were all wearing pro choice and lqbtqi positive pins in pre-op.

[Susie]

This morning H told me he understood how I felt as a woman this morning.  I told him that kindly, I didn't think he did.

I'm 42 and a mom of two, kids are school age, family complete.  But with reproductive health care and the possibility of a federal abortion ban, it absolutely crossed my mind:  what if I'm assaulted while out running?  What if I'm raped?  What if I got pregnant as a result?  What if I were legally required to have that baby?

We're like 2-3 weeks removed from the news of Alyssa Lokit's murder in Nashville hitting the running community, on a running trail that looks a lot like the one I run on.  She isn't the first, and sadly she won't be the last.  It doesn't feel like absurd catastrophizing to worry about.

My ob/gyn has recommended having my tubes removed when I was done having kids, to lower my risk of ovarian cancer (which my mom died of).  I've been reticent to have abdominal surgery based on, what if I might develop cancer in the future?  But as we add to the what-if's, the balance does start to shift.

All of this to say I'm thinking about similar things, and it's dark and sad.

[cereal K]

I have an IUD (I’m on my third, I think?). I’ve had this one for about 9-ish years. They recently extended the “life span” to 10 years, but I’ve been noticing some increased cramping and spotting where I previously had none. I called my OB/GYN today to ask to get it replaced. I’d like to lock in by January and be good for 10 years.

For me, I plan to stay on my IUD to ease through peri-menopause. My mom had a hysterectomy in her early 40’s (fibroids) and so did my grandma, so I neither of them really went through menopause. I’d like something to help ride it out.

[sdlaura]

Putting myself in your shoes - on a practical level, the chances of a sexual assault that happens to be in the couple days a month when I was fertile, that would result in a pregnancy at the age of 48 are so, so low that I would never elect to have surgery based on that extremely remote possibility. So I would get the IUD.

I say this as someone who personally elected to terminate a pregnancy at 21 weeks along because we found out at the anatomy scan (and several follow-up medical appointments) that the baby would not survive outside my body, and I am beyond angry that so many American women already would not have the right to do that, and it's possible that no woman in America will have the ability to make that healthcare decision in the future. So I don't take reproductive decision-making lightly, but in your case I would still just get the IUD vs. surgery.

[mrsslocombe]

I'm 42, CFBC. My husband had a vasectomy years ago. I can't take birth control pills, but I was already contemplating getting an IUD because my periods are horrendous. This will probably push me over the edge into getting one. Women in my family go into menopause early, so I think the IUD would last me long enough.

For me, the calculus doesn't make it "worth it" to me to go through the surgery, and the cost of the surgery. And I hate that cost is such a huge factor.

[Nugget T. Brain, The OG]

I just got spayed 3 weeks ago. That is considered birth control under the ACA and is supposed to be fully covered under health insurance. If you're sure you don't want any more kids I would just go in and get it done while ACA is still a thing.

It's pretty easy, they don't actually do a full cut it's done in 3 places larposcopically.  It was outpatient and a very easy process, recovery is usually quick.  Some folks go back to work within a day or two.

[fernweh]

Nov 6, 2024 14:29:43 GMT -5 cereal K said:

I have an IUD (I’m on my third, I think?). I’ve had this one for about 9-ish years. They recently extended the “life span” to 10 years, but I’ve been noticing some increased cramping and spotting where I previously had none. I called my OB/GYN today to ask to get it replaced. I’d like to lock in by January and be good for 10 years.

For me, I plan to stay on my IUD to ease through peri-menopause. My mom had a hysterectomy in her early 40’s (fibroids) and so did my grandma, so I neither of them really went through menopause. I’d like something to help ride it out.

Which do you have? I currently have Mirena and last time I discussed with my doctor they had just expanded the approval to 8 years (was 5 when I originally got it implanted). Wondering if they expanded again - either way if I stick with an IUD I will insist on a new one now.

[cereal K]

Nov 6, 2024 14:50:48 GMT -5 fernweh said:

Nov 6, 2024 14:29:43 GMT -5 cereal K said:

I have an IUD (I’m on my third, I think?). I’ve had this one for about 9-ish years. They recently extended the “life span” to 10 years, but I’ve been noticing some increased cramping and spotting where I previously had none. I called my OB/GYN today to ask to get it replaced. I’d like to lock in by January and be good for 10 years.

For me, I plan to stay on my IUD to ease through peri-menopause. My mom had a hysterectomy in her early 40’s (fibroids) and so did my grandma, so I neither of them really went through menopause. I’d like something to help ride it out.

Which do you have? I currently have Mirena and last time I discussed with my doctor they had just expanded the approval to 8 years (was 5 when I originally got it implanted). Wondering if they expanded again - either way if I stick with an IUD I will insist on a new one now.

I have Mirena. Maybe it was 8? Shit. Now I don’t know if this was my fourth? I think I got the last one in 2016 bc there was some election timing to consider then, too. Which, how fucking sad is that. I’m planning my gynecological health around the fucking election cycle.

Fingers crossed the coordinator gets the green light from my insurance.

[TR]

Nov 6, 2024 14:42:28 GMT -5 Nugget T. Brain, The OG said:

I just got spayed 3 weeks ago. That is considered birth control under the ACA and is supposed to be fully covered under health insurance. If you're sure you don't want any more kids I would just go in and get it done while ACA is still a thing.

It's pretty easy, they don't actually do a full cut it's done in 3 places larposcopically.  It was outpatient and a very easy process, recovery is usually quick.  Some folks go back to work within a day or two.

OH REALLY? Because I've considered a salpingectomy for both that reason and reducing the risk of ovarian cancer, but was worried about the cost with my HDHP.

[Nugget T. Brain, The OG]

Nov 6, 2024 15:24:13 GMT -5 TR said:

Nov 6, 2024 14:42:28 GMT -5 Nugget T. Brain, The OG said:

I just got spayed 3 weeks ago. That is considered birth control under the ACA and is supposed to be fully covered under health insurance. If you're sure you don't want any more kids I would just go in and get it done while ACA is still a thing.

It's pretty easy, they don't actually do a full cut it's done in 3 places larposcopically.  It was outpatient and a very easy process, recovery is usually quick.  Some folks go back to work within a day or two.

OH REALLY? Because I've considered a salpingectomy for both that reason and reducing the risk of ovarian cancer, but was worried about the cost with my HDHP.

Yep, most insurances have to cover it.  I would give yours a ring and ask but they should cover either that a hysterectomy or both. 

[bunnies]

I did a permanent sterilization in 2008. No regrets, but the procedure has been discontinued. It didn't involve surgery either.

[wambam]

I had a bilateral salpingectomy in 2018 and I am glad every goddamn day I made that decision. I never have to worry about it ever again. Would do it again in a hot second.

[wanderingback]

For about 6 months I planned to get a salpingectomy. I just switched insurance so was waiting for that. So hopefully I can get it done in Dec or Jan. I don’t feel like dealing with an IUD. I already had an appointment.

And I absolutely will have an abortion in the meantime if I were ever to get pregnant. You can buy abortion pills in advance before you know you’re pregnant in all 50 states, just like you keep ibuprofen on hand.

[wildrice]

Nov 6, 2024 14:30:43 GMT -5 sdlaura said:

Putting myself in your shoes - on a practical level, the chances of a sexual assault that happens to be in the couple days a month when I was fertile, that would result in a pregnancy at the age of 48 are so, so low that I would never elect to have surgery based on that extremely remote possibility. So I would get the IUD.

I think I am here - if an IUD is not a big deal for you, I'd probably just go the less invasive route and do that. I am all for safety and preparation, but realistically we cannot prepare for every single worst case remote scenario in our lives. It sounds like your scenario is very unlikely, so I don't think it's as urgent to prepare for it. I know it's easy to spiral on that though.

However - I had my tubes removed about 3 years ago and would support anyone in doing so! For me, I went this route for 2 reasons: one, I had had a blood clot that couldn't be attributed to anything else, so I went off BC altogether as a precaution. I had thought of doing an IUD or something else low hormone, but I found I felt better off of BC and I was also worried that since I hadn't had kids, I would have difficulties with insertion (I probably have mofongo 's horror stories to blame for that fear). Second, I had a "suspicious" ovary that was found on a PET scan and they gave me the option of watching it or removing it. I did not want to mess around with cancer, so I decided to just remove the ovary and the tubes while they were in there. IDK that I would have pursued the surgery if not for that. Because of this and the reduction of cancer risk altogether, I didn't have a hard time getting the surgery or getting it covered (I also live in Maryland so YMMV in a state with less support for reproductive freedom).

The surgery itself was pretty easy - while it's obviously scary to go under for any reason, I was discharged that day with minimal pain. It hurt a lot when getting up and down from the bed/couch, but the pain was always for a matter of seconds during that transition and then would disappear, so it was very manageable. I never even took anything stronger than ibuprofin, and I'm not one to try to tough things out! I just really was fine. I was off work for a week, but probably could have done it on Friday and worked Monday if I was able to WFH - I really wasn't feeling bad at all. It was a good idea to take it easy with going places or doing a whole lot for a couple of weeks. I do have scars but at 42 and chunky, it's not like I'm walking around showing off my belly anyway, so I mostly forget they are there. 

I do notice that my periods have been heavier since having it done, but I have been blessed with very easy periods overall so heavier is still probably lighter than what a lot of people deal with, and I haven't noticed any other symptoms that have changed (like bad PMS or cramps or whatever). 

[timorousbeastie]

I made the call to my gyn to set up my bisalp the day after the Dobbs decision was released. There were many reasons why I didn’t want to deal with any type of BC any more, but among them were a) what if BC becomes illegal by the time the IUD expires and b) although the failure rate of an IUD is low, it’s not low enough for my peace of mind if I wouldn’t be able to terminate a resulting pregnancy. I was 41 at the time, so an IUD might have taken me through to menopause, but maybe not.

Recovery was rough for a few days, and I couldn’t handle wearing anything with a waistband for ~3 weeks, but it was absolutely the best decision I could have made. No regrets at all.

[redhead610]

PDQ
I had my tubes removed a year ago and I'm very glad I did.
My H has a vasectomy after our 3rd was born, in 2019. I had a horrific pregnancy, and complications left it so that I should not be pregnant again. H had all necessary follow-up testing after his procedure.

Summer of 2023, I wind up pregnant. We still have no clue how. I could not keep it, because I would have risked leaving my husband alone and 3 children motherless. At that point I decided I wanted my tubes removed because I could not go through this again. I didn't want to be on bcp again because it messes with my anxiety, which i finally have under control. My doctor was very supportive.

I recommend having a discussion with your doctor, and hopefully they are supportive.

[penguingrrl]

I think I will plan for sterilization. H had a vasectomy after our 11 year old was born, but I had preeclampsia in all three pregnancies and after I delivered my son my doctor advised against being pregnant again. Until now we figured that god forbid Hs vasectomy reversed itself or I was raped I would use plan B or an abortion as needed. But based on family history I’m over a decade out from menopause and the risks of pregnancy are too high for me.