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Minipill or IUD?

7 May, 2017

Question:

I'm currently 2 months after a baby and not nursing. In the past I've taken the combined pill, I didn't want to go down that route as it affected me. My doctor suggested either the mini–pill or the IUD. I started on the mini–pill and got a period on day 15 (I was supposed to go that night). I'd like to know what usually happens when on the mini–pill. Does this calm down? Is there any possibility that I'll remain clean for longer stretches? And if I decide to go for the IUD will it start all over again (as I've read that the cycle can be affected for up to 6 months after insertion)?

I would really appreciate your advice on this whether to continue on the mini–pill or whether to go for the IUD? Which is the better option in the long run?


Answer:

Mazal tov on the recent birth of your baby!

All of the methods you are interested in have an adjustment period in which irregular bleeding/staining is common. The pill (both the minipill and combined pill) usually have an adjustment period of 1-3 months until your body adapts. Some women continue to experience irregular staining on the minipill for the duration of its use. Both the minipill and the regular pill may cause unwanted side effects (beyond staining) due to the hormones. Please note that there are many different formulations of the regular pill, so even if you had a negative experience with one in the past, it may be possible to find a different type that affects you differently.

The copper IUD often has an adjustment period of up to 3 months in which irregular bleeding/staining is common. After that point the irregular bleeding usually subsides, although some women experience heavier and/or longer periods.

The hormonal IUD (Mirena) has the longest adjustment period (up to 6 months) but after that point many women experience very light or no periods at all. Some women experience other side effects from the hormones as well.

In all cases, it is important to note that every woman will have a different experience on these various methods. Some women have a difficult adjustment period, and some women are barely affected. In any case it is important to note that not all irregular bleeding/staining will render a woman niddah or invalidate the clean days. As long as you don't experience an actual flow of blood (comparable to a period), you may take precautions against becoming niddah from any staining by wearing colored underwear, and waiting 15 seconds after urinating before wiping. See our article on stains for more details.

We recommend reading our article on choosing a contraceptive method for more details about the pros and cons of the available options, and working with your doctor to find the right option for you.

B'Hatzlacha!


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