What are my longish-term birth control options?

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I'm a mama to the best two little boys around… and would not like to have any more. Yep, my husband and I are in mega-agreement that two kids are plenty for us. So, it's time to figure out our long-term birth control plans. Ideally, vasectomy is what we'll do, but my husband had MAJOR surgery this year and is not interested in any other bodily changes for a while.

Right now I'm on the pill, but after a panicky day of where's-my-period last week due to my inability to remember to take the thing on time (or even within 12 hours of the right time), I'm motivated to check out other options that don't require a daily commitment until my husband is ready for the big V.

So, what longish term birth control do you use and why? — NW Mama

We've only talked about permanent birth control (vasectomies and tubal litigation, anyone?) on Offbeat Mama… what not-quite-so-permanent options are out there?

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  1. IUD is the big one for this situation, I think- I have a copper one, but they also make hormonal varieties. They last 5+ years, are more effective than the pill, can be removed immediately if you don't like them, and don't interfere with your daily life at all!

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    • I've had the copper IUD ("ParaGard")for almost 4 years now and have had absolutely no problems or pregnancy scares. My Dr. told my I could stay in for 10 years, maximum. The most important aspect of getting the IUD is to go BACK to your gynecologist after the first month to make sure that the insertion went in correctly – then you are good to go. My period was heavier for a while but this also seemed to happen as my body adjusted to life without The Pill. I have never been happier.
      Good luck with whatever you choose!

      1 agrees
  2. I am a big fan of the copper IUD, no hormones, never forget it and it is approved for up to 10 years continuous use. It can cause worse cramping but it cleared up after a few months for me, I also hear if you have already had kids the cramps aren't nearly so bad.

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    • Just to clarify for those that don't know: the paragard is the copper IUD used in the States. That one is good for 10 years.

      However, in other countries, different IUDs are used and they are not necessary good for as long. In Canada we have the flexi-t, good for 5 years, and the nova-t, good for 2 (or three? Not sure).

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  3. I loved my copper IUD and plan to go back to it after I pop out this baby. We're probably just having one, but want to give ourselves some space to make that decision before my husband gets a vasectomy. I may consider the hormonal one this time (though I think for me it might not be the right call) because it's ever so slightly more effective. In fact, I've read that it's as effective as a tubal ligation, but don't quote me on that because I can't seem to find my source.

    One of the things I like most about IUDs is that their theoretical effectiveness rate (the number most often given, which is based on perfect use) is about the same as their actual effectiveness rate (the number that is not often given that includes user error).

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    • Just wanted to pipe in and give a +1 for the IUD. I've had mine for a year, and while it was painful during insertion/afterwards, it's been great ever since (though, I've never had children, which definitely makes insertion more uncomfortable). I haven't really had a period since, and I don't even know it's there. It's comforting to know that I'll most likely not have to worry about anything again until 2016.

      Also, cost was a huge factor. In the States, with my health insurance, the Pill was about $360 per year, or $1,800 per 5 years. Mirena was about $400 all-included, and so I saved quite a bit of money.

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  4. Another vote for an IUD, I have the Mirena and I am walking proof that the 99.9% effective rate is right on. The Mirena is a hormone IUD and is good for 5 years, after that you get it taken out and can have another one put right in. I got it right after my son was born, since my plan was 5 years difference inbetween children, if I chose to have another one. So far it has been amazing, although my fiance is having some concerns that since it stopped my period altogether, that maybe it has messed me up and we won't be able to have baby when the time is right. Anyone sucessfully get pregnant after having one taken out?

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    • I had a successful full term pregnancy after using Mirena for a year…
      Mine, however, was not removed. It fell out.

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      • It took us a couple months ( not sure of that was due to the IUD or just bad timing ) but we are now the happy parents of a beautiful baby boy … And my period had stopped completely not long after I had had the IUD inserted.

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    • My friend (who may pipe up on here) had an IUD and her period stopped and then got pregnant after removal. Enjoy the lack of period!

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      • That's me! I'm the friend! I love my IUD, and had my first one for 5 years. My period stopped altogether for 4 of those 5 years. After I had it removed, my periods returned within 6 weeks, and were very regular. At my 6 week post partum checkup, IUD #2 went in and will stay in until we 1) decide to have another kid or 2) hubby gets the snip.

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    • I had Mirena for about 18 months after my first son. My periods stopped almost completely for the better part of a year with it in. I got it taken out on October 26 when we decided to try for another child, and conceived our second son the first week of December. 🙂

      • I had the mirena for 5 years and an half (had to wait to be officially on remission of cancer before trying to conceive and my OB/GYN thought it was alright (in fact the thing is full proof for 7 years it seems). It was pure heaven: no more period, no more cramps, pains etc that I had for 25 days out of 28 from my teenage years on… I got pregnant within 4 months after removal and even if I miscarried it was not related. I am now 6 days before my due date (and I want to pop out this baby NOW!!!) and plan to have another one after birth. As an aside, I got it inserted even if I didn't had have children at the time: it is possible and risk-free but not every health specialist agrees with it (big discussions about it in Europe where I live) and put it for the good reasons (my OB at the time waited for me to be married before agreeing to put it, WTF???)

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    • Thanks for all the replies! I'm so happy to hear that everyone had such great experiences, I can't wait to tell my fiance!

      • i wanted to pipe up and tell the other side regarding Mirena. i had a Mirena for almost 18 months and really, really disliked it. Yes, the insertion was *very* painful, although that wasn't the biggest deal after a few days. My biggest problems with it were: i felt emotionally like i had pms about 80% of the time. I felt bloated and crampy, too. Like 70% of the time. i never got a period at all, and i discovered that i'm one of those weirdos that likes getting a period every 29 days. I would spot, though, totally randomly…. that was a pain in the ass because it was utterly unpredictable. Also, it hurt sometimes (maybe that was because it wasn't in properly? i dunno, but i didn't spend the $200 out-of-pocket for the "extra" appt. to find out) By that point i was just sick of the damn thing, and ready to get it OUT. To add insult to injury, it cost 300+ out of pocket to have it removed (it was covered 100% to go in, covered 0% to go out)
        within 2 weeks of it being removed all of those symptoms were over.
        i hope i'm an outlier (but a LOT of my friends had the same or worse experiences). I hope the copper one is better (no hormones!), and maybe if you have better insurance than i did it'll be worth it even if you wind up having problems.
        anyway. sorry so long! good luck.

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    • i am part of a group of women who all had mirena iuds taken out during the same month. most of us took 6 months+ to get pregnant and many had multiple miscarriages. i would recommend waiting a while before actively trying to conceive after mirena. all of us have had children in the past and conceived fairly easily in previous attempts, sans mirena. it's not all rainbows and sunshine like the manufacturers say. i have a paragard now and i'm hoping the lack of imbedded hormones makes it easier to conceive if we decide to have another child.

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  5. I have the implanon inserts in my arm, it is a 3 year thing and I have had it for 2. Besides a little soreness the first few days, I have had no side effects. It is a little costly though, but since we were going to be loosing health insurance indefinitely ( due to my husband changing jobs) we thought shelling out the extra money was worth it wo prevent any unexpected surprises 🙂

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    • I had a very bad experience with the Implanon (yes I think I tried everything on the market): weight-gain, hairs in areas they are not supposed to grow when you're a woman (and some still subsides 5 years later), mood-swings…. Some of my friends had it without problem though… Important to check your hormones levels before putting it

    • I also had the implanon fo 3 years and was VERY happy with it. No periods during that time but they returned within a month of having it out and got pregnant first try a few months later.

      I do know a lot of people that had bad side effects (lots of bleeding, nausea, weight gain etc) so as with anything hormonal different people will have different reactions.

      As for cost, in Aus it was $20 to buy and have inserted – MUCH cheaper than depo shots I was 3 monthly having before it.

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      • I've had Nexplanon for several months now. I initially had some intense itching at the site, but no dude effects

    • I just got Essure back in May due to the fact that the shot was doing somethings to my body, plus having PCSO not keeping my hormones in check. So far the Essure is working. I am having some spotting here and there is what you should expect for the 1st 6 months and some cramping. Otherwise I am happy with my choice. Another thing about Essure is that you will be on a back up birth control for the first 3-4 months to make sure it work. Just make sure you go to the follow up with your doctor and let them know if you have any sign effects that may bother you.

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    • I had Essure 8 years ago, and it was the best decision I ever made. It is permanent, no reversal. However, there is currently a huge class action lawsuit against them from hundreds of women who have had terrible experiences including severe pain and bleeding, failure, and shifting of the implants. While I had a dream experience and am thankful every day that I did it, I'm hesitant to recommend it to anyone else because apparently that's not always the case.

  6. I liked the copper IUD, but my husband could feel the strings and they sometimes hurt him. I also ended up pulling mine out by accident.

    I also really liked Nuva Ring. Low in hormones, versatile (easy to move your period around for many) and easy to deal with.

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    • I second the Nuvaring. After our Happy Accident twins we decided that counting on my memory to take a daily pill wasn't the best planning for our family. I haven't had any issues with using it and it's covered by my insurance. I always got a little crazy taking the pill and haven't had the same problems with the Nuvaring.

      Also, at our recent preconception apt my doctor told me that we could start trying to conceive right after removing it. Their was no need to wait.

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      • I third that. I used the nuvaring for 4 years before having kids. I never had acne, weight gain or emotional issues with it. I only had to remember it for two days a month. Sometime at the end of the month I would take it out, and then remember to put it back in one week later. You don't have to be too exact with when to take it out, you have about a week to decide when to do it. I would make sure I wasn't doing anything too ridiculous 5 days later when I would be tired and crampy, and then take it out. There were a few times I used it to schedule my period just after a swimming or waterpark outing with friends/family so I wouldn't have to deal with that while I was trying to party.

        I usually didn't notice it during sex, and if I did, it felt better for me and my partner. The only issue I had at all was that I had to make sure it was still in there when I was done with sexy time.

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        • I totally agree with all of this. I love mine, and the only issue I have with it is that I'm apparently one of those people who can't skip their period on hormonal birth control 😛

    • I've only pills and NuvaRing, and I only used the pills because I couldn't afford NuvaRing for a while; went back to the ring as soon as I could afford it. It took me a year after I went off it to conceive my daughter, but I suspect that has more to do with the age difference between my husband and me than the birth control. I almost gave up trying to conceive, actually, because the year without NuvaRing I experienced such awful cramps and heavy flows (which switching to a menstrual cup helped to alleviate some, I think).

      The only problem I remember with NuvaRing is that I'd lose track of when I put it in or took it out; I never was god at keeping a calendar like that.

    • I love love love the nuvaring. My only issue with it is that I can't put in properly myself so my husband does that. Also that I don't get my period anymore on it and I freak out every month haha.

  7. I've heard good things about the IUD, and am giving it some thoughts since I want to avoid the side effects of hormones. I think its also fairly cost-effective.

  8. I was on the Nuva Ring for years and years – you put it up there and then 3 weeks later you take it out. So much easier for my forgetful self than a daily pill. And you have a 3 hour window, so if you remember late that you haven't put it in yet this month then it's okay.

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    • Why I am the only one who had a terrible experience with the nuvaring with periods like niagara falls? (facepalm ;-)!) (I remember having to explain in broken english to the guard of the Hoover Dam I wanted to visit while on vacation in the States that I had something in my hands because I had to change arggggghhhhhhh)

      • I had serious issues with the nuvaring. I broke out, had periods like Niagara Falls, and my emotional state was volatile at best, Carrie on prom night at its worst. It got to the point where my friends and partner asked me to stop using it because I was a crazy, sick, emotional wreck. I have a really hard time with hormonal fluctuations though.

  9. I had my tubes tied. It's a major surgery, I know, but I also know I am majorly sure that 3 rugrats is my limit. I also am unable to take any kind of hormone birth control, including a hormonal IUD due to health issues. Take that and the fact that I had some bedrest-worthy complications with my last two pregnancies, I wanted to make extra-super-duper-sure I didn't get pregnant again. Obviously, not a lot of people are comfortable with surgery just to take their baby maker offline when other options are on the table, but for me it was the only option I was comfortable with.

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    • I'm surprised this didn't come up more in the replies. If he's not ready for surgery because of his recent medical history, maybe you could do it?

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    • For the record, tubal has the same failure rates as any other birth control. Your body can heal itself from that procedure or even grow a NEW tube… if it wants to badly enough. I have a friend who had one and had her husband do it as well, just to be sure. 😉

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      • Just to clarify, tubal ligations, vasectomies, both types of IUDs and Implanon (arm implant) are the only forms that are most effective (99+% effective).
        Every other type of birth control is decidedly less effective, even more so because average use brings that percentage down even further.

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  10. Im a nurse at a Women's Health clinic. Sounds like you're looking for LARC (long acting reversible contraceptives). You have three options, the Mirena, the Paragard or the Implanon. Mirena is a progesterone only IUS. It's effective for five years. The hormones are there to help with bleeding. Your periods can go away all together, become shorter and lighter, or you can have (rarely but unfortunately) irregular and unpredictable bleeding. The Paragard is a copper IUD. No hormones, so only side effects can be heavier periods with more cramping. Rarely it causes breakthrough bleeding. It is effective for ten years. The Implanon is an implant in your arm. Progesterone only and good for three years, your period will go away all together or (commonly) cause irregular and unpredictable bleeding. With all of these your fertility will return completely. (Most women get pregnant within 6 months post removal).

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    • I'd love to hear more user reviews of Implanon. I'm curious about the side effects and comfort (I'm a plus sized woman and the tissue in that area is super soft and doughy. I only imagine it would be uncomfortable for me.)

      I can't use IUD (weird cervix placement, never had kids,) so an implant would have to be my non-permanent, leave-it-alone option.

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      • You shouldn't feel it once it's correctly placed. In my experience there's a lot of irregular bleeding, but this often gets better in the first six months.

      • When I got the implanon, it killed my sex drive. Like, within a couple days it was pretty much gone. I kept it in for 6 months in the hopes that it would improve, and it didn't, and then within a few days after getting it out, I was ok again. I don't think this is necessarily a super-common side effect, but I do know that I was leery of getting the implanon because hormones usually mess with me somehow, and they assured me that the hormone levels are so low that they wouldn't affect me. If you decide to get one, make sure that you listen to your body – give it some time, but if you are pretty sure you are feeling undesirable side effects from it, you probably are.

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          • I replaced it with a copper IUD, which I have been very happy with.

            The other thing that was problematic was the unpredictable bleeding. Normally, there's a couple days of cramping or spotting or whatever before a period – or at least some indication. With implanon, I had a couple of occasions where there was no indication and then suddenly there was lots of bleeding. I work in a job where I am up in front of people a lot, so that wasn't going to work for me.

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        • I noticed a fall in my sex drive after getting my Implanon as well, but it works out alright because my lovermans is a longhaul trucker so he's not around much. The problem becomes the fact that while I do get aroused, the ladybits aren't always quick to get with the program and we end up having to use lube (which, at the risk of TMIing! Is something we've never had a problem with before, or a problem I've had previously.) But I can deal with that if it means very rarely having a period and not dealing with the level of pain I had on my cycle before.

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      • I've had Implanon for a year and a half. If I deliberately feel for it with my fingers I can find it (it's about as wide as a pin and maybe half as long – not sharp of course) as it's just under the skin, but other than when I want to find it I never notice that it's there. There was a little soreness for a few days, much like getting a shot, but after that it's been completely unobtrusive.

        I don't think that I've had any side effects, although I've gone through some major life changes so I can't really say. Actually, since posting this I saw Sarah's comment and she's right. My sex drive has been a lot lower in the past year than ever before. That's interesting. I hadn't pinned it on the Implanon.

        As far as bleeding goes, I had some light spotting for the first month, then nothing for a year, then one light period this summer. The latter was so unexpected I worried that something was wrong at first.

      • I was on implanon for nine years (three separate rods at three years each) and I loved it. I know they don't work for everyone but they were fantastic for me. My periods were immediately shorter and more spaced out until they stopped altogether until the eighth year when I 'spotted' a few times. I got pregnant within three weeks of removal and to my knowledge (though I'm happy for someone to correct me) there have been no recorded pregnancies when inserted correctly. Here in Australia it costs the same as a four month package of the pill so it is also great economically. It's progesterone only so it's essentially the same as the mini pill, without having to remember to take anything. A friend of mine never stopped menstruating altogether on it so everybody is different, but I had a very, very positive experience and if my partner didn't want a vasectomy I would absolutely go back to implanon. Good luck to the original poster with your decision!

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      • The IUD may not be an option for you, but women who have never been pregnant can safely use an IUD.

        Some doctors are unwilling to place an IUD in a woman who has never had children, but the research shows that it is safe and effective.

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        • I took my daughter for her IUD as soon as she asked for birth control. She is 19 and has no children. They did warn her it might be a bit more uncomfortable while her tiny closed body accepted a foreign object but that was all.

        • I'm one of those women who was warned against an IUD. My doctor suggested it, the gynocologist I went to for getting it inserted said no, no way. The reason I was given is that there is a chance of causing scarring or damage to your uterus which could prevent conception so this gyno wouldn't do it for any woman who had not had children but did plan to. Obviously not all medical professionals agree though.

        • This was my main question. I've used the Pill since I was 20 (before being sexually active). Now, at 27, I'm married…but still to paranoid to have sex without a condom most of the time. I do NOT want to have kids for a few more years, so if I miss a pill or take it late, it's "Sorry honey, gotta use a condom for the rest of the month."
          I'd rather swap to something that doesn't require a daily dose to remember. My doctor always frowns when I ask about an IUD, since I've never had children….but maybe I just have to do my own research, bring in some facts, and be like, "This. I want this!"
          Another question….does anyone have issues with using a DivaCup with an IUD?

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          • You can use the cup with an iud if you are diligent about breaking the suction before you remove it each time. The suction can pull the iud out of place.

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          • If daily dosage is a problem, consider the patch. I started using it at 18 and pretty much loved it (had some nausea/vomiting in the very beginning), and only stopped using it yesterday when I had Nexplanon (the next gen Implanon) put in – so about eight years (though I've only been having condomless sex for one).

            I switched to Nexplanon because I wanted an even higher level of protection, didn't want to make the trip to the clinic every three months for refills, and all the cool kids are doing it…and also 'cause my sex drive has fallen off a bit the last two years or so and I thought a change to progesterone only might help.

            IUDs and in-arm implants can both cause scarring. If you're planning on having kids again in the future, you might prefer to have that possible scarring be in your arm rather than your uterus.

        • The only reason my doctor agreed to give me an IUD is that other medical conditions put me at risk for stroke, so I can't use most hormonal forms of birth control.

          I don't have any kids so they had to do a sounding to make sure my uterus was big enough to accommodate the IUD, since it hasn't ever been stretched out by a pregnancy.

          What I really want is to get my tubes tied, but since I'm childless and only in my 30s, no doctor will agree to do it.

          • I think you should look for a more open minded doctor. Ask your friends and family. I had my tubes tied a month after my 31 birthday…something I'd been waiting until I was "old enough" to do since I was a teenager. And I was completely single, not dating anybody (they didn't even ask). I went to a well known and respected OBGYN in my home town (I hadn't lived in my current town very long and didn't want to ask a friend to take a day off to drive my and stuff, so my dad took me). Anyway, I went to the consultation expecting a fight, but it went down like this:

            Doc: So, you want a tubal?
            Me: Yep.
            Doc: Have you thought about an IUD?
            Me: I don't want one, I just want to be permanently done with birth control.
            Doc: Ok. Regret rates are really low for women over 30. We'll do an exam and get you scheduled for surgery.

            Three weeks later, done. So, there are reputable doctors who understand that women know themselves and are capable of making this type of decision. I'd suggest looking for a doctor who's more willing to listen to you and not give you any nonsense about "when you get older" or "when you meet the right person."

          • The sad thing is, my current doctor is my new and more open-minded doctor. Previous doctors told me that I'd have to rely on barrier methods if I couldn't tolerate hormonal birth control.

        • If your doctor won't give you an IUD, it's time to find a new doctor!! Unless they cite a REAL medical reason (shape of uterus/cervix etc) then they're leting their bias creep into their work.

          Reasons that I've heard from students
          -too young
          -no children
          -multiple partners

          ALL BS

          Beware of doctors who want you to "try everything else" before considering an IUD. Most women want an IUD because they know themselves and an IUD is best for them right now. Get a doctor who trusts you know what you want. It makes for a much better relationship.

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          • From my experience (Maybe it's just my area?) doctors tend to heavily push the IUD, specifically Mirena. I was a teen mom, and they tend to act like teenage parents are 'too irresponsible' for anything else. As it was, I had an awful experience, as did many others. I felt like I would die. I ended up in the emergency room several times, and it took 5 months to find a dr who would remove it. I do reccommend the copper IUD to women, but not Mirena.

      • I had the Implanon for 2.5 years. You really can't tell it's there unless you try, although I have to admit I was a little more protective of that arm getting hit. But the placement takes care of that mostly–how often do you accidentally hit the underside of your arm on something?

        I had regular periods on the Implanon. My pattern was that I would have two very light periods, then a period that was a bit heavier (and crampier) than my non-birth-controled periods. No irregular bleeding.

        Like others I did notice my sex drive decrease, although it was slight enough that until I got it out I attributed it to life changes. But within a month or so of getting it out suddenly it was a lot easier to orgasm! Go figure. That was really the only side effect I experienced, and like I said it was relatively subtle.

        My cycles were back to normal within 3 months of getting it out.

        TL;DR A+ would do again.

      • It's not perfect, but it's the best thing I've ever tried. I've used it twice, first time I barely had a period and didn't notice it much at all. Second time I started getting fairly regularly frequent bleeding – almost weekly – but this was toward the point when I decided to get it taken out anyway, to start trying for a baby (and I fell pregnant in the second month post-removal, so I'm fairly confident to say it doesn't affect fertility)
        I found the area where it was put in got itchy and sore sometimes, but I have incredibly, incredibly sensitive skin and break out in rashes at anything. It didn't hurt, and it wasn't noticeable unless I pushed my finger into my arm to make the other end "pop" out (by, like, 1/2mm). Pretty cool party trick – my friends (and husband) would always freak out when I did that.
        You know what was the absolute best thing. It was so reliable and I didn't have to do anything after it was put in and the insertion and removal were so simple and non-invasive (I have a bit of a squick at the idea of IUDs etc)
        TL;DR? Awesomeness, I definitely recommend

      • I am also a plus sized woman who has quite pudgy arms 🙂 I just got my 2nd Implanon inserted a few weeks ago. It sits just under your skin, not actually down in the fatty tissue and it doesn't move around. The only time I feel it in my arm is if my arm is bent and my body weight pressing against my arm. Even then, it is just slightly uncomfortable, no pain. The thing that did concern me about the Implanon and my weight was that there were no clinical trials done on women above normal body weight. I ended up getting my last one replaced 3 months early because my periods (which had been pretty few and far between/light for the first 2 years) had gotten heavier and closer together. I became worried that perhaps my larger body would require more hormones than a smaller body…I have no idea if this is actually true, but it seems to make sense. My doctor agreed it was strange that my periods had gotten so close together (the last ones were only 2 weeks apart) and agreed to replace it early. All in all, I think the Implanon is fantastic. I love not having to worry about having to take a pill or make sure my Nuvaring didn't come out during sex! On a side note – had the Nuvaring for a few years too. I had so many yeast infections with it…ugh. I have not had another yeast infection since I stopped using the ring. I think it just irritated my vagina. No fun.

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      • I am childless and have the Mirena. The reason doctors don't want to give them to child free women is 1) they think you'll just decide one day to have kids tomorrow and get it yanked after a month and 2) there aren't as many studies that were done on child free women. The studies that were done produced the same results as ones done on mothers (minus there may be more pain with insertion and the doc has to check and see if your uterus is large enough to accommodate). I've found that the reasoning behind most doctors not offering it (when asked) has a lot more to do with no. 1. I LOVE it when someone I've talked to for, oh, 5 minutes has a better idea of my long term plans than I do!

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      • I had a horrible experience with Implanon. Unpredictable, irregular bleeding for about 8-9 months. I went on it 6+ months before my wedding and was not sexually active until the wedding night. I was spotting during the entire honeymoon. I've talked with several friends about Implanon and apart from internet strangers, have only heard bad stories. I eventually just got sick of it! I used to be so very regular, even now, a whole year later, I'm not quite back to normal!

      • I had implanon for 8 months, at the end of that time I had to have it taken out because I basically hadn't stopped menstruating for the entire time.

        I didn't find it uncomfortable, although I was aware that it was there. Getting it removed was really painful, but I think that was because I had it done at my doctor's instead of at the family planning clinic.

      • I had the injections, which is basically the same. Apparently the implant is only the size of a grain of rice, so you shouldn't notice it, I know my sister hasn't mentioned that she notices it.
        I still got irregular bleeding, but no cramps, and I gained about 10kg (though that was coupley weight too). It also killed my sex drive (i don't have much of one to begin with) but it was good to only have to think of it every 3 months.
        The injections are really expensive – paying for the doc appointment and the prescription, but the implant is only about $20 once in three years (in Australia).
        I don't think my sister gets any bleeding, but she hasn't mentioned any sex drive issues.

  11. Mirena IUD!!! I've had mine for 5 years (actually I am overdue to have it replaced). I have not had my period in almost as long which was weird at first but obviously awesome. It is the best birth control method I have ever used and seems ideal for your situation. Good luck with whatever you decide to do. 🙂

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    • Here's another mirena recommendation. I LOVE mine so much. No more periods and super easy to use. Insertion hurt terribly, but only for two days. Totally worth it in my opinion.

  12. Love love Loved my copper IUD. I had 4 kids in 5 years on various types of birth control. After #4, I put in the copper IUD (hormones are not for me) and had 13 pregnancy free years. Took it out and was pregnant again within 3 months.

    Can't say enough about how awesome it was to be carefree, pregnancy free, BC symptom free (Yes, it's crampy the first few months but then…did I mention, 13 years?)

    1 agrees
  13. I love my nuvaring! If you're main issue with the pill is forgetting to take it then the nuvaring is a great option.

    1 agrees
  14. Just have to add to the copper IUD chorus! Through college and into my mid-20's I did The Pill, The Patch, The Ring, The Depo-Provera (aka The Worst), all with mixed success. I always had varying degrees of emotional and physical reactions to being on the hormones, and it always just sort of skeeved me out. When I met my husband I decided to try ParaGard. Yes, the initial insertion is uncomfortable (for me, like an intense menstrual cramp) and my first 5 or so periods were quite heavy and crampy, but after that I literally never had to think about birth control. Hooray! And no hormone craziness!

    3 agree
  15. I've had my Mirena IUD for 4 years now and it was the best decision I've ever made. It looks like everyone here has already posted a lot about it, but I do have one thing to add: Make sure your doctor/nurse practitioner numbs your cervix before insertion! My doctor numbed mine with lidocane injections and I was peachy keen, but almost every other woman in my circle who got one with out the lidocane was in a lot of pain and one of them even passed out. Then again, none of them have had children yet, so I don't know if that makes a difference.

  16. I love my Mirena IUD! I have had since Feb this year (2012) and after the first three months of heavy cramping, long periods and just feeling weird it got A LOT better! I haven't had a period since March tho I do have to wear a panty liner during "that time of the month". I will most likely be getting another one once this 5 years is up. It didn't hurt when it was placed, at least for me. I got it 6 weeks after my son was born and I am so happy that I did! DH and I don't want anymore children right now and most likely wont but I wanted to make sure if we changed our minds that we still could make that choice. I am planning on keeping the IUD at least until I am about 35 and then we are going to talk about who will be getting cut open or if we want just one more precious baby!

  17. I have a copper IUD, which is mostly great. I'm on my second one. A few things to consider, from my experience:

    First, for me, the first one was great for 7 years, and then it got slightly dislodged (not expelled, just pushed down a little too much).. The strings started poking my boyfriend, but when I went in to the gyno he just said "ok, well we can trim them a little," without any indication that anything might be wrong . Welp, shortly after that, even though it should have still been placed well enough to be effective, I guess I'm just quite fertile, because I got pregnant. Partly because it was in no way the right time for me to have a child, and partly because there is a very high miscarriage rate with pregnancies with IUDs still in place, i opted to get an abortion.

    This isn't to say that IUDs aren't effective – more to say that if you get one, make sure that you and your gyno have a good handle on how long the strings are so that if they lengthen by 1/4 or 1/2 inch you'll notice and can replace it. Particularly with the copper IUD, because there aren't hormones to help it out.

    Second, even though the IUD is worth it, depending on your cervix and uterus, it can be quite painful to get inserted. Both times I had mine inserted (with different gynos) I bled a lot and it was definitely far more severe than any severe menstrual cramp I've ever had. It was only a few minutes of pain for many years of effective birth control, but I'd definitely take some ibprofun before I went in to get it inserted, or, if you happened to have any vicodin or percocet around your house left over from wisdom tooth surgery or anything, I'd take a dose of that. Many people don't experience that much pain, but it's always better to be surprised by less pain than more.

    i don't want my experiences to scare anyone away from the IUD – I just want to be honest that everything doesn't always go 100% ideally with the IUDs. My issues were mostly preventable, though, with better knowledge of how long the strings were and better pain preparation both of them could have been avoided. I'd still definitely go with this form of birth control over any other, by far.

    • I've had a few friends experience pretty severe cramping with their IUD's being placed, too; I'm planning to take some Ibuprofen and possibly some kind of sleepy meds so I can just nap afterwards, since I don't have anything heftier lying around the house. 🙂

      • I use the Diva cup with my IUD and never had a problem. That doesn't mean it can't become a problem and you need to be careful. Checking the length of your strings regularly can help you find out if it has moved.

      • I didn't use a diva cup before that happened, no. The only thing I can think of is that I had a new sex partner, and things were rather…frequent and intense for a little while right before this happened.

        Since then, I have tried using a Diva Cup and it hasn't worked for me – caused a lot of very uncomfortable cramping.

  18. Super excited to get my Paragard (copper IUD) because I had such hideous experiences with hormonal birth control in the past. The lease evil option was the patch, which had few to no side effects other than being kind of a pain in the butt to keep on. I found that the edges peeled up a bit after even a single shower, and every now and then, I'd wake up with the sucker stuck to my sheets and not my upper thigh, but it was otherwise very easy, painless, and uncomplicated to use. All things being equal, a really good doctor who can consult and place an IUD is where I would start.

  19. I had a Mirena between children and loved it. It was hassle free and I had an immediate return of fertility after removal. A friend of mine who had trouble with oral contraceptives had no trouble with the Mirena because it's progesterone only and very low dose.

    I had the contraceptive injection years ago, and it really messed with my sex drive, but I had no such issues with the Mirena, and it's safe to use when breastfeeding.

    You can have an IUD placed even if you've never had children. If your OB/GYN tells you otherwise, get a second opinion.

  20. I have a copper iud and they last 10 years. Mirena lasts 5. Copper iud you don't have to worry about hormones, Mirena has added hormones. If inserted properly you should have no issues with tubal pregnancies. It also is rare that it falls out, usually because it wasn't put in properly or the person getting one hasn't had a child before. I have one child and may or may not have one in the future, but I can't do hormones anymore. Copper iud is a dream come true. People say you get heavier periods. I haven't noticed mine being any heavier. However I have noticed I spot for about a week before my period but it's not enough to wear a panty liner.

  21. Loved my copper IUD. No problems, aside from some light mid-cycle spotting after having it in for about 4 years. Highly recommend it (and if you don't like it, it's super easily reversible,)

  22. I had the three-year Implanon contraceptive implant, and I had no periods and no babies for the duration. I LOVED it and would definitely use it again when I need long-term contraception with peace of mind!

  23. I have the hormonal IUD, Mirena. I read bad things about the copper IUD, including heavy waterfall flow periods and terrible cramps… whereas I kept reading about the Mirena STOPPING periods all together!! So I went with Mirena, and haven't had a period since 2008!

    Mirena is AMAZING. I know sometimes they can fall out, but that usually happens within the first few months or first year. It's not an issue though if you check for it regularly. You can either check for it yourself in an odd squatting position, or do like I do, and ask my partner if he feels the strings every once and a while during sex. I had the strings on mine cut short, so my partners don't feel it except in certain positions where he hits deeper. And those positions tend to be painful for me anyway (…I don't need my cervix bashed…), so I'm glad that partners learn to avoid those specific positions lol. And since my period disappears, they REALLY don't complain… They seem to love that I never have to deal with periods.

    I've seen some Mirena users complaining of the hormones in it online, but I think that's an overreaction. I've been on the birth control pill and had crazy mood swings & huge weight gains, but with the localized hormones of Mirena, I have had zero issues.

    Also, I've heard from my doctor that they are running studies that seem to indicate that the Mirena IUD is functional for at least 8 years, more than the 5 originally tested for. Which would be AWESOME.

  24. I also have a copper IUD, and I really like not having to use hormones. It was pretty expensive initially, but not nearly as much as having a tubal ligation, (or a baby!). I think my bill was over $600, and done my a midwife. I'm sure cost varies from region to region. It's supposedly just as effective as serilization.

  25. It's funny that this came up today, as I just had a Paragard (copper) IUD placed yesterday. I have one son that is a year old and we are not certain whether we want another. Hormones don't work for me and I actually became pregnant in the first place because we were inconsistent with condom use.

    The insertion process was uncomfortable but not overly painful. I had to have it inserted during my period and it looks like the bleeding is about to stop today.

  26. I got the Mirena in May 2006. My body works better with a small dose of hormones as it actually reduces my headaches (weird, huh?). My periods slowed, then stopped by 2007. I got it removed in Feb 2010. We used condoms for March so I could plan out my period (I'm uber regular). I got pregnant in April. Babe was born in Jan 2011 and I got another Mirena in Feb. I hadn't even had my post-partum period yet. Now, I still haven't had a period. I do think that my body keeps an extra 5 -ish lbs because of the hormones, but that is worth is for the convinence.

  27. I have Paraguard, the HORMONE-FREE (!!!!!) IUD. It lasts 10-12 YEARS! And again, no hormones. I still get my period but other than that–no pill, no worries, nothin'. I've had it almost 3 years now and it's been the best decision of my LIFE!

    1 agrees
  28. I decided to go with ParaGard (copper IUD) for my birth control when I was a senior in high school — four years ago now. I've never looked back! I haven't had any pregnancies or changes in my period (i.e., my IUD doesn't make my periods heavier or more painful.) I had tried the Pill, the Patch, and NuvaRings as teen, all of which I either forgot, was annoyed by, or had hormonal issues with; in contrast, I don't have to think about my non-hormonal IUD, and it has never made me gain weight, break out, or get mentally unstable. Initial insertion was uncomfortable and I was sore and crampy for about a day, but since then it's been the easiest and most effective birth control choice I've ever made.

    Only caveat: twice (and I would stress that this is in a four year time span), when my husband and I have been having especially deep penetrative sex, I have experienced some severe cramping pain — my gynecologist said that he may have nudged my cervix a little roughly, which could have shifted the IUD slightly and caused the cramps. I checked it afterwards both times to make sure it was still in place; it was, I moved on.

    In summation: ParaGard! Fuck yeah!

    • So with your Paraguard, you still get a regular cycle? I kinda like the regularity and really get weirded out by the thought of complete cessation of periods even though my body's still supposed to do the same hormone dance.

      2 agree
      • i'm with you on this. i don't know why people think not having a period is awesome. the thought freaks me out. i have had mirena and paragard and have still had regular periods with both. cycles are kinda wonky right now with the paragard but i'm pretty sure it's being caused by breastfeeding, not the iud.

  29. i have a mirena IUD which in general i would recommend without hesitation. i *have* experienced some significant negative side effects with it, but i'm well-versed in the research on it and know that i'm most definitely a statistical minority.

  30. I had the Mirena for 3 years before having it out in December last year and getting pregnancy in February. I loved it and I think it's a great option if you're looking for something to last.
    We plan on having another child within 18 months of this one due in November so I have been wondering what options people have gone with in this circumstance? I figured we'd just end up using condoms, but I'm interested in people's experience with diaphrams? They seem to have gone out of fashion lately…

    • 6-24 pregnancies per 100 women using them for a year. Not to knock them. I've been using diaphragms for years, but always as a backup to another method.

  31. I use the Depo shot, and everyone yelled at me for it, but really I have had no problems, no scares, you just have to take EXTRA care that you dont have unprotected sex the first 7 days after you get it…any responsible person can achieve that. 🙂

    1 agrees
    • Just want to quickly add about depo that it can take 6 months to 2 YEARS to regain fertility after just one injection. Not a problem for people who aren't planning more children or won't be in a hurry, I just know a lot of people (including myself) who weren't aware of this and have been caught out waiting a very long time for ovulation to return.

      Other than that small but important thing, it was great for me.

  32. I'm a big implanon fan. I'm getting it put back in in a few weeks. I had some light bleeding for the first 6 weeks or so and then almost none for 3 years. As someone who had the kind of period pain that required a day in bed curled up in a little ball popping paracetamol, the no period thing was a massive bonus for me.
    As for drop in sex drive I'm not really sure, I've always had a high one and it's still high. Weight gain is something I'm not sure about as I was 18 when I got it put and in since then I've gone to college and had considerable lifestyle changes which were more likely to contribute to me gaining weight that the hormones.

  33. Just gotta chime in since I didn't see any similar comments: I had the Paraguard/Copper T IUD for about a year and absolutely loved it…UNTIL I suddenly was having super heavy, super painful periods that didn't seem to end. It took me a couple of months to realize how bad it had gotten before I finally went my new gyno (not the one who inserted it) and was promptly diagnosed with a raging pelvic infection. After the infection didn't resolve with a course of antibiotics, Dr. recommended removal of the IUD and I agreed. It took two more rounds of antibiotics to get the infection cleared up. I don't think my experience is typical, but please pay attention if you have an IUD and start experiencing unnaturally heavy periods (think soaking a pad/tampon more than once an hour) and pain. I don't know why I ignored the symptoms so long. Also for the record – I thought the insertion was terrible and was not warned at all by my old gyno how painful it would be (I have never been pregnant so I know that's a factor.) But – the removal is no big deal at all. Not trying to scare anyone at all with my story- IUDs are awesome and I still recommend them to any ladies looking for non hormonal, long term birth control. Just be aware that not all heavy bleeding while using the Paraguard is normal.

  34. I'd like to note that IUDs may now be FREE depending on your precise insurance situation. I had a 6 year old Mirena removed in …May? after 5.5 period-free years, and I'm currently using condoms while I decide if I should get another Mirena. I loved the no-periods, but it kind of flattened my sex drive. Now that I'm off hormones entirely for the firs time since i was 16, I've realized that my natural rhythm includes an ebb and flow of my interest in sex through the month, from SUPER HIGH when I'm ovulating to FUCK NO at the beginning of my period. With the Mirena, it was all "medium".
    So I'm now deciding between a Mirena or a Paragard, and weighing 'no periods' against 'more fun sex drive' (and unexpectedly, my partner has come out in favor of the no-hormones plan). Before the healthcare reform changes, I was also counting in 'cost' as a factor (Mirena costs about 50% more), but now…IDK. It's a weird place to be, because I LOVED not bleeding from the vag, but I also LOVE the hormone-free sex drive (as in, turns out my sex drive didn't decline after my mid-teens, I just put it on too many drugs).

    ARGHHH

    But long story short, whichever you pick, GET AN IUD. It's going to suck to get inserted, and suck for the first few weeks, and then it's going to be fucking awesome for the next several years.

  35. I've used both the Mirena IUD (with hormones) and the ParaGard copper IUD. Both were great. I did have heavy bleeding with the ParaGard, though, and that got old after a while. I had it taken out when I decided to try and conceive, and after the pregnancy opted for the Mirena. No periods, no hormonal side effects (other than no periods 🙂 ), I am sold.

  36. I thoroughly recommend the Mirena coil. It *can* be fitted in women who've not had children, it's just technically a bit more difficult to do. That doesn't stop them being fitted in childless by general practitioners here in the UK- in fact my last GP was at a student-only medical practice and they actively promoted the Mirena to their patients who were almost universally women who'd never been pregnant. My own experiences have been excellent, so much so that I'm now on my second and I have to say I can't ever imagine using a different contraceptive. My periods have stopped entirely (and safely- no build up of uterine lining!), I've got incredibly reliable and convenient contraception without the systemic effects that hormonal contraceptives usually bring. I tend to promote the Mirena to my patients as the safety profile is so good and it's so reliable.

    TBH though, the best person to speak to would be your doctor. Every woman's experience of every contraceptive will be different.

  37. I used the Nuvaring for 5 years before baby and now post partum I am going with the Depo shot since I plan on breastfeeding. Depending on what kind of hormones you can take will depend on your options.

  38. ring! I had an IUD for two years, but it became very painful…there's also a service that will text you a birth control reminder, i LOVE it, after two accidental and unwanted pregnancies ending in expensive and painful terminations it definitely gives me peace of mind.

    here's the link.
    http://bedsider.org/

  39. I tried the copper IUD, and wound up not caring for it because it increased my cramps and both the quantity and length of flow. I gave it 6 months to even out and for every 30-day cycle, I was still bleeding my regular 7 days (1 or 2 days of those heavier than before), plus an additional 10 days of spotting to light flow. My gynecologist said that about 1/3 of her patients have their IUDs removed because of problems like these. But I'm glad I tried it, and I hope the 2/3 who keep theirs are deliriously happy with it.

    Now I have the hormone-releasing IUD (Mirena) and I love it. Some women don't get periods at all with the hormone-releasing IUD. I do, and for the same 7 days I've always had periods, but the flow only ranges from spotting to light flow. (so light, in fact, that instead of using feminine products I just wear dark-colored underwear).

    IUDs can be painful to insert. I haven't had children yet, and my first IUD was about 30 seconds of very intense pain. The second one was slightly uncomfortable—like a pap smear—but not painful.

    The main concern with IUDs (of any kind) is that they can give STDs an entryway up into the uterus, which can scar the fallopian tubes shut. Therefore they are not a good choice for anyone who can foresee any STD exposure.

    A much more minor concern is that your partner may be able to feel the string (which is kind of like a fishing line) poking him during sex during the first couple of months, and he may prefer to avoid deep penetration during that time. But, the string usually curves to conform to your body after a month or two, and no more poking.

  40. I really really recommend reading the book "Taking Charge of Your Fertility." Learning to understand how my fertility cycle worked–and how to track it–was an amazingly empowering feeling for me, and I also don't have to use any "artificial" form of birth control now. I've been successfully doing this for 2 years. Depending on your particular cycle, lifestyle, etc. etc., natural birth control may not be a good option for you….but I still think the book is worth reading!

    1 agrees
  41. As a physician, I think either IUD is a great option. Everyone's body is different and reacts different to the hormones in birth control. Everyone's uterus can also respond differently to having the IUD placed there. Usually, with the placement itself, it is more painful in women who have not had children before and less with people who have had one child. Even less uncomfortable with those that have had multiple children vaginally (or at least dilated during labor). The placement is usually pain free if placed about 6 weeks postpartum. I just placed one in a lady a few days ago, who is overweight, dilated about 5 cm during labor but had to have a c-section because of a fetal arrhythmia. The placement went great and she had no associated cramping. However, like I said above, everyone is different and some have a lot of cramping with placement. You leave the strings long for about a month and then trim them if needed at your next check. I think the strings feel like fishing line, so they can be pokey on your partners penis during intercourse at times. The strings can always be trimmed if this is the case. I enjoy reading all the comments about because I think all the experiences are true and reiterates that everyone is different. You need to figure out what is best for you but I think it is worth trying either one of the IUDs. It sounds like a great option for what you are looking for. It might be a great idea to further discuss this with your physician or a group like planned parenthood! Good luck with your decision!

  42. I have the contraceptive implant in my arm, which is great, but I've noticed it's never mentioned on US-based forums, so I presume it's not available there.

    Lasts 3 years (but is removable) and can be used while breastfeeding, so I had it fitted ASAP after my son was born. It will easy to remember when to speak to the docs about replacing it – on his third birthday!

  43. Now granted I have lots of issues with plenty of different hormones for multiple reasons but I was on Nuvoring for a couple of years and while it was incredibly convenient, I had all my normal period side effects magnified – cramps, flow, fatigue, mood swings, acne etc. Though really, while it sucked, I hardly noticed how much worse my periods were until I quit using it. And while my partner could feel the ring, it was funny as hell when he got a 'hole in one.'

    On a different note, a friend of mine though had a horrible time with mirena after her baby. She had preeclampsia and still had high blood pressure afterwards so her doctor didn't want her on the pill anymore. She ended up getting pregnant anyways a few months later and resulting in a miscarriage. Although when she was back on the pill she got pregnant again anyways and everything looks healthy as she hits her second trimester.

  44. Under the Affordable Care Act (aka "Obamacare"), beginning September 23, 2010, all FDA-approved forms of contraception including sterilization are available with no cost-sharing (no copay, deductible, or coinsurance). That means that not only can you get birth control pills for free, you can get any FDA-approved method. I have so, so, so many reasons for advocating the IUD that I dedicated a post on my blog to it 🙂
    http://crunchyintraining.tumblr.com/post/24455157581/eco-friendly-family-planning

    Obviously, call your health insurance first before getting one so you make sure you go through an in-network provider, etc. Or if you don't have insurance, check with Medicaid, Planned Parenthood, and other clinics to find out how you can go about getting your free contraception. Even if you end up paying out-of-pocket, the up front costs is cheaper in the long-term than the monthly pharmacy bill. For more info go to http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen

  45. I know that these comments have gotten long and thorough – but I wanted to link to Rebecca Woolf at Girls Gone Child – who had a genuinely awful experience with the Mirena between her second and third pregnancies & is currently having a very unpleasant time with her paraguard

    Mirena – after her removal, with links to the previous posts
    http://www.girlsgonechild.net/2010/04/mirenafterward.html?m=1

    This post contains her paraguard problems – lots of good comments
    http://www.girlsgonechild.net/2012/09/liner-notes-95.html?m=1

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