I’m so glad things have progressed so much since I first asked a dr birth control 20 years ago. They basically gave me the pill, no other options were discussed and it wasn’t covered. I switched to the jaydess iud three years ago and it was so much better for me. I had no idea how much better I could feel off the pill!!!!
@@dr.kristinadervaitis789 hi there! I am trying to find a progesterone that will work with my estrogel. I am so sensitive to steroid hormones, even the progesterone iud I had to remove as insomnia hit. Is there a progesterone that is not a steroid hormone?
I just got mirena! I already feel a lot better about this than I did taking the combination pill. The pill gave me such horrible headaches and migraines almost everyday. And I’ve been diagnosed with early onset glaucoma so my obgyn said NO estrogen birth control ever again. Especially with the migraines I had.
Good morning Doctor Kristina hope you doing well.. thanks for the information.. I myself actually got an IUD liretta yesterday.due to having my estrogen levels to high and dealing with the bloatness, mood swings, weight gain, etc so and so with that being said.. I'm hoping for the symptoms reduces while having the IUD..🙏❤️
🙏i was like too got mirena insertion last week im feeling a bit with my hormone madness but monitoring any orher side effect Hope yours reduce completely give it time🙏
Hi Dr. Kristina, First of all, I want to say I love watching and listening to your videos. The details you provide are succinct. I absolutely love the way you speak and present yourslef. I have watched 10 videos of yours already and this is my first time ever doing it on TH-cam. You are very smart, not monotone, and every second of your video has useful information unlike the unnecessary, waste-of-my-time sort that I usually find on youtube. You are a gem. Thank you for enlightening me. I live in Edmonton, Canada and I wish you were my doctor. My specialist was not informative at all and didn't seem to like answering, let alone hearing my questions. I wonder if you could answer some questions that I have. 1) I am 28 years old and has never been pregnant. I had my copper IUD inserted last April 30, 2020, but I was told to come back only after 3 months for a follow-up, why is this different from the after 1-month post-insertion protocol you follow? I would be more at ease if I came back after a month and not after 3 months. 2) I have been having occasional unilateral lower abdominal and lower back/sacral pain (right side). Is this to be expected? 3) I could only feel one string when I check for the placement of my IUD. What should I do? Thanks for the time in reading my comments. Hoping for your kind response. God bless you.
Hello- Wow! Thank you for such kind words! It is such a privilege to be able to help patients all over Canada (and the globe!) via TH-cam. I can’t tell you how meaningful it is for me to hear that someone out there finds this information useful. I can answer general questions, so: 1) Every practitioner varies in terms of what they recommend for follow up. Some do 1 month check ups, some 3 months (others may not offer any routine follow up at all). I am “guessing” but perhaps the rationale behind waiting for 3 months is that most patients will be past the frustrating “adjustment phase” by that time? If you have problems, I’m sure your doctor would be willing to see you sooner. 2) I can’t give personalized medical advice over the internet, so I can’t really comment on this specific symptom of yours. If you are concerned, see your doctor. 3) Usually the strings sort of stick together and just feel like one string, so I would not be concerned. Hope this helps. Thanks for watching! Tell your friends! During the pandemic women need to continue to attend to their reproductive health and prevent unplanned pregnancy! Take care, Dr. Dervaitis
Hello- The IUD might not be effective right away (if it is the hormonal IUD, it depends on where you are in your menstrual cycle when it is inserted... ) Your doctor will give you instructions as to when it will be effective- after that point no other contraception is required (ie, you do not need to use the “pull out” method in addition...) (But remember, the IUD does not prevent STI’s, so always use condoms with a new partner to prevent infection!) Thanks for watching! -Dr. Dervaitis
Hi Natalia- I continue to accept new patients for contraception counselling and IUD insertion. Because I am a specialist, it requires a referral from your family doctor. If you have questions feel free to give my office a call (info available online). See you soon! -Dr. Dervaitis
Hello, thank you so much for your useful content. I had severe depressive events and suicidal thoughts with the pills for the 15 years I have taken them, and noticed a drastic improvement when I stopped for the past 6 months. Yesterday I decided to place the hormonal IUD as I was told by the nurse that since it is only progestin and because the hormone would be localized I would not have the same experience. but I am scared I would be depressed again from the hormonal contraceptive. Would you please share your insight on this? Thank you, I have nowhere to ask..
Mood side effects are possible, but relatively uncommon with the hormonal IUD. The amount of hormone that reaches the bloodstream is 100 times less compared to the pill. I routinely prescribe hormonal IUD’s for patients with a history depression (even severe depression)- it is not a contraindication. -Dr. Dervaitis
Hi Meka- It’s difficult to say what would happen in this situation re: acne. Some patients may find that their acne returns (since they no longer are on the pill) while others may not. These sorts of decisions need to be on a individual, case by case basis. It also depends on their reason for wanting to switch to an IUD: are they bad at remembering to take pills, and thus at increased risk of unplanned pregnancy? Which would be more bothersome: acne, or an unplanned pregnancy? Are they having heavy menses despite being on the pill and wanting to try Mirena for that reason? (There can be many other factors that weigh into the decision making). -Dr. Dervaitis
MekaSharee, I am NOT a doctor, but my doctors told me that Mirena would be fine even though I have a history of acne. This is NOT true. Progesterones are all different, some affect acne worse than others. Levonorgestrel is what is used in most (maybe all) of the horomonal IUDs. Levonorgestrel (the type of progesterone) is the worse type of progesterone for acne! It is highly androgenic, and increases oil production, without having any estrogen to counteract the androgens. My acne got so bad that they want to give me accutane now. But im just going to remove it as im suffering many other side effects. Very upset that I was told it would be fine for someone with a history of acne. I would suggest the non-horomonal IUD if you have a history of acne. But do your own research. Definately ask your doctor but do not rely on their information alone.
Hi! I just had the copper IUD inserted and am staying on the pill as it helps with my skin's acne. Will this affect bleeding at all? So far since insertion (five days ago), I have had rather heavy bleeding that feels like a period and on and off cramps (which I believe is normal for people without the pill but i'm not sure if it is the same with the pill). For most people in this scenario would it be better to wait until this is over then continue the pill or keep taking them regularly?
Hi, thanks a lot for the information, found it really good to have a Doctor's opinion. Would you say a woman who'd like to switch from the pill to the copper IUD should wait a few months until the normal period cycle is "back on track" before inserting the IUD? Also, I see a lot of videos of women who say that stopping the pill (and any kind of hormones for that matter, hence considering the copper IUD) made them feel better mentally, less anxious and to have more libido. Any medical reason/opinion on that matter?
Hi Diane- There is no reason to discontinue the pill months prior to IUD insertion (doing so really just increases the risk of unplanned pregnancy in that time interval). Mood related side effects are a possibility with hormone use. The patient’s medical history (and previous potential mood/ psychiatric issues) is definitely relevant. Overall, mood side effects are relatively uncommon with the pill, and even less common with a hormonal IUD (please see video #10 regarding Possible Hormonal Side Effects). There is no convincing evidence in the medical literature that either the birth control pill, or the hormonal IUD, have any negative impact on libido. Thanks for watching! -Dr. Dervaitis
I have a copper IUD and I’ve been having irregular periods and spotting, and recurrent yeast infections. I’ve had it for over a year and I’ve never had yeast infections before except while pregnant. The only reason I’m afraid of using the pill is the long-term hormone exposure, otherwise I’ve used it before without major side effects.
Hi Katie- Unfortunately I can’t give personalized medical advice over the internet. I’d recommend that you watch video #7 (re: bleeding post IUD insertion) and video #18 (in which I discuss the issue of yeast infections- there is actually not any evidence to link yeast infections to either the copper or hormonal IUD). -Dr. Dervaitis
Hi Katie, Im not a doctor, but I had similar problems with Yazmin (a pill that can cause spotting). I had a ton of side effects from that pill, one of which was constant spotting. I had yeast infections all the time as well, which I did not have spotting or yeast infections before on any other birth control. It persisted for years. What I learned from a walk in doctor somewhere after seeing so many many doctors and specialists who said they had no idea why this was happening, was that the yeast infections could be caused by a change in PH, which obviously the blood can cause a change in PH. So that made a lot of sense. Its like how they say Chocolate bars don't cause acne, horomones do, or dirt does. WELL sugar in chocolate bars does affect your horomones, causing more androgens, which in turn can increase oil production in the skin, which in turn can cause acne. But they still like to say the cause of acne is not the food. Same idea.
A very informative video. I have been thinking about going from the (combination) pill to an IUD. The problem for me is that I like not menstruating every month (for example: when I’m on holiday), but I’ve been reading that some people do menstruate and some don’t when using an IUD. What is your thought on switching if I like being able to skip a month?
Can acne be caused from the IUD? I was on the pill for 10 yrs (never had a problem with acne) and after having my daughter switched to the IUD so I could continue breastfeeding without worrying. Now I get frequent breakouts even on my back now and I think it might be from that....
Hi Dr. Dervaitis, Could you speak to the differences between the mini pill and the LNG iud such as kyleena? I was on the mini pill and experienced extreme mood change/depression. I had to discontinue the pill due to this. I really don’t want to be on the combination pill (been on it before and didn’t like it), but could you please speak to the research, and to your thoughts on if because I had this effect on the mini pill (progesterone only) if I would have the same effect on a progesterone only Iud? Or would I be at a lesser risk possibly because of the localized rather than systemic integration of hormones in your system?
Yes, lesser risk due to local versus systemic (blood stream) absorption. The same concepts regarding the combined pill versus the LNG IUD apply here (ie- 100x less hormone exposure compared to the mini pill). Refer back to video #14 (the pill versus IUD). -Dr. Dervaitis
I want to go on birth control after I give birth I’ve watched several videos on different types of birth control and still do not know which one would work for me I noticed a lot of women experience acne and irregular periods/bleeding for weeks at a time and mood swings depression with IUDs ? Which ones do you prefer ?
Hi Michelle- For more information on this subject, please see my video #11- “Copper versus Hormonal IUD”.Choosing the right IUD is a very individualized process, and many factors need to be considered (including what the patient’s menstrual cycles are like, any other medical conditions...) Please also consider watching video #29- “Interpreting Online IUD Reviews- An Approach”. I will say that, as a gynecologist, I am all about helping patients have better periods, and for this reason, I generally tend to recommend the hormonal IUD (although it depends on the patient, their medical history and their personal preferences). -Dr. Dervaitis
Hello Dr.Dervaitis I watched the videos there so informative! I’m still stuck on which would be the best for me My skin is pretty clear overall I do get anxiety and have hormone imbalance And my periods have always been regular Would the hormonal iud work for me
Hello, thank you so much for all of the information I recently got back on the pill, and have notice major breakouts and hair loss. I've switched to a few different pills and continue to have the problem which now has me looking at iud's instead. Would you see hormonal side effects like that with an iud?
Hello Dr , I had a IUD Mirena put 5 days ago but the doctors told me later I had cervix erosion , is that a problem, Pap smear has some inflammation, I had antibiotics for it .
Hello- Speaking generally (as I am not your physician and have not had the opportunity to examine you myself...) a “cervical erosion” is a variant of normal anatomy that does not require treatment (it occurs when the cells that typically live the inner “tunnel” of the cervix, are visible on the outer surface of the cervix). I don’t know the details of your Pap smear or the antibiotics, so I can’t comment on that aspect. -Dr. Dervaitis
I have a question- even though the pill as higher levels of levonorgestrel than the IUD, will the IUD still work once inserted after the pill with lower levels of levonorgestrel? This may seem like a silly question, but I have to ask. Thank you 🙂
Yes- the pill and IUD work by different mechanisms. While the pill suppresses ovulation (which requires higher levels of hormone in the blood stream…) the hormonal IUD works by creating a “hostile” uterine environment and by preventing sperm entry with thickening of cervical mucus. It also thins the lining of the uterus which helps to prevent implantation. These mechanisms are able to be accomplished with the hormonal IUD’s local delivery of levonorgestrel to the uterus. -Dr. Dervaitis
I've had the mirena iud for a month now. I was wondering, does it change your skin?? I used to have super oily skin and now im super dry besides my T zone but that isn't as oily as it was
Hi Dr Dervaitis, I am 47 and having heavy bleeding (endometrial hyperplasia without atypia). My gynae has given me the progestogen only hormone pill but not much improvement. Since the hormone pill is not working, do you think I should give IUS Mirena a try? Are the hormone pill and mirena function the same? Your advice is much appreciated. Thank you.
Hi Alison- Unfortunately I can’t give personalized medical advice over the internet. Speaking generally, I will say that although use of Mirena is considered “off label” for this indication, an RCOG (UK) guideline does list the levonorgestrel IUS as a first line option for treatment of hyperplasia without atypia. If you are unsure about your treatment plan, I suggest that you review your questions with your doctor. -Dr. Dervaitis
This has not been my personal practice. There is no evidence to support use of Cytotec (misoprostol) prior to IUD insertion (the thought is that it will help soften/ open up the cervix, but studies have not confirmed that it really helps the insertion). Patients can take an analgesic or anti-inflammatory medication prior to the procedure, although there is not strong evidence that it makes a difference to take it before versus after. -Dr. Dervaitis
😳 I have no idea why this amount is so high. ??? While every health care system is different... if a Mirena is done in office and privately billed in Canada (if the patient is not covered by the government sponsored insurance plan), right now the Mirena itself would cost about $450 (paid to the pharmacy) the office visit portion would be at the discretion of the doctor but I suspect much less than that (I’d estimate less than around $200, given that the government sponsored insurance amount is even less than that...) If the procedure were being done in an operating room setting with an anesthesiologist and other staff, it would be more expensive (but that is rarely necessary). -Dr. Dervaitis
No! Efficacy would be the same (if anything, risk of pregnancy would be even lower due to the effects of the combined birth control pill). -Dr. Dervaitis
Hello- Unfortunately I can’t give personalized medical advice over the internet, I can only answer generalized questions. Please be sure to look at the full library of my videos, which might help in answering some of your questions. -Dr. Dervaitis
Hi Dr, thank you for these helpful videos. I have had and iud since 2008 and had it removed in 2018. I am 35 > I noticed clotting sometimes when I menstruate. I visited my obgyn here in South Africa and she has advised me to start the yaz plus pill. Would this be advisable? I am a smoker, I don't want to have another iud put is there any other options for me I also have mild acne. Thanks
Hi- Unfortunately I can’t give personalized medical advice over the internet. (But I will say that I’d encourage you to quit smoking! ) I generally don’t prescribe the combined birth control pill to smokers age 35 and over. The treatment options for heavy menstrual bleeding depend on a number of variables. You’ll need to speak to your doctor for further evaluation and treatment. You can check out the website: www.heavymenstrualbleeding.com -Dr. Dervaitis
Hi! I have recently seen some information surrounding the increased risk of ovarian cysts when switching from the pill straight to an IUD. Is the occurrence of ovarian cysts a common finding in patients that make this switch? Thanks for all your help!
Functional (benign) ovarian cysts are fairly common in all women with functioning ovaries that are ovulating each month. Because the IUD does not suppress ovulation in most women, these cysts can occur. They are usually self limited (resolve spontaneously) and rarely cause symptoms. Women on the pill are less likely to have these cysts because the pill prevents ovulation. -Dr. Dervaitis
The combination pill Lari Fe 1/20 stopped my periods completely which I loved. Will the Mirena IUD stop my periods too? I am thinking of changing to the iud.
@@Sumadhura_ I stopped birth control for a while. I just got back I am taking lo loestrin. I plan to skip the placebo pills to skip my periods. I know many women do it without any issues. If you want to stop your period just don’t take the placebo.
I am actually looking into changing from depo to this. Now I know my Dr. Says this isn't supposed to have you gain weight but I have gained over 20 pounds in the last 3years. Can you please make a video about changing from depo to this
Hello- I will add your suggestion to my video “to do” list- thank you! Great idea👍 Depo Provera has definitely been shown to be associated with weight gain in studies- average 5lbs but up to 20lbs has been documented. The hormonal IUD is totally different: 1) different delivery method of progesterone 2) far less absorption of progesterone into the bloodstream (100x less compared to the pill or Depo) 3) no study evidence showing weight gain There are plenty of advantages to switching from Depo (“the shot”) to the hormonal IUD, and I’ll go over it in the video. Make sure you’re subscribed so that you’re alerted when the video is posted! Thanks for watching! -Dr. Dervaitis
Hello, I was wondering is it a good idea to stay on iud, I have irregular periods, and have sharp cramps, I also spot and had it for a year. I wanted to get back on the pill, I didn’t have and issues with it
Hi! I recently just had a mirena iud put in and I have been getting headaches on and off, almost like migraines and I’ve heard some things about intracranial hypertension and was wondering if that’s something that should be of concern? and if headaches are a common symptom, when should they stop?
As per the Mirena Product Monograph, ICH is not a known adverse drug reaction with Mirena. A small percentage of women may report headaches. The hormonal IUD is not contraindicated in migraine sufferers. If you are experiencing headaches, talk to your doctor. -Dr. Dervaitis
Dr. Kristina Dervaitis, are any headaches or dizziness normal due to the hormone changes with the hormonal iud? and if they continue, would you recommend I get it taken out?
Headaches are a reported potential side effect, but not dizziness. If you are wondering about whether to continue with your IUD, speak to your doctor (this channel is not intended to provide personalized medical advice). -Dr. Dervaitis
Dr. Kristina Dervaitis, I ended up getting it removed as I was really nervous, but am not sure if what I was experiencing was caused by it or not because I still felt that way a little while after. I’m supposed to be getting another one at the end of September again after doing more research and was going to get Kyleena, but am not sure if I should try Mirena again. I have seen that Kyleena is slightly less effective then Mirena due to the amount of hormones, but I don’t know if this is true. How do you know how many hormones is enough for you? I know some women need more and some women need less, but I really don’t know for me.
Hello- Unfortunately I can’t give personalized medical advice over the internet. But speaking generally, note that for pregnancy prevention, Kyleena and Mirena are equivalent (both have a 2/1000 chance of pregnancy). Although the 52mg hormonal IUD (Mirena) is approved by the FDA for treatment of heavy menstrual bleeding, Kyleena also has recognized beneficial effects on the menstrual cycle. -Dr. Dervaitis
There is not any harm to “overlap” the hormonal IUD and depot- but both contain progesterone, so we would not usually prescribe both for the long term. The copper IUD does not contain any progesterone, so it would be OK to use a copper IUD Depo Provera concurrently (for whatever period of time, as prescribed by your doctor). -Dr. Dervaitis
Hi- This video is just about the IUD versus the pill. I may plan to do a future video that compares the IUD to “the shot” (Depo Provera). -Dr. Dervaitis
I’m so glad things have progressed so much since I first asked a dr birth control 20 years ago. They basically gave me the pill, no other options were discussed and it wasn’t covered. I switched to the jaydess iud three years ago and it was so much better for me. I had no idea how much better I could feel off the pill!!!!
Thank you so much for this public service!
You are so welcome! Thanks for watching!
😊Dr. Dervaitis
@@dr.kristinadervaitis789 hi there! I am trying to find a progesterone that will work with my estrogel. I am so sensitive to steroid hormones, even the progesterone iud I had to remove as insomnia hit. Is there a progesterone that is not a steroid hormone?
No.
I just got mirena! I already feel a lot better about this than I did taking the combination pill. The pill gave me such horrible headaches and migraines almost everyday. And I’ve been diagnosed with early onset glaucoma so my obgyn said NO estrogen birth control ever again. Especially with the migraines I had.
Thanks Dr. D! I have been debating between birth control and an IUD and this really helped! Love your channel
Thanks for watching 😊 Glad you found the videos helpful!
All the best,
Dr. Dervaitis
Im debating between staying on the pill or the iud so this is a very helpful video for making my decision. Thanks!
What decision did you make? How are things going so far?
Good morning Doctor Kristina hope you doing well.. thanks for the information.. I myself actually got an IUD liretta yesterday.due to having my estrogen levels to high and dealing with the bloatness, mood swings, weight gain, etc so and so with that being said.. I'm hoping for the symptoms reduces while having the IUD..🙏❤️
🙏i was like too got mirena insertion last week im feeling a bit with my hormone madness but monitoring any orher side effect
Hope yours reduce completely give it time🙏
Hi Dr. Kristina,
First of all,
I want to say I love watching and listening to your videos. The details you provide are succinct. I absolutely love the way you speak and present yourslef. I have watched 10 videos of yours already and this is my first time ever doing it on TH-cam. You are very smart, not monotone, and every second of your video has useful information unlike the unnecessary, waste-of-my-time sort that I usually find on youtube.
You are a gem. Thank you for enlightening me.
I live in Edmonton, Canada and I wish you were my doctor. My specialist was not informative at all and didn't seem to like answering, let alone hearing my questions.
I wonder if you could answer some questions that I have.
1) I am 28 years old and has never been pregnant. I had my copper IUD inserted last April 30, 2020, but I was told to come back only after 3 months for a follow-up, why is this different from the after 1-month post-insertion protocol you follow? I would be more at ease if I came back after a month and not after 3 months.
2) I have been having occasional unilateral lower abdominal and lower back/sacral pain (right side). Is this to be expected?
3) I could only feel one string when I check for the placement of my IUD. What should I do?
Thanks for the time in reading my comments.
Hoping for your kind response.
God bless you.
Hello-
Wow! Thank you for such kind words! It is such a privilege to be able to help patients all over Canada (and the globe!) via TH-cam. I can’t tell you how meaningful it is for me to hear that someone out there finds this information useful.
I can answer general questions, so:
1) Every practitioner varies in terms of what they recommend for follow up. Some do 1 month check ups, some 3 months (others may not offer any routine follow up at all). I am “guessing” but perhaps the rationale behind waiting for 3 months is that most patients will be past the frustrating “adjustment phase” by that time? If you have problems, I’m sure your doctor would be willing to see you sooner.
2) I can’t give personalized medical advice over the internet, so I can’t really comment on this specific symptom of yours. If you are concerned, see your doctor.
3) Usually the strings sort of stick together and just feel like one string, so I would not be concerned.
Hope this helps. Thanks for watching! Tell your friends! During the pandemic women need to continue to attend to their reproductive health and prevent unplanned pregnancy!
Take care,
Dr. Dervaitis
Thank you so much for making these videos! They’re so helpful in deciding what method to use!
Hi Dr. D! Thank you for all this great information. I really appreciate all the openness. With the IUD, is the "pull out" method still recommended?
Hello-
The IUD might not be effective right away (if it is the hormonal IUD, it depends on where you are in your menstrual cycle when it is inserted... ) Your doctor will give you instructions as to when it will be effective- after that point no other contraception is required (ie, you do not need to use the “pull out” method in addition...)
(But remember, the IUD does not prevent STI’s, so always use condoms with a new partner to prevent infection!)
Thanks for watching!
-Dr. Dervaitis
I wondered this too Makenna. I have the Paraguard. Thanks for the answer Dr. D!
Really appreciate your videos! Wish I would of found them before having my IUD inserted but still very helpful. Thank you!
Omg! Nobody has ever explained this to me as good as you did!
Very informative! Thank you.
Thank you for this, very informative 🙂
I would like to come to the clinic for a consultation. How can I please make an appointment? Thank you. Natalia
Hi Natalia-
I continue to accept new patients for contraception counselling and IUD insertion. Because I am a specialist, it requires a referral from your family doctor. If you have questions feel free to give my office a call (info available online).
See you soon!
-Dr. Dervaitis
Hello, thank you so much for your useful content. I had severe depressive events and suicidal thoughts with the pills for the 15 years I have taken them, and noticed a drastic improvement when I stopped for the past 6 months. Yesterday I decided to place the hormonal IUD as I was told by the nurse that since it is only progestin and because the hormone would be localized I would not have the same experience. but I am scared I would be depressed again from the hormonal contraceptive. Would you please share your insight on this? Thank you, I have nowhere to ask..
Mood side effects are possible, but relatively uncommon with the hormonal IUD. The amount of hormone that reaches the bloodstream is 100 times less compared to the pill. I routinely prescribe hormonal IUD’s for patients with a history depression (even severe depression)- it is not a contraindication.
-Dr. Dervaitis
Can you please talk about IDU & CKD side effects
For someone who specifically started the pill to prevent acne and it has been successful, would it be wise if they switched to an IUD?
Hi Meka-
It’s difficult to say what would happen in this situation re: acne. Some patients may find that their acne returns (since they no longer are on the pill) while others may not. These sorts of decisions need to be on a individual, case by case basis. It also depends on their reason for wanting to switch to an IUD: are they bad at remembering to take pills, and thus at increased risk of unplanned pregnancy? Which would be more bothersome: acne, or an unplanned pregnancy? Are they having heavy menses despite being on the pill and wanting to try Mirena for that reason? (There can be many other factors that weigh into the decision making).
-Dr. Dervaitis
MekaSharee, I am NOT a doctor, but my doctors told me that Mirena would be fine even though I have a history of acne. This is NOT true. Progesterones are all different, some affect acne worse than others. Levonorgestrel is what is used in most (maybe all) of the horomonal IUDs. Levonorgestrel (the type of progesterone) is the worse type of progesterone for acne! It is highly androgenic, and increases oil production, without having any estrogen to counteract the androgens. My acne got so bad that they want to give me accutane now. But im just going to remove it as im suffering many other side effects. Very upset that I was told it would be fine for someone with a history of acne. I would suggest the non-horomonal IUD if you have a history of acne. But do your own research. Definately ask your doctor but do not rely on their information alone.
Hi! I just had the copper IUD inserted and am staying on the pill as it helps with my skin's acne. Will this affect bleeding at all? So far since insertion (five days ago), I have had rather heavy bleeding that feels like a period and on and off cramps (which I believe is normal for people without the pill but i'm not sure if it is the same with the pill). For most people in this scenario would it be better to wait until this is over then continue the pill or keep taking them regularly?
This channel is not intended to provide personalized medical advice. I’d recommend that you speak to your doctor.
-Dr. Dervaitis
Hi, thanks a lot for the information, found it really good to have a Doctor's opinion.
Would you say a woman who'd like to switch from the pill to the copper IUD should wait a few months until the normal period cycle is "back on track" before inserting the IUD?
Also, I see a lot of videos of women who say that stopping the pill (and any kind of hormones for that matter, hence considering the copper IUD) made them feel better mentally, less anxious and to have more libido. Any medical reason/opinion on that matter?
Hi Diane-
There is no reason to discontinue the pill months prior to IUD insertion (doing so really just increases the risk of unplanned pregnancy in that time interval).
Mood related side effects are a possibility with hormone use. The patient’s medical history (and previous potential mood/ psychiatric issues) is definitely relevant. Overall, mood side effects are relatively uncommon with the pill, and even less common with a hormonal IUD (please see video #10 regarding Possible Hormonal Side Effects).
There is no convincing evidence in the medical literature that either the birth control pill, or the hormonal IUD, have any negative impact on libido.
Thanks for watching!
-Dr. Dervaitis
Hi! I have seen a lot of information online linking the copper IUD to hair loss. Is this something I should worry about when considering a copper IUD?
Jordan-
Thanks for your question. There is not any scientific evidence to link either the copper IUD or the hormonal IUD with hair loss.
-Dr. D
Thanks very informative
I have a copper IUD and I’ve been having irregular periods and spotting, and recurrent yeast infections. I’ve had it for over a year and I’ve never had yeast infections before except while pregnant. The only reason I’m afraid of using the pill is the long-term hormone exposure, otherwise I’ve used it before without major side effects.
Hi Katie-
Unfortunately I can’t give personalized medical advice over the internet. I’d recommend that you watch video #7 (re: bleeding post IUD insertion) and video #18 (in which I discuss the issue of yeast infections- there is actually not any evidence to link yeast infections to either the copper or hormonal IUD).
-Dr. Dervaitis
Hi Katie, Im not a doctor, but I had similar problems with Yazmin (a pill that can cause spotting). I had a ton of side effects from that pill, one of which was constant spotting. I had yeast infections all the time as well, which I did not have spotting or yeast infections before on any other birth control. It persisted for years. What I learned from a walk in doctor somewhere after seeing so many many doctors and specialists who said they had no idea why this was happening, was that the yeast infections could be caused by a change in PH, which obviously the blood can cause a change in PH. So that made a lot of sense. Its like how they say Chocolate bars don't cause acne, horomones do, or dirt does. WELL sugar in chocolate bars does affect your horomones, causing more androgens, which in turn can increase oil production in the skin, which in turn can cause acne. But they still like to say the cause of acne is not the food. Same idea.
A very informative video.
I have been thinking about going from the (combination) pill to an IUD.
The problem for me is that I like not menstruating every month (for example: when I’m on holiday), but I’ve been reading that some people do menstruate and some don’t when using an IUD.
What is your thought on switching if I like being able to skip a month?
20-30% won’t menstruate while using the hormonal IUD (but there’s not really a way to predict who will or will not have a cycle...)
-Dr. Dervaitis
Can acne be caused from the IUD? I was on the pill for 10 yrs (never had a problem with acne) and after having my daughter switched to the IUD so I could continue breastfeeding without worrying. Now I get frequent breakouts even on my back now and I think it might be from that....
Please see video #10 (about possible hormonal side effects with the IUD).
-Dr. Dervaitis
Hi Dr. Dervaitis,
Could you speak to the differences between the mini pill and the LNG iud such as kyleena? I was on the mini pill and experienced extreme mood change/depression. I had to discontinue the pill due to this. I really don’t want to be on the combination pill (been on it before and didn’t like it), but could you please speak to the research, and to your thoughts on if because I had this effect on the mini pill (progesterone only) if I would have the same effect on a progesterone only Iud? Or would I be at a lesser risk possibly because of the localized rather than systemic integration of hormones in your system?
Yes, lesser risk due to local versus systemic (blood stream) absorption. The same concepts regarding the combined pill versus the LNG IUD apply here (ie- 100x less hormone exposure compared to the mini pill). Refer back to video #14 (the pill versus IUD).
-Dr. Dervaitis
I want to go on birth control after I give birth I’ve watched several videos on different types of birth control and still do not know which one would work for me I noticed a lot of women experience acne and irregular periods/bleeding for weeks at a time and mood swings depression with IUDs ?
Which ones do you prefer ?
Hi Michelle-
For more information on this subject, please see my video #11- “Copper versus Hormonal IUD”.Choosing the right IUD is a very individualized process, and many factors need to be considered (including what the patient’s menstrual cycles are like, any other medical conditions...) Please also consider watching video #29- “Interpreting Online IUD Reviews- An Approach”.
I will say that, as a gynecologist, I am all about helping patients have better periods, and for this reason, I generally tend to recommend the hormonal IUD (although it depends on the patient, their medical history and their personal preferences).
-Dr. Dervaitis
Hello Dr.Dervaitis I watched the videos there so informative! I’m still stuck on which would be the best for me
My skin is pretty clear overall
I do get anxiety and have hormone imbalance
And my periods have always been regular
Would the hormonal iud work for me
Hello, thank you so much for all of the information I recently got back on the pill, and have notice major breakouts and hair loss. I've switched to a few different pills and continue to have the problem which now has me looking at iud's instead. Would you see hormonal side effects like that with an iud?
See video #10 for information about possible hormonal side effects.
Hello Dr , I had a IUD Mirena put 5 days ago but the doctors told me later I had cervix erosion , is that a problem, Pap smear has some inflammation, I had antibiotics for it .
Hello-
Speaking generally (as I am not your physician and have not had the opportunity to examine you myself...) a “cervical erosion” is a variant of normal anatomy that does not require treatment (it occurs when the cells that typically live the inner “tunnel” of the cervix, are visible on the outer surface of the cervix). I don’t know the details of your Pap smear or the antibiotics, so I can’t comment on that aspect.
-Dr. Dervaitis
for women looking for acne control... wouldn't the combined pill be better?
In some cases, yes…there are many variables to factor into the decision about which contraception is best for each individual.
I have a question- even though the pill as higher levels of levonorgestrel than the IUD, will the IUD still work once inserted after the pill with lower levels of levonorgestrel? This may seem like a silly question, but I have to ask. Thank you 🙂
Yes- the pill and IUD work by different mechanisms. While the pill suppresses ovulation (which requires higher levels of hormone in the blood stream…) the hormonal IUD works by creating a “hostile” uterine environment and by preventing sperm entry with thickening of cervical mucus. It also thins the lining of the uterus which helps to prevent implantation. These mechanisms are able to be accomplished with the hormonal IUD’s local delivery of levonorgestrel to the uterus.
-Dr. Dervaitis
@@dr.kristinadervaitis789 Thank you so much for answering my question, it has helped a lot.🙂
I've had the mirena iud for a month now. I was wondering, does it change your skin?? I used to have super oily skin and now im super dry besides my T zone but that isn't as oily as it was
A small percentage of patients may experience acne with Mirena, but there is no association with drying of the skin.
Hi Dr Dervaitis, I am 47 and having heavy bleeding (endometrial hyperplasia without atypia). My gynae has given me the progestogen only hormone pill but not much improvement. Since the hormone pill is not working, do you think I should give IUS Mirena a try? Are the hormone pill and mirena function the same? Your advice is much appreciated. Thank you.
Hi Alison-
Unfortunately I can’t give personalized medical advice over the internet.
Speaking generally, I will say that although use of Mirena is considered “off label” for this indication, an RCOG (UK) guideline does list the levonorgestrel IUS as a first line option for treatment of hyperplasia without atypia.
If you are unsure about your treatment plan, I suggest that you review your questions with your doctor.
-Dr. Dervaitis
@@dr.kristinadervaitis789 Thank you doctor.
Can you maybe assited my my doctor prescribed cytotec and voltaren for before my iud is this normal
This has not been my personal practice. There is no evidence to support use of Cytotec (misoprostol) prior to IUD insertion (the thought is that it will help soften/ open up the cervix, but studies have not confirmed that it really helps the insertion). Patients can take an analgesic or anti-inflammatory medication prior to the procedure, although there is not strong evidence that it makes a difference to take it before versus after.
-Dr. Dervaitis
My OBGYN told me Merina IUD will cost $ 3000 for the procedure.
😳 I have no idea why this amount is so high. ???
While every health care system is different... if a Mirena is done in office and privately billed in Canada (if the patient is not covered by the government sponsored insurance plan), right now the Mirena itself would cost about $450 (paid to the pharmacy) the office visit portion would be at the discretion of the doctor but I suspect much less than that (I’d estimate less than around $200, given that the government sponsored insurance amount is even less than that...)
If the procedure were being done in an operating room setting with an anesthesiologist and other staff, it would be more expensive (but that is rarely necessary).
-Dr. Dervaitis
Dr. Kristina Dervaitis
It was surprising for me too.
If I took the combined pill while having a copper iud will it make the iud less effective ?
No! Efficacy would be the same (if anything, risk of pregnancy would be even lower due to the effects of the combined birth control pill).
-Dr. Dervaitis
Hi Dr how can i message you privately i have a few questions?
Hello-
Unfortunately I can’t give personalized medical advice over the internet, I can only answer generalized questions. Please be sure to look at the full library of my videos, which might help in answering some of your questions.
-Dr. Dervaitis
I am experiencing breast soreness and Brest tenderness and swelling is this normal?
Please see video #10
The combination pill is giving me severe acid reflux. Will the IUD give me this side effect too?
There is no evidence to link the IUD to acid reflux.
-Dr. Dervaitis
Hi Dr, thank you for these helpful videos. I have had and iud since 2008 and had it removed in 2018. I am 35 > I noticed clotting sometimes when I menstruate. I visited my obgyn here in South Africa and she has advised me to start the yaz plus pill. Would this be advisable? I am a smoker, I don't want to have another iud put is there any other options for me I also have mild acne. Thanks
Hi-
Unfortunately I can’t give personalized medical advice over the internet.
(But I will say that I’d encourage you to quit smoking! )
I generally don’t prescribe the combined birth control pill to smokers age 35 and over.
The treatment options for heavy menstrual bleeding depend on a number of variables. You’ll need to speak to your doctor for further evaluation and treatment.
You can check out the website: www.heavymenstrualbleeding.com
-Dr. Dervaitis
Hi! I have recently seen some information surrounding the increased risk of ovarian cysts when switching from the pill straight to an IUD. Is the occurrence of ovarian cysts a common finding in patients that make this switch? Thanks for all your help!
Functional (benign) ovarian cysts are fairly common in all women with functioning ovaries that are ovulating each month. Because the IUD does not suppress ovulation in most women, these cysts can occur. They are usually self limited (resolve spontaneously) and rarely cause symptoms. Women on the pill are less likely to have these cysts because the pill prevents ovulation.
-Dr. Dervaitis
The combination pill Lari Fe 1/20 stopped my periods completely which I loved. Will the Mirena IUD stop my periods too? I am thinking of changing to the iud.
About a 30% chance of no periods with Mirena.
Hii..can you please tell if pill stopped your periods immediately?
@@Sumadhura_ I stopped birth control for a while. I just got back I am taking lo loestrin. I plan to skip the placebo pills to skip my periods. I know many women do it without any issues. If you want to stop your period just don’t take the placebo.
@@janetrodriguez5445 hii ty for prompt response..I’m asking how many
months it takes to stop the cycles for good ? I’m weary of spotting even..
I am actually looking into changing from depo to this. Now I know my Dr. Says this isn't supposed to have you gain weight but I have gained over 20 pounds in the last 3years. Can you please make a video about changing from depo to this
Hello-
I will add your suggestion to my video “to do” list- thank you! Great idea👍
Depo Provera has definitely been shown to be associated with weight gain in studies- average 5lbs but up to 20lbs has been documented. The hormonal IUD is totally different:
1) different delivery method of progesterone
2) far less absorption of progesterone into the bloodstream (100x less compared to the pill or Depo)
3) no study evidence showing weight gain
There are plenty of advantages to switching from Depo (“the shot”) to the hormonal IUD, and I’ll go over it in the video. Make sure you’re subscribed so that you’re alerted when the video is posted!
Thanks for watching!
-Dr. Dervaitis
Hello, I was wondering is it a good idea to stay on iud, I have irregular periods, and have sharp cramps, I also spot and had it for a year. I wanted to get back on the pill, I didn’t have and issues with it
This channel is not intended to provide personalized medical advice. Talk to your doctor.
Hi! I recently just had a mirena iud put in and I have been getting headaches on and off, almost like migraines and I’ve heard some things about intracranial hypertension and was wondering if that’s something that should be of concern? and if headaches are a common symptom, when should they stop?
As per the Mirena Product Monograph, ICH is not a known adverse drug reaction with Mirena. A small percentage of women may report headaches. The hormonal IUD is not contraindicated in migraine sufferers. If you are experiencing headaches, talk to your doctor.
-Dr. Dervaitis
Dr. Kristina Dervaitis, are any headaches or dizziness normal due to the hormone changes with the hormonal iud? and if they continue, would you recommend I get it taken out?
Headaches are a reported potential side effect, but not dizziness. If you are wondering about whether to continue with your IUD, speak to your doctor (this channel is not intended to provide personalized medical advice).
-Dr. Dervaitis
Dr. Kristina Dervaitis, I ended up getting it removed as I was really nervous, but am not sure if what I was experiencing was caused by it or not because I still felt that way a little while after. I’m supposed to be getting another one at the end of September again after doing more research and was going to get Kyleena, but am not sure if I should try Mirena again. I have seen that Kyleena is slightly less effective then Mirena due to the amount of hormones, but I don’t know if this is true. How do you know how many hormones is enough for you? I know some women need more and some women need less, but I really don’t know for me.
Hello-
Unfortunately I can’t give personalized medical advice over the internet. But speaking generally, note that for pregnancy prevention, Kyleena and Mirena are equivalent (both have a 2/1000 chance of pregnancy). Although the 52mg hormonal IUD (Mirena) is approved by the FDA for treatment of heavy menstrual bleeding, Kyleena also has recognized beneficial effects on the menstrual cycle.
-Dr. Dervaitis
Can I used IUD and depot same time?
There is not any harm to “overlap” the hormonal IUD and depot- but both contain progesterone, so we would not usually prescribe both for the long term. The copper IUD does not contain any progesterone, so it would be OK to use a copper IUD Depo Provera concurrently (for whatever period of time, as prescribed by your doctor).
-Dr. Dervaitis
She never mentioned depo shot.
Hi-
This video is just about the IUD versus the pill. I may plan to do a future video that compares the IUD to “the shot” (Depo Provera).
-Dr. Dervaitis
How many crazy glasses do you have
Lol! I know there are quite a few pairs but my prescription hasn’t changed in probably 15 years (so I’ve slowly grown my collection over time! )🤓