My body has now been the host to a copper, Paragard Intra-Uterine Device (IUD) for roughly six months, and I believe it’s time for an update on my relationship and adventures with this controversial form of contraception. When I last commented on my IUD, I recounted the relatively painless procedure, the fact that IUDs are the most cost-effective contraception available, and my jubilation at its incredible rate of effectiveness and non-hormonal properties. However, I would be withholding information if I didn’t relate some of the downsides to Paragard IUDs that I’ve now encountered. I was not expecting some of the strings that are attached to an IUD – either in the physical or theoretical sense – but I want to make sure you are prepared.

After initial insertion tenderness dissipated (about five days after the procedure), I felt fantastic. I had virtually fail-proof protection against pregnancy, but I wasn’t exposing the rest of my body to extra, unnatural hormones that could decrease my sex drive, cause fluctuations in my mental, psychological or physiological patterns, or result in extended amenorrhea if I decided to discontinue my use of birth control. These were all side effects I experienced while using NuvaRing, a hormonal form of contraception.

It wasn’t until about three weeks later that I ran into trouble. For about eight days before I was due to get my period I experienced a constant, dull ache on the left side of my lower belly. Soon, the pain level increased and became sharper. It limited my activities and made me nauseous. To top it off, I was not yet bleeding – a strange twist that made me more nervous than the discomfort. I worried that the IUD had slipped out of place, damaged my uterine lining, or that I was experiencing an ectopic pregnancy (when an egg implants outside of the womb). All of these situations have the potential to cause infertility and require immediate medical attention.

Luckily, the pain eventually subsided and I got my period. Unfortunately, my reproductive organs were apparently of the opinion that once started, my period should never stop. I bled sluggishly for the next three weeks – heartened that I wasn’t pregnant but increasingly anxious about anemia (low iron levels) and why my IUD was causing strange side effects. No one had mentioned to me that any of these things had happened in the course of their IUD experience. I spent an embarrassing amount of time feeling for the strings of my IUD to see that they were still hanging in the right place.

The icing on the cake: when I was finally able to engage in sexual intercourse, it was extremely painful! “What is the point of protection against pregnancy if you can’t enjoy the sex?” I asked my body.

Don’t worry – there is a light at the end of the tunnel. In recent months, my cramping has become significantly lighter and I bleed for an appropriate number of days. According to my nurse practitioner, I passed the point when it is likely that the IUD will slip out of place and cause damage (after the first menstrual cycle, chances are very low). My appreciation of a birth control method that lasts 10 years is rejuvenated. And yours should be too! Yes, there are strings attached to this contraceptive device, but they are meant to be there; feeling for and finding them is how you know your IUD is doing its job.