I've got Mirena, it's marvellous, I never bleed at all now, which saves me from a deluge & anaemia every month, cos I'm on lifelong anticoags. You do gain a bit of weight, but......hey!

I got my second DVT after being convinced by two different doctors that progesterone-only BC pills would be OK. Five weeks later, and bam!

So, no hormones for me, ever. I went with the copper IUD for a while and really liked it. A little more cramping and bleeding, in my case, although we discovered later that I only have HALF a uterus, so it really wasn't fitting right at all. Still, despite that, it was super convenient. Plus, you can leave it in for ten years (as opposed to Mirena's five).

Finally did Essure (permanent) last year because getting pregnant was just too risky between the half a uterus thing and the warfarin.

I'm undecided about Depo-Provera as a clotter. It does have hormones in it (and I'm pretty sure blood clot risk is in the fine print), plus if you did get clot, you can't just stop taking Depo. It'll take three months to get out of your system! In my wild youth, I did do Depo for about two years. Super convenient and that was well before my clotting days. Plus, my periods disappeared almost completely. A little weird, that ...

Ultimately, you have to decide what you are comfortable with in terms of hormone exposure. At this point, I'm not comfortable at all, so I steer away from everything with any hormones.

Best wishes!

I went with the copper IUD. I've had it for a few years with no issues. My periods are a heavier and longer than they were when I was on the pill but when I was on the pill, my period consisted of a brown smudge over a 24 hour period, so it's a rather unfair comparison. Also I'm on warfarin and my periods are still manageable with the copper IUD.

I'd recommend talking over all the options with a Gyno, given your clotting history.

My doctor told me not to use any hormonal birth control ever. Never Ever. He suggested the copper IUD, but the thought of one makes me feel a bit queazy for some reason.

I don't know of any other options that allow for sponteneity, so I'm also keeping an eye on this thread.

It's a pretty easy procedure. Some cramping and discomfort, but manageable. Let me know if you have any questions, and I'll try to help.

Thanks for the replies. I haven't made up my mind yet, though I'm strongly leaning toward the Mirena. I feel okay with the hormones because at the time of my clot I was taking Drospirenone (Yaz), which is a fourth generation Progestin prescribed to treat acne, but also known to create clotting problems. Also at the time, my body was an ideal environment for a clot to form - I was very dehydrated (being on crutches made it hard to get water), and I loaded up on things like tofu (high estrogen intake), spinach, and broccoli (which helps with blood clotting). At one point during my injury I may have even doubled up on my dose of BC because I remember missing a pill one day. And I was very immobile. I hardly bent my knee for several weeks.

Right now my main hesitation for going with Mirena is the idea of having a foreign body inserted in me for an extended period and the possible risks like expulsion or pelvic pain. Also, IUDs are not covered by my insurance. I was told I could file an appeal if my doctor thinks other contraceptive methods are out of the question, however if insurance falls through, I'm looking at upfront costs of about $600.

The cost sounds more painful than the insertion!
I didn't find the process as bad as I'd expected. Not painful, just a bit crampy.
As for expulsion - you can find the little 'threads' easily, so you'd know if you'd lost it. Pelvic pain - I haven't had any more than I usually have (clot related)
I was very, very anti-IUDs, the very idea of anything left floating around up there! - up until that was really the only option for BC and to deal with the 'torrential monthlies' and it really has dealt quite adequately with both.

Yeah, the idea of an IUD wigged me out for a while, but necessity drove me to it.

For me, insertion was quite uncomfortable, but that was before we knew I had only half a uterus. Trying to fit a triangle-shaped device into a banana-shaped cavity didn't work as well as I'd like. Still, it was crazy convenient for me and I really liked that aspect.

You put it in, get a follow-up check to make sure everything is going well, and then go on with your life for five years. Really low maintenance.

Otherwise, if you're avoiding hormones, you're basically back to the 1950s in terms of birth control. Condoms and diaphragms, pretty much.

Hi there. My doc's best bet is that
BC pills caused my clot. I got the Mirena IUD and am happy I did. I am still on Warfarin, and my period each month was hell before getting the IUD (in November). Not only was my period much longer than I was used to, but it was very heavy and the cramping was crazy painful. So after 4 months of torture, I got the IUD. I had some spotting afterward but now I don't get my period at all. Guess you don't have to worry about that as you are off Warfarin now.

I have gained weight. I am very upset by that. It was expensive (I'm a student, so no benefits and it isn't covered by healthcare).

Insertion was extremely painful for me, even though the dr used an ultrasound to aid in placement. I have a tilted uterous so that was the problem. I actually had to miss class & was laid in bed for 2 days the pain was so great. Since then, I have had no pain or discomfort.

I also have had major fluctuations in my INR (thus my Warfaring dosages are ever changing) since then. Not sure if it is related to the INR or the weight gain (although my INRs go way up and then way down, etc).

Anyhow, wish you luck. Take care!

Just to follow-up, I went with Mirena. I didn't get it until about 2 1/2 months after I made my decision because I had to check with insurance. It is NOT covered, so I paid about $850 out of pocket for the device, and an additional $300 in doctors fees for the visits. Ouch.

The actual insertion procedure went smoothly. Women who have never had children are strongly advised to have it done during your period to lessen the discomfort. The doctor also warned me that in some cases, women who have never had children may not have a uterus big enough to fit the IUD so there was a chance it couldn't be done, though mine turned out to be okay. The procedure took about 5 minutes and the cramping during insertion was not bad at all. It lasted maybe 15 seconds. I've felt worse during some of my cycles.

I get some cramping occasionally but usually for only a couple seconds, and there's been some minimal spotting but I was told that is typical early on. I've had the Mirena for only a week so I can't comment on weight gain, decreased bleeding, etc... There is a "string" that hangs down and I am to check to make sure it's in place. It feels like fishing wire to the touch but I only feel it when I check (and not when I'm sitting around or whatever).

Now for the scary part... For the past couple days my DVT leg has felt different from how it's been since I stopped taking Coumadin a couple months ago. I started running and ramped up my exercise regime so I thought some of this discomfort might be from that, but I've also occasionally felt "flutters" which I hadn't felt since my Coumadin days. There's been on and off tightness in my calf/knee area but I wouldn't classify it as pain. There's also been some intermittent numbness in my big toe and three red dots showed up on my foot this morning. Under the advice of my doc I went to the ER today. They ran an ultrasound and blood work including a d-dimer. All tests were negative for DVT, though I am scheduled to follow-up with my doctor Thursday.

Right now I'm trying to stay calm about this but wondering if maybe I should have gone with the Paraguard Copper IUD. The ER doc was surprised I was allowed to even have the Mirena because of the hormones. I told her my OBGYN and hematologist thought it would be fine since it doesn't contain estrogen and is a low dose progestin released locally into the uterus. I had felt some aches in my leg before the Mirena was inserted (I thought due to the running) so it's possible that the timing of all of these sensations is all coincidental, though it still worries me a bit. I'm wondering if I should consider switching to the Copper IUD, though my pocket book is already suffering with all the medical expenses I've accumulated over the past year.

Why do I feel like I have the worst luck, ever?

I guess I should feel lucky to be alive, since I had a DVT and PE last year, was diagnosed in time, and survived. But Is it too much to ask for the life of a normal 31 year old? Sigh.

Well, you've been checked pretty thoroughly for a new clot and it doesn't sound like you've got one, hormonal IUD or not. I wouldn't start writing checks for a copper one just yet...

I had surgery last year where they went into through an artery on my leg, right where my leg meets my pelvis. There was a little device in there that closed it up afterward and dissolved within two months or so. I'm probably 15 months out at this point and I still get weird feelings in that spot (where they went in) sometimes, for no apparent reason. It does wig me out, especially considering it is also my clot leg, but if I take a deep breath and ride it out, it usually disappears within a day or so.

I mean, your body might just be reacting in a weird way to the trauma of having that IUD put in. Plus, like you said, you've been ramping up on the exercise and etc. I'd give it some time, talk to your doc, and see if the "flutters" and etc., start to disappear after another week or so.

I mean, lots of us with DVTs in our past do go through episodes where the leg acts up a little more than usual. If there is some reason to suspect clotting, we do tend to freak out (at least I do). I think we forget that sometimes our bodies just feel weird for no good reason at all.

Take a deep breath and ride it out for a few days. You've been checked and your clot free and I'm betting you'll stay that way.

Just to add to this discussion, here are several articles we did over on our Clot Connect website that Dr. Moll answered):

http://patientblog.clotconnect.org/category/special-situations/women-and-blood-clots/

Likewise, a newsletter we did when I was national Secretary for the National Blood Clot Alliance that discusses oral contraceptives:

http://stoptheclot.org/Newsletters/FINAL_Spring%20Summer%2008%20Nwsl_WEB.pdf

Dr. Moll of Clot Connect was the Medical Advisor for the National Blood Clot Alliance and was also my fellow co-founder of NBCA.

R/
Tom

Thanks for the links Retired Navy.

I copied this thread into a post on the PE site. I think the information in the links Tom provided are really helpful for women to start the discussions with their Gynos.

When you first are diagnosed with your clot, women are just basically told no more birth control pills for you which you can get your head around, but as you recover and start living your life again, you think well, I gotta do something, and what CAN I take. It's kind of a confusing time for women, worrying not only about the whole PE/DVT experience, but then their other health concerns with unplanned pregnancies as well

Hi everyone, thanks for the replies. I thought I'd follow up for anyone going through a similar experience with contraception choices. Since I last wrote, the strange sensations went away and I feel fine now. I think the person who said my body was "reacting in a weird way to the trauma of having that IUD put in" was probably right. Anxiety probably factored in as well.

As far as the Mirena, the only change I've noticed so far is I cramp a little more during my period. Also, my flow is a lot lighter now, however my period lasts a couple days longer than before.

On a side note, I've started running again, after being on break for about a year. I stayed away mainly because I have bad knees, not just because of the DVT. For the first time in a while I also played in a softball game recently and my old teammates thought I had actually gotten faster and stronger. I know my legs will never be the same as before, but on the whole I feel wiser from the experience. I don't take as many risks with my body as I used to, and I truly appreciate any good run or workout session now. I take nothing for granted.