Periods can be frustrating. On trail, they can be a bit more of a hassle. If you use tampons or pads, you have to pack them out; if you use a Diva Cup or similar, you risk infection; if you choose to freebleed — well that’s on you (literally).
During my backpacking trips, I don’t have to worry about a period. I had an IUD put in when I was eighteen years old, and have not had a period since. I’m twenty-two now. I have the Mirena IUD which secretes the hormone progestin to prevent pregnancies, and in some cases — periods! It works by thickening the mucus in the cervix to prevent sperm from reaching the egg while thinning the lining of the uterus and suppressing ovulation.
Hormonal IUDs, such as Mirena, Kyleena, Liletta and Skyla will lighten or prevent periods. The copper IUD, ParaGard, will not prevent periods since it does not interfere with hormones.
The absence of a period might be disconcerting to some. Periods are a natural part of being a cis woman, and it can be fun to sync up with friends and commiserate together. Birth control, including IUDs, can cause breast tenderness, headaches, acne, cramping and/ or mood changes. Some mood changes can be severe. I have friends who needed to come off birth control because it was contributing to their depression.
I have been lucky with my birth control — or possibly, I just haven’t known anything different since I had it put in at eighteen. Either way, I’ve enjoyed not stressing about a period every month.
When I first had my IUD put in, it was not a pleasant experience. However, it was only an unpleasant experience for about five minutes. In fact, it was the length of Elton John’s Tiny Dancer, which for some reason I chose to listen to in order to distract myself as it was inserted. I’d recommend listening to a favorite song, as music is known to decrease pain levels — as anyone who’s ever run for long distances, or backpacked into the wee hours of the night, can tell you. However, now Tiny Dancer reminds me of having an IUD put in…hold me closer tiny intrauterine device. It has a lovely ring to it.
On that note, IUDs are pretty small. The Mirena IUD is smaller than your pinkie — but that doesn't mean it does not hurt when first inserted. I’m going to be honest — it’s hard to sugarcoat a process where a gynecologist is inserting something up your cervix. Things are usually only supposed to come out of there, and your body will let you know it!
For some, it might feel like mild cramping (I have yet to meet a person who confirms this) and for most, it feels like super unpleasant cramping. If you have bad period cramps, or have experienced cramps associated with runner’s stomach, it’s similar to that. For me, this cramping drastically lessened after two days. It’s a great excuse to bum out on the couch and binge your favorite TV show.
My advice is to take Ibuprofen beforehand and not think about what’s going on (even though I just told you). Along with music, mindfulness practices can be helpful when experiencing discomfort. I tried to keep a sense of curiosity and distance during my procedure, thinking about how I am a physical body experiencing pain, instead of myself in pain.
Long story short, if you are willing to trade five minutes of pain for upwards of five years without a period, an IUD might be right for you.
With an IUD, I don’t have to worry about taking birth control. Granted, this isn’t really on my mind much anymore since I’m a lesbian. However, when I was in my experimental straight phase in college, it was helpful to have peace of mind knowing I was on a 99.9% effective birth control.
For my straight cis women friends, this can be very comforting on trail. An unplanned pregnancy could potentially end a thru-hike, not to mention completely altering the trajectory of your life, and making things with your Tramily a little awkward.
If you miss a dose of birth control pills, it can lower in effectiveness — not to mention the chance of misplacing the pills on a thru-hike, and the logistical headache of getting a prescription refill. I’d argue an IUD is an ultralight form of birth control (a kind of “worn weight” lol) — you don’t even have to carry the pill!
(SA Trigger Warning:) Additionally, one of my personal nightmares as a person who has experienced many incidences of sexual assault, is becoming pregnant as a result of rape. While I have had wonderful experiences with strangers on trail, and usually don’t worry about sexual assault as much as I would in an urban scene, it helps me have peace of mind knowing that if anything happened, at least I wouldn’t have to deal with a pregnancy on top of it. I hate that this is how I have to think in the world we live in, and hope no one ever has to deal with this.
IUDs also greatly mitigate the cost of buying menstrual products. I have not had to spend money on tampons or pads in five years — which cuts out a large expense! According to Huffington Post, if you use one tampon every six hours for the five days of a period each month, that $7 box of tampons from CVS can add up to over $1,700 per year. In five years without a period, I’ve saved more than enough to fund a thru-hike! With insurance, the Mirena IUD could cost as little as $20 out of pocket. Without insurance, it can be more expensive, but the website provides other resources to lower the cost.
To simplify things, here are some pros and cons of an IUD.
Pros
- Potentially no period for five to seven years
- Not having to remember to take birth control pills
- 99.9% effectiveness in preventing pregnancies
- Lowers cost of menstrual products
- No need to carry pads, tampons, menstrual cups, or birth control pills on trail
- No need to pack out used pads and tampons on trail
Cons
- Intense cramping for five minutes, recovery period of one to two days
- 20% chance of stopping your period (may still have a less intense period or spotting)
- Side effects can include: mood swings, breast tenderness, headaches, acne, cramping
Bottom Line
So far in my five years of having an IUD — I’d say it’s worth it! And I expect I’ll feel all the more so during my Appalachian Trail thru-hike this year.
Abby Evans is currently thru-hiking the Appalachian Trail. She is fundraising for the Venture Out Project, a nonprofit that brings queer and transgender youth backpacking.
13 comments
Margaret
Booo to all the people who tell you not to post this. You’re just sharing your opinion of your personal experience with the IUD, sure some people have bad experiences, but for the most part it is good or it would have been approved. I have an iud too and I puked when I got it in but I think it was worth it, just my personal experience.
Kim Kremer
I scoff at the notion that “this is an opinion piece and should not go out in the newsletter.” All of these articles are “opinion pieces.” The writer presented more than one viewpoint.
I used to believe that it’s “abnormal” for a cis female body to artificially stop periods from happening. But that wasn’t based on any science, and I’ve since read that there is no inherent health benefit to the period cycle if you’re not trying to become pregnant. Adding hormones does have some potential health consequences, but that’s the reason a person needs to have this conversation with their doctor. All forms of birth control have risks, and it’s up to the individual to decide if those risks are outweighed by the benefits.
When I had a uterus, I had increasingly painful & heavy periods that completely disrupted my training and fun activities like hiking. I ended up having a complete hysterectomy, and it was an absolute blessing. I wish I’d let go of my own ignorance and explored the option an method of artificially stopping my periods back when I was in my twenties or thirties. It could have saved me years of living with this.
J Wood, MD
Birth control is an incredibly personal choice with many considerations that can/should be discussed with a healthcare provider. I appreciate this article for introducing and providing worthwhile information, while normalizing an important topic and sharing her own personal experience.
Jessica
Thanks for this article. Not every article is for every person and that is okay! It’s good to highlight options for reproductive care as it relates to the trail. Dealing with periods in the backcountry sucks. IUDs are a great option for a lot of people. Obviously people know to talk to their doctors to make the right healthcare decisions for each individual. Just sending some love to counteract some of these ruder comments. Nice writing thanks.
(Katie skipping periods isn’t necessarily bad for you. I haven’t had one in years, by way of… my doctor who understands my personal healthcare. We can enable people to make their own medical decisions instead of just blanket saying things are bad.)
Michelle Maggiore
From what I’ve read and what I’ve heard from the women in my life and my own experience, there can be a lot of side effects and long-term consequences from taking hormonal birth control, especially for a long period of time. This article does not cover all of the downsides. I would not want to mess with my hormones like that, whether I planned to have children or not, just mho. I have the copper IUD, and it has been okay, and I still get my period. I learned to hike with my period early on, and I’ve been backpacking for over 20 years now. It is less convenient, yes, but it can be successfully done. I would rather know I am not damaging my health for the sake of convenience. Again, just mho, but I think an article like this can be kind of dangerous to the uninformed.
Lani
I agree that this is NOT good health advice and should not be posted as a “Case for an IUD”. There are many pros and cons that vary depending on the individual. Furthermore, there are also plenty of low-cost, easy, and environmentally friendly resources for those who are still getting a period – many of which were not mentioned or discussed in this article.
Helga Hikes
I am an older hiker (47 to be precise) and was excited about the same potential ideas with Mirena and had it installed about a month and a half ago. I was having irregular period times and heavy catch up bleeding later. Sooooo…. I had a period for the first month, tapering down to heavy daily spotting now. Apparently this can happen with some women. They said give it up to a year to be sure if it is/is not for me. Was hoping to also go to the option of no period as the time Mirena lasts would see me into menopause.
Long story longer- no two women are alike. Read the literature, consider your age group, talk to others who have experienced the product and be educated.
Cheers, and many safe hikes. – Helga
Hannah
I’ve also had a brilliant experience with a Mirena and agree with everything the writer says. She clearly isn’t giving medical advice, just sharing her experience. It’s not possible to get one without going through a medical professional anyway so it’s not like you can skip talking to a doctor-or-similar because you’ve read this article. Nice writing and definitely a great option for a lot of people with a uterus, I’d massively recommend it too!
D E Foley MD
IUDs work via several mechanisms, and this depends in part on the type of IUD, including preventing sperm from reaching the egg by thickening cervical mucus, partially inhibiting ovulation, and direct toxicity to sperm. But one of the ways they also may work is by inhibiting implantation of an egg, after it has been fertilized by sperm, and is developing (called a blastocyst, early embryo). Some people may have ethical problems with this information, some may not. But this information should be known by those considering an IUD.
Mary
I have had an iud for years without problems. I love it. Many negative opinions of this device may be because of the history and use of the iud in the early 1970’s. I don’t agree with the previous comment. Birth control pills can also stop a woman’s period. Since the iud can only be inserted by a medical professional, ask their advice before forming an opinion on the iud or any other form of birth control.
Stephanie
I agree… this is more of an opinion piece. Absolutely should not go out in a newsletter.
Chris Gerard, MD
Information presented in this article is perfectly factual and well written -Kudos!
Chris G , MD
Katie Lyford
This type of article should not be posted. This is extremely dangerous and not good health advice. Skipping periods this way is really bad for your body and can lead to problems that last a lifetime. Diva and other menstrual cups do not have risks as bad as messing with your natural cycle and natural hormones. IUDs have much high rates of infection, puncture of an organ, internal bleeding, developing polyps or other fibroids, among many other complications. Only a well educated and experienced health professional should be sharing information of this nature.