"i&#039;m in my 40s and have had this for 5 years and i absolutely love it. the insertion, while not painful, made me nauseous to the point where i almost passed out when i stood up. my doctor (a man) told me nothing about what to expect with insertion. you should take a motrin before the procedure. that being said, it&#039;s been effective and completely problem free.  i wish i&#039;d known about this years ago.  only about 9% of women in the us use this method, whereas in europe it&#039;s about 31% and in china 40%.  doctors need to be telling their patients about this option. i didn&#039;t know about it! the pill absolutely killed my sex drive, as it did with my sister.  my sister&#039;s now gotten one and we&#039;ve both been very happy. lasts 10+ years or until removal."