"i am 25 years old and have never been pregnant.  due to having migraines with aura, i needed an estrogen-free form of bc.  i was on depo provera (&#039;the shot&#039;) for 1.5 years and hated it.  i gained 20lb without changing my diet, spotted for a year straight with no breaks, and was an overall mess.  mirena was the obvious choice for me.  insertion was not fun (&lt;5 min.) and the 2 hours after insertion i had awful period-like cramps.  however, they subsided and by the end of the night, i was okay. the next morning, no pain!  my spotting from the depo even lifted.  i have only been on mirena less than a week, but so far i love it.   my anxiety definitely made the insertion process worse, so try to relax."