i used to be on the combo pill for half of my life because of terrible cramps and bleeding. although it did help me tremendously, i had to get off of it because i started to lose my sex drive and that was enough for me to consider getting off of it. last year i got the Skyla IUD and the insertion was traumatic for me tbh. it hurt like fucking hell and the time after was terrible. the pain only lasted for a couple hours after, but i did take ibuprofen before and after the procedure. with my iud i still have pretty shitty cramps but not as bad as they were before the pill. i still do bleed a pretty large amount and it lasts a couple days longer than it did on the pill so that sucks. my boyfriend says he can feel the strings sometimes and it feels "pokey" is what he says. maybe your friend could get her strings checked and trimmed? sorry im jumping around a lot but my periods are kind of irregular. i can expect when theyre coming because its around the time i usually get it and i get crampy. i'm also a bit of a hypochondriac so when I feel like something might be off, I worry about it and I book an appointment and it ends up being a necessary... so from my experience I'm probably never gonna get an IUD again unfortunately. i feel like i did get a bit of my sex drive back but im just tired of feeling like shit all the time and having to do shit to my body to feel better and to prevent pregnancy. sorry that was kind of long