In the past decade or so, intrauterine contraceptive devices (IUDs) are making a big comeback. After a lot of bad press in the 70’s, the IUD is safer than ever and is one of the most popular types of contraceptives worldwide. As many as 1/3 of childbearing-age female-bodied people in China have an IUD! This number is increasing in the US as well, especially among college students who do one day plan on having children.
An IUD? What’s that?
IUDs are thumb-sized, plastic, T-shaped devices placed into the uterus, with one arm at the opening of each fallopian tube. A thin monofilament string comes out of the cervix so that the user can check to make sure it is still placed properly (don’t worry, it can’t be felt during sex!). There are two types of IUDs on the market in the US: Mirena (a.k.a. hormonal IUD) and Paragard (a.k.a. copper IUD). Both methods prevent fertilization, and are often classified as barrier methods, since their “arms” create thickened mucus in the fallopian tubes, blocking sperm from reaching an egg. Mirena contains a low dose of estrogen and progesterone, which prevents ovulation. Paragard contains copper, which is a potent natural spermicide.
What are some of the benefits?
- Over 99% effective at preventing pregnancy
- No pills or daily responsibilities, only need to check the strings periodically
- Mirena: makes periods lighter and shorter, approved for 5 years of use
- Paragard: no hormones, approved for 12 years of use
- Very cost effective: $500-$1,000 without insurance, but IUDs are covered by most insurance plans and the Family Planning Waiver at Planned Parenthood
- Easily reversible for those who might wish to get pregnant in the future
Why might an IUD not be right for me?
There are many reasons an IUD might not be the best method for you: consulting with a doctor is the best way to decide if you are a good candidate for an IUD (and be honest – this is your reproductive future!). Typically, IUDs have been given only to those who had already given birth at least once and were in a long term, committed relationship. Now, it has been shown that those who haven’t given birth are still good candidates for an IUD. However, some female-bodied people have uteruses that are naturally shaped in a way that won’t support an IUD. Your health professional will be able to tell you if this is the case. For women who have anemia, Paragard is often not recommended since it can potentially lead to heavier periods.
Are there any risks?
Both types of IUDs come with a risk of Pelvic Inflammatory Disease, which can lead to infertility if left untreated. The biggest cause of PID in patients with an IUD is a sexually transmitted infection. While you will be tested before you receive an IUD, once it has been inserted, it is important to always use barrier methods if you are not in a committed, monogamous relationship to prevent STI transmission and PID. Another concern is the uterine wall being perforated during insertion. This is extremely rare, especially with experienced healthcare professionals, and generally does not have an effect on long term fertility.
How do I get one?
UHS, your OB/GYN, or a health clinic like Planned Parenthood are all great options for getting an IUD. General recommendations include going to a doctor who has done many insertions. Some doctors who have been practicing for 30 years might have done very few IUD insertions, so it is important to ask. The more experienced your medical professional is with IUDs, the less likely you will experience major discomfort or a complication. Planned Parenthood is well known for doing many IUD insertions, and clinicians there often have more experience inserting IUDs than your regular OB/GYN. Make sure to ask your clinician at your consult about their experience!
Typically, someone looking to get an IUD will have two doctor’s appointments: the first is a consult to make sure the IUD is right for you. The second is to place the IUD – which takes all of five minutes but can be uncomfortable. Typically doctors recommend taking ibuprofen beforehand and often prescribe a medication called Misoprostol which helps to relax the cervix. Insertion and removal is fairly easy, although it is a procedure that you should seriously consider before having one placed.