We talked with Dr. Jennifer Landa, chief medical officer of BodyLogicMD and author of The Sex Drive Solution For Women (Atlantic Publishing Group, February 2012), to find out more on this long-term form of birth control. Here are answers to the most common IUD questions.
Dr. Jennifer Landa: IUD stands for intrauterine device. It is a T-shaped plastic device that is placed inside of a woman's uterus to prevent pregnancy. It can be inserted during a brief procedure that can easily be accomplished in the doctor's office. The device is safe and effective at preventing pregnancy.
Dr. Jennifer Landa: There are several different types of IUDs on the market, but primarily there are hormonal IUDs and non-hormonal IUDs. Hormonal IUDs, like Mirena, contain levonorgestrel, a hormone that is classified as a progestin. Progestins are hormones that are similar but not identical to progesterone, a natural human hormone. This IUD can stay in place for up to five years. Then there are the non-hormonal IUDs. For example, ParaGard is known as the copper T IUD. The non-hormonal copper T can stay in place for up to 10 years.
Dr. Jennifer Landa: The main advantage of the hormone-free IUD is that the woman avoids exposure to progestins. In some studies, progestins have been associated with an increased risk of cancers, strokes and cardiovascular disease. Additionally, some women suffer side-effects from progestins which may include headache, dizziness, breast pain or tenderness, mood swings and acne.
Dr. Jennifer Landa: An IUD is inserted through a simple in-office procedure. There may be mild cramping, but it is not really painful and it only takes a matter of minutes.
Dr. Jennifer Landa: Women who use an IUD need to be especially careful about being exposed to sexually transmitted diseases. STDs are more likely to become more serious pelvic infections with an IUD in place. Theoretically, the IUD can propagate the infection from the vagina and cervix upwards into the uterus and the fallopian tubes where it can lead to a serious infection known as pelvic inflammatory disease (PID). For this reason, it is recommended that women who use the IUD be in monogamous relationships where they have a low expectation of contracting an STD.
Dr. Jennifer Landa: After the hormonal IUD is removed I would wait a couple of months before trying to become pregnant because the hormonal IUD's progestin causes a thinning of the lining of the uterus which may increase the risk of miscarriage until the lining of the uterus is able to become thicker again. However, after the non-hormonal IUD is removed, it is safe to become pregnant right away.
Unless a woman has a pelvic infection which can block the fallopian tubes or if she has uterine lining thinning as mentioned above, then the IUD does not affect future fertility.
Dr. Jennifer Landa: As mentioned previously, women who are in non-monogamous relationships should avoid the IUD. Additionally, many doctors used to avoid putting IUDs into women who have never been pregnant before, but that has been shown to be an unnecessary restriction. Women in monogamous relationships who wish to have long term contraception may use the IUD now, whether or not they have ever been pregnant.
Dr. Jennifer Landa: The hormonal IUD can have a negative effect on sex drive. The progestin hormone in the hormonal IUD can negatively affect libido.
Dr. Jennifer Landa: Yes, I absolutely recommend the IUD as a safe and effective method of birth control. It is actually the method of contraception that I recommend most strongly. It is as effective as permanent tubal sterilization, but with less risk. Also, its effectiveness is almost assured as there is no room for user error. The IUD is a great way to go and I definitely recommend it for all of my patients.
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