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Everything you ever wanted to know about the IUD

Stefanie Iris Weiss is the author of Eco-Sex: Go Green Between the Sheets and Make Your Love Life Sustainable and 8 other books. She keeps her carbon footprint small in New York City, where she writes about sexuality, sustainability, su...

IUDs are hot right now: Here's all you need to know

COME AGAIN: YOUR WEEKLY DOSE OF SEX & WELLNESS 


Got birth control? The IUD is a remarkable bit of contraceptive technology that's been around since the 1970s, but has recently gotten a whole lot of attention — with good reason.

Millennials are picking up where "eighties ladies" left off. The copper IUD is one of the safest, most effective and sustainable birth control options for women. The fact that the IUD is likely your gynecologist's personal birth control method of choice might be convincing. The 99 percent effectiveness against unwanted pregnancy will definitely take the anxiety out of your sex life, won't it?

The tiny, T-shaped copper IUD is inserted into the uterus by your OB-GYN and can remain there for up to 10 years, pretty much worry free. There are no daily pills to take, no condoms to find and roll on and no permanent effects on one's fertility. Whether you're child-free and know you won't change your mind, or you're planning to have a few puppies one day in the future, or have several and don't want any more, it could be the right choice for you. Up until recently, IUDs were more commonly inserted after women finished having children, but women who've yet to have kids are signing up now, too.

Side note: the IUD's popularity tanked after the Dalkon Shield, a particular IUD brand, was found to be defective and dangerous in the '70s, causing infections, pelvic inflammatory disease, infertility and even death for approximately 200,000 women. Although other pharmaceutical companies continued to make perfectly safe IUDs, the birth control device's overall reputation was not spared, mainly because a class-action suit against the brand was not settled until 1988. The Dalkon Shield was a defective brand, but much in the way that people have stopped buying car models known to have non-working airbags, we didn't give up driving cars altogether. The same can be said for IUD brands proven safe after the Dalkon Shield was put out of business.

In the 1990s, only one percent of women had IUDs, but that number rose to six percent between 2011 and 2013, for women between the ages of 15 and 44. Planned Parenthood reported a 75 percent increase in IUD requests between 2008 and 2012. Reports suggest that women who've decamped from the pill, victims of migraines, bloating, lowered sex drive, mood swings and more serious side effects, are hopping onto the IUD bandwagon. It's not just a matter of the stress of potentially forgetting your daily pill and accidentally getting pregnant — it's a matter of general wellness.

According to Dr. Mylaine Riobe, M.D., a board-certified OB-GYN with special areas of expertise in integrative and holistic medicine, "Orally consumed hormones (especially synthetics) place significant stress on the liver for detoxification of these compounds and this adds up over time and contributes to nutrient deficiencies in riboflavin, zinc, B12, B6, folate and vitamin C. Deficiencies of these vitamins are implicated in several conditions including cancer, Alzheimer dementia, cardiovascular diseases, pain syndromes, anemia, fatigue, weight gain, among others." This and a whole host of other reasons are why I stopped using birth control pills in my twenties.

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I'm not a fan of hormonal birth control, but many women find the Mirena IUD an effective contraceptive option and also love it because it reduces cramps and in many cases eliminates periods. (Again, I personally don't think period suppression is a good idea.) The Mirena supplies a constant stream of progesterone to your uterus, thickening the cervical mucus and in some cases, preventing ovulation. The Mirena only works for five years whereas the copper IUD works for up to 10. (The Skyla is another hormonal IUD that came on the market recently; it lasts for three years.)

According to Dr. Carolyn Thompson, "An IUD works by making the interior of the uterus a place where sperm cannot survive. The hormone is present within the Mirena to counteract the foreign body effect that can lead to heavier, more painful periods such as some women experience with the copper IUD."

The copper IUD (my favored method) works a bit differently — and frankly doctors aren't 100 percent certain why it works. The theory is that copper ions stop squiggly sperm in their baby-making tracks, by leaching into the uterine tissue and cervical mucus. Because copper is toxic to sperm, even if one little guy gets in and fertilizes an eager egg, it cannot implant in the uterus. This method is almost as effective as getting your tubes tied — it fails less than 1 percent of the time. The ParaGard is the current brand of choice, and despite anecdotal stories of ectopic pregnancies online, less than 1 percent of copper IUD users have experienced this.

The potential drawbacks to IUDs include pain during insertion, cramping, expulsion (three to six percent of women experience this) and irregular bleeding. Uterine perforation can happen, but it is extremely rare. Your doctor will do a six-week checkup to make sure your insertion was successful. Perhaps the biggest issue for women who aren't in monogamous relationships (where both partners have been tested) is STIs. The IUD is not a barrier method and thus cannot prevent sexually transmitted diseases. (That's why it's always wise to keep some condoms around, just in case.) 

The other big drawback is that IUDs are still very expensive, and out of reach for those without health insurance. And with red-state governors blocking health insurance for poor and middle class people, and the War on Women continuing to destroy our access to reproductive rights, it's not a given that we can all get the birth control we want. That's why we have to fight for it.

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If you know you don't want to get pregnant right now, and the risk is stressing you out, the IUD might be for you. If you're in a long-term relationship where STIs aren't an issue, it's pretty ideal. If you're single and dating, you can still get one — just remember that you need to use a barrier method with new partners.

This handy Planned Parenthood IUD fact sheet can answer additional questions, but contact your doctor to find out if an IUD is right for you.

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