Well Being

IUD: The Ugly Stepchild of Birth Control You Shouldn’t Be Afraid to Use

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My life was made possible by the recall of an intrauterine device. It was the mid-1970s and my older sister had been born a few years before. My mother, bleary-eyed, blissful—and definitely not ready for a second kid—went to the gynecologist and, like many women at the time, was introduced to a piece of plastic shaped like a small bug or a fish, her free pass to a life without worries about birth control for the new few years.

Everything was fine—wonderful, in fact—until her gynecologist informed her that the Dalkon Shield had been recalled. It turned out her carefree birth control method also had a proclivity to cause ectopic pregnancies and pelvic inflammatory disease (PID).

“Please don’t take my IUD,” my mother pleaded with her doctor. “I love my IUD.” (Seriously, that’s what she said.) The doctor apologized, removed it, and one year later she was expecting me.

It’s been close to four decades since doctors nationwide pulled the plug on intrauterine devices, so to speak, and thankfully today's IUDs are a far cry from the faulty Dalkon Shields of my mother's era. But even though they no longer carry the same health risks, many health practitioners and patients still shrink at the sound of the three initials in the U.S.; only 5% of American women use IUDs, compared to 15% worldwide. On closer examination of today's IUDs, it's hard not to think that many of us are missing out my Mom's favorite kind of birth control.

Today’s IUDs look nothing like yesteryear's, and don't carry half the risks. Today's options are t-shaped and work by damaging and killing sperm, as well as changing the uterine lining to make it an especially inhospitable environment for little embryos (should the sperm survive). The Dalkon’s danger came mostly from the strings attached to the device, used to remove it. They were a breeding ground for infection. However, the strings attached to today's models are essentially anti-microbial, says Dr. Brad Douglas, a board certified gynecologist and OB/GYN expert on JustAnswer, a consumer resource website.

Currently, there are two types of IUDs on the market: the Mirena, which releases hormones, and the ParaGard, which is made of copper and doesn't contain any hormones. The Mirena contains Levonorgesterol, a type of progesterone, which stops ovulation and changes the cervical mucous, making pregnancy incredibly unlikely. And for some, the Mirena can actually help improve problems such as bleeding, pain and endometriosis. For women who are unable to take any form of hormones, such as long-term smokers, the non-hormonal ParaGard contains copper, which is spermicidal and hostile to eggs. Both are FDA-approved; the Mirena may be used for up to five years before removal, and the ParaGard can be left in for up to ten. “Both IUDs offer women the freedom to not have to remember to take a birth control pill, to change their patch or to change the ring,” said Dr. Douglas.

The device is not only carefree; it's also low-risk for women who may want to have children in the future. Dr. Brent Davidson, service chief for Women's Health Services at Henry Ford West Bloomfield Hospital and medical director for contraception in the Michigan Department of Community Health, calls the IUD “long-acting, reversible contraception,” or LARC (more acronyms to remember!). Short of getting your tubes tied, an IUD clinically remains the most foolproof contraception out there (said to be 99% effective), but without the long-term commitment: fertility typically returns to normal shortly after removal.

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