“It is our choices that show what we truly are, far more than our abilities.” Joanne Kathleen Rowling
The Intrauterine Device: IUD: Excellent Birth Control
In the Adolescent Gynecology literature as well as that of all reproductive-aged women, there has been tremendous support among the experts for increasing the use of IUDs in our patients. The IUD, after all, is an extremely effective, relatively inexpensive contraceptive method that requires little to no work from you, once it is in place.
The accepted reasons gynecologists and patients have shied away from IUD use date back to the 1970s, when a defect in a specific IUD ("The Dalkon Shield") was associated with an increased risk for infertility in women who developed a cervical infection with an IUD in place. This catastrophe, understandably, affected patients and their physicians, and for years the IUD was not even in the top 10 list of birth control method options.
Times have changed. The defect has been corrected long ago, and we offer 2 kinds of IUDs in the United States, and hope to have more in the near future. The distinctions between the brands have clinical implications, and the specific IUD chosen by the patient should follow a lengthy and tailored discussions of benefits and downsides of each, so that you make the best choice for you, if you decide on this method.
Choice 1: Mirena IUD: (levonorgestrel, a progesterone, releasing system)
Choice 2: Paragard IUD: "Copper T"
How IUDs Work
We, one of your physicians, inserts the device into your uterus (womb). It is a quick and safe procedure with short-term discomfort. We recommend Ibuprofen an hour before the procedure, or will call in something stronger, if you have a low pain threshhold or are nervous about the pain.
If you have never had a vaginal delivery (either you are a teenager looking for an exceptionally effective method or a mom with previous cesarean sections), we will call in a pre-medication to help soften your cervix, to increase the chances that the office procedure will be successful.
Both options prevent pregnancy mostly by keeping a woman’s egg and a man’s sperm from meeting. Copper disrupts sperm movement. The hormone helps block sperm from getting intothe uterus. Both products also may make it harder for an egg to reach or attach to the uterus.
Questions to Ask Yourself
- Do I want to avoid being pregnant for a few years? The IUD is an easy way to postpone having children for the short-term, orup to 12 years. If you’re in your late 30s or early 40s, an IUD couldlast throughout your childbearing years.
- Do I want (more) children in the future? You can have the IUD taken out whenever you want to have a child. Your fertilitywill return right away.
- Do I prefer a method that doesn’t require any action before or during sex? Many women become pregnant because the couple does not always put birth control in place once sex isunder way. And some people feel that thinking about birthcontrol during sex hurts “the mood.”
- Have you ever had to use Emergency Contraception (EC) because you had sex but didn’t protect yourself? An IUD protects you against pregnancy all the time it’s in place. You don’tneed to plan ahead for sex — or take action later if you didn’t.
- Do you smoke or have other health problems, such as migraines with aura, or predisposition to blood clots that keep you from taking the pill (or using other methods with hormones)? Copper IUDs are a safe and highly effective method for women who should not use hormones.
