Intrauterine devices are trendy among public health students (at least those with uteri). There’s a number of reasons for this: they are safe, over 99% effective, and provide you with three or more years of protection from pregnancy without a daily pill or monthly patch/ring. Hormonal IUDs (especially Mirena) can help regulate your menstrual cycle, reduce bleeding, and improve cramping.
Unfortunately, the average American woman is not a public health student. Only 15.0% of women who have ever had sex have tried any form of IUD. This number is very measly compared to more popular methods such as male condoms (95.0%) and hormonal pills* (79.3%). This being said, the number of women who have tried IUDs in the United States has grown exponentially compared to other methods.
There are a number of likely reasons for this small number. IUDs sound scary. Having a medical device inserted through your cervix and into your uterus is a less-than-pleasant experience, but most IUD users will tell you that the pain was worth the reward. The procedure is performed by an OB/GYN in-office without any anesthesia, though most doctors recommend taking about 800 mg of ibuprofen the morning of insertion. It is also recommended you take the day off school or work and spend the afternoon relaxing with a hot water bottle, but you can typically return to your daily routine the following morning.
Unfortunately, the average American woman is not a public health student. Only 15.0% of women who have ever had sex have tried any form of IUD. This number is very measly compared to more popular methods such as male condoms (95.0%) and hormonal pills* (79.3%). This being said, the number of women who have tried IUDs in the United States has grown exponentially compared to other methods.
There are a number of likely reasons for this small number. IUDs sound scary. Having a medical device inserted through your cervix and into your uterus is a less-than-pleasant experience, but most IUD users will tell you that the pain was worth the reward. The procedure is performed by an OB/GYN in-office without any anesthesia, though most doctors recommend taking about 800 mg of ibuprofen the morning of insertion. It is also recommended you take the day off school or work and spend the afternoon relaxing with a hot water bottle, but you can typically return to your daily routine the following morning.
ALSO READ: Can't Feel Strings of IUD Anymore! Should You Be Worried?
There have also been reports of IUDs expelling or moving within the uterus in such a way that they either lose effectiveness or cause additional medical problems. Though online forums such as /r/birthcontrol may lead you to believe this is a common phenomenon, it is actually quite rare. The overall expulsion rate of modern IUDs is ~6%, but expulsions are most often associated with Paragard, the non-hormonal, copper IUD that is not a good choice for women with strong cramps or heavy periods. Adolescents ages 13-19 and nulliparous women (those who have not given birth) are not at a higher risk for IUD expulsion compared to women 20+ or those who have given birth [2]. IUDs are a safe and effective birth control option for teenage girls.
A few more points:
➧Do IUDs harm long-term fertility? No
➧Can a woman who has never had children get an IUD? Yes. If your OB/GYN tells you otherwise, find a new doctor.
➧Will my partner be able to feel my IUD? They will not feel the device itself. It is possible they may feel the strings, but they are quite soft. They can be shortened by an OB/GYN if need be.
➧Can I use tampons/the menstrual cup with an IUD? Yes. Just be certain to ease out tampons and break the seal on the menstrual cup before removal.
So, now you might be curious about getting an IUD, yourself. In that case, you are probably asking “what are my options?”.
IUDs come in two varieties: hormonal and non-hormonal. The only non-hormonal IUD on the market is Paragard, a device that safely releases copper into the uterus to prevent both egg fertilization and the movement of sperm. This is an excellent option for women who are sensitive to hormones and for whom hormonal contraception is not an option. As a bonus, the FDA has approved Paragard use for 10 years of protection! Unfortunately, Paragard oftentimes makes cramps and bleeding worse, so it is not a great option for women with heavy or painful periods.
The most popular hormonal IUD is Mirena, which is FDA approved for five years of protection. Mirena works by thickening cervical mucus, preventing the movement of sperm, and thinning the endometrial lining of the uterus. The localized hormones make it a good option for people who are sensitive to the pill, implant (Nexplanon), or depo shot, as the progesterone does not enter the bloodstream the same way as other methods. Mirena is also progesterone-only, so it does not have the side effects associated with synthetic estrogens such as blood clots and hypertension. Mirena also has the benefit of lightening periods due to the thinning of the endometrial lining over time. Some women have their period disappear altogether!
There are three other hormonal IUDs: Kyleena, Liletta, and Skyla, all of which have lower levels of progesterone compared to Mirena.
There have also been reports of IUDs expelling or moving within the uterus in such a way that they either lose effectiveness or cause additional medical problems. Though online forums such as /r/birthcontrol may lead you to believe this is a common phenomenon, it is actually quite rare. The overall expulsion rate of modern IUDs is ~6%, but expulsions are most often associated with Paragard, the non-hormonal, copper IUD that is not a good choice for women with strong cramps or heavy periods. Adolescents ages 13-19 and nulliparous women (those who have not given birth) are not at a higher risk for IUD expulsion compared to women 20+ or those who have given birth [2]. IUDs are a safe and effective birth control option for teenage girls.
A few more points:
➧Do IUDs harm long-term fertility? No
➧Can a woman who has never had children get an IUD? Yes. If your OB/GYN tells you otherwise, find a new doctor.
➧Will my partner be able to feel my IUD? They will not feel the device itself. It is possible they may feel the strings, but they are quite soft. They can be shortened by an OB/GYN if need be.
➧Can I use tampons/the menstrual cup with an IUD? Yes. Just be certain to ease out tampons and break the seal on the menstrual cup before removal.
So, now you might be curious about getting an IUD, yourself. In that case, you are probably asking “what are my options?”.
IUDs come in two varieties: hormonal and non-hormonal. The only non-hormonal IUD on the market is Paragard, a device that safely releases copper into the uterus to prevent both egg fertilization and the movement of sperm. This is an excellent option for women who are sensitive to hormones and for whom hormonal contraception is not an option. As a bonus, the FDA has approved Paragard use for 10 years of protection! Unfortunately, Paragard oftentimes makes cramps and bleeding worse, so it is not a great option for women with heavy or painful periods.
The most popular hormonal IUD is Mirena, which is FDA approved for five years of protection. Mirena works by thickening cervical mucus, preventing the movement of sperm, and thinning the endometrial lining of the uterus. The localized hormones make it a good option for people who are sensitive to the pill, implant (Nexplanon), or depo shot, as the progesterone does not enter the bloodstream the same way as other methods. Mirena is also progesterone-only, so it does not have the side effects associated with synthetic estrogens such as blood clots and hypertension. Mirena also has the benefit of lightening periods due to the thinning of the endometrial lining over time. Some women have their period disappear altogether!
There are three other hormonal IUDs: Kyleena, Liletta, and Skyla, all of which have lower levels of progesterone compared to Mirena.
For those who are too sensitive to hormones to take Mirena, but for whom Paragard is not an option, these may be worth looking into. The only drawbacks of these methods are that they are only FDA approved for 3-5 years and do not generally reduce menstrual bleeding to the degree of Mirena.
Do your research and consult your doctor to determine if the IUD is right for you! Taking charge of your sexual health in the 21st century has never been more convenient. Find more information at Planned Parenthood.
*includes both estrogen/progesterone combination pills and the progesterone-only mini pill.
Does the IUD do more than prevent pregnancy?
Long-acting reversible contraceptives (LARCs) are those birth control methods—like the IUD—that work really well at preventing pregnancy without you having to do anything special on a daily (or even yearly) basis. We love them because they’re easy to use, very effective, and when you factor the overall cost over time, they’re super affordable. Those reasons alone make IUDs popular, but there may be another surprising health benefit associated with them. Researchers have recently uncovered a potential link between IUDs and decreased risks of cervical cancer.
Drawing on 16 studies of over 12,000 women around the world that examine the relationship between IUD and incident of cervical cancer, the researchers conducted a meta-analysis (which is “research-speak” for examining studies to find common themes) to identify the association between IUD use and rates of cervical cancer. They found that the rate of cervical cancer was about 30% lower in women who reported having an IUD (both hormonal and non-hormonal).
While these findings are promising, the authors note that many of the studies included in the analysis were published before the HPV vaccine was available. Additionally, most of the studies included in the meta-analysis were based on the non-hormonal IUD (ParaGard) because hormonal IUDs (Mirena, Skyla, Kyleena) were not as widely available when the initial studies took place.
Many of the studies included in the analysis are observational in nature which means we don’t necessarily know that the IUD is causing the decreased risks of cervical cancer. Researchers suspect that IUDs may help the body clear persistent HPV infections, and HPV infections are a leading cause of cervical cancer.
Ultimately, these findings are good news. Why? Because they suggest that IUDs not only provide an effective way to prevent unplanned pregnancy, but they may also provide protection against one of the leading cancers among women globally. While you may not necessarily want to run out a get an IUD of your own, many birth control methods have benefits beyond preventing babies. Whatever you decide, we want you to take charge of your sexual health on your own terms.
References
[1] Centers for Disease Control and Prevention. Key Statistics from the National Survey of Family Growth – C Listing. Centers for Disease Control and Prevention. 2018;(https://www.cdc.gov/nchs/nsfg/key_statistics/c.htm#contraception). (Accessed June 25, 2018)
[2] American College of Obstetricians and Gynecologists. Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices. American College of Obstetricians and Gynecologists. 2018;(https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Adolescents-and-Long-Acting-Reversible-Contraception). (Accessed June 25, 2018)