New Options for Your Body
Part III: IUD
Update
Dateline: January 22, 2000
by Tamar
Love
According to the Center
for Disease Control (CDC), fewer than one percent of women who
use contraceptives in the US use an intrauterine device (IUD). Those
who do, find it a highly acceptable form of birth control: it's
safe, easy to use and relatively inexpensive. Furthermore, the most
commonly used IUD in the US reports a 1 percent or less pregnancy
rate per year and a low rate of side effects. So why do so many
women shy away from using IUDs?
During the 70s,
the IUD got a bad
rap. The Dalkon Shield, a faulty and badly designed IUD, caused
many women to experience pelvic inflammatory disease and a number of
other serious complications. Even though it was promptly withdrawn
from the market, women were frightened enough by the scare to eschew
the device for decades. Even today, although the FDA
has approved IUD use and Planned
Parenthood touts it as a safe, effective form of birth control,
few women use the device.
However, women's
health experts are hoping that will soon change: women in the United
States will have a new birth control option available in the first
quarter of 2001. The Food and Drug Administration has
approved a new progestin intrauterine device (IUD) called Mirena®.
Just as safe as its counterpart, Progestasert,
Mirena boasts fewer side effects and a usage life of five years,
making it a more attractive and lower-cost option for many
women.
What Is
It?
An IUD is a
T-shaped plastic device about 3.5 cm long which is placed into the
uterine cavity to prevent pregnancy. Small doses of a particular
substance are released into the uterus, blocking sperm from entering
the Fallopian tubes and thus preventing fertilization. If
fertilization were to occur, the IUD would prevent the fertilized
egg from successfully implanting in the lining of the uterus. IUDs
begin working immediately upon insertion and stop affecting
fertility immediately upon removal.
The FDA has
approved two kinds of IUDs:
- Copper
T (Paragard®): The vertical and
horizontal arms of the Copper
T 380A IUD contain copper, which the IUD slowly releases into
the uterine cavity. The Copper T IUD Can be used for up to ten
years.
- Progestin (Progestasert® or
Mirena®): The vertical arm of
the progestin IUD contains the hormone progesterone, the same as
the hormone produced by a woman's ovaries during each monthly
cycle. The progesterone causes the cervical mucus to become
thicker so sperm cannot reach the egg. It also changes the lining
of the uterus so implantation of a fertilized egg cannot occur. Progestasert
can be used for up to one year. Mirena can be used for up to five
years.
The IUD can also
be used as an effective method of emergency
contraception (EC). While hormonal
EC taken orally can be used for 72 hours after intercourse,
an IUD can
be inserted up to five days after unprotected intercourse for
emergency pregnancy prevention.
Who
Should Use It?
For many women,
the IUD may be a better, less costly birth control solution than
their current method. However, the IUD is not for all
women.
You CAN use an IUD if...
- You have had
at least one baby (pregnancy stretches the uterus and reduces the
chance that your body will expel the device).
- You are in a
mutually monogamous relationship or are otherwise not at risk of
contracting STDs.
- You have no
history of PID.
- You cannot
use hormonal contraceptives.
- You are
breastfeeding.
- You smoke
cigarettes and cannot use the Pill.
You should NOT use an IUD
if...
- You have a
sexually transmitted infection. IUD use increases the
possibility that a STI (such as gonorrhea or chlamydia) will lead
to PID, which can cause infertility, increased risk of ectopic
pregnancy, and even death, if it goes untreated.
- You might be
pregnant.
- You have an
increased rate of ectopic pregnancy.
- You have
certain cervical and uterine abnormalities.
- You do not
have access to follow-up health care.
How Do I
Get It?
You can get an
IUD from your doctor, nurse practitioner, nurse midwife, Planned
Parenthood or the health department. Not all clinicians insert IUDs,
so check in advance. To avoid inserting an IUD into a woman who
might be pregnant, most clinics insert IUDs when a woman has her
period or within seven days after her last period began. If the risk
of pregnancy can be excluded, it may be possible to insert an IUD at
other times.
Read
More
IUDs:
What Most American Women Don't Know
IUD.com
Sexuality at About's Contraception Guide
New
Options for Your Body, Part I: RU 486
New
Options for Your Body, Part II: The "Morning-After"
Pill
What do you think about using an IUD?
Share your
thoughts on the sexuality message boards or
chat about it
with others!
And don't forget to subscribe
to Sexuality Snippets, our weekly sexuality
newsletter.
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