The IUD has suffered years of a bad reputation. Once lauded as the device that punctured a thousand wombs and rendered hoards of women sterile forever, its gradual re-acceptance has been gaining over the years.I blame big pharma and the manufactured fear mongering of a cheap and effective birth control that you don’t have to purchase every month. I also blame a lack of education, fears of systemic sterilization in multiple communities, and a few other obstacles that have made the IUD less popular then it could be. Only 2% of American women are using the IUD, yet worldwide, its one of the most popular forms of reversible birth control. 33% of Russian birth control users are IUD users ““ 40% in Kazakhstan, 45% in China, and overall rates of 27 % in the countries that represent the European Union. With lingering fears from the 1974 Dalkon Shield case decreasing and the FDA regulating more birth control products, it might be time to look at the option of an IUD working for you.
First off, what exactly is the IUD? The Intrauterine Device is a small “T”-shaped device made of a soft, flexible plastic, inserted into your uterus for long term pregnancy protection. There are two types of IUDs.
The Paraguard IUD – This IUD is a non-hormonal birth control and contains copper. The copper in the IUD works to negatively affect the mobility of sperm and essentially acts like the Death Star, blasting sperm back into the twinkle in the eye from which they came forth. This IUD is effective for 12 years.
The Mirena IUD – This IUD is hormonal and releases small and balanced amounts of progestin, working similarly to most hormonal birth control pills, keeping you from releasing eggs during ovulation and thickening your cervical mucus, creating an impenetrable barrier, a fortress of solitude from your bodily fluids. This IUD is effective for 5 years.
Secondly, how much is this puppy gonna cost? It all depends. IUDs range in price, like most birth controls, but on average can cost around $500. Before anyone looks at me like I’m Captain Moneybags aboard the S.S. Dollar Boat, let’s make it clear that most often you do not have to pay that total. If you are lucky enough to have a decent health insurance plan, it’s possible to get all or most of the cost covered. No health insurance? Planned Parenthood works on a sliding scale payment plan, an option that provided me with the ability to purchase an IUD for only $50. If you do decide to go the route of your local reproductive health clinic, you most likely will have a free cost analysis meeting and will speak with one of the clinics representatives on the best way to ensure that you are able to get an IUD at a price that is best for your financial situation. A good thing to remember to is that it’s a one-time payment, upfront for five to twelve years of protection, but even then most clinics work with monthly payment plans. Mathematically speaking, you end up paying less up front than over a span of so many years for other forms of birth control.
Next, there’s the insertion. I’m not going to lie – this was the worst part about the entire experience. For those who have experienced surgical abortion, there can be some potential semi-triggering similarities to the process. It’s recommended that if you have an IUD inserted, its best to do it mid-cycle, when your cervix is the most open, but an IUD can be inserted at any time. It also can be inserted 48 hours after birth, immediately after an aspiration abortion, and four weeks after a surgical abortion. The process is unpleasant but quick. Your provider will open up the vaginal canal with a speculum, administer a topical anesthetic, and clamp your cervix with a tenaculum. They will measure the length of your uterus with a uterine sound – this is about ten seconds of discomfort and slight pain as they essentially send a small thin ruler up your uterus. With the same uterine sound, they will administer the IUD through, placing it in the top of the uterus, causing another few seconds of discomfort and pain. When I had mine inserted, I experienced the discomfort and pain but also dizziness and faintness. After the IUD is in place, your provider will cut the IUD strings that will hang a few centimeters out of your cervix – these will be the way that you continually check to make sure everything is okay from now on. After the procedure, my clinician allowed me to have a few moments to myself and gave me some pads for the slight bleeding that will occur as well as juice and crackers. You will have a follow up scheduled for four to six weeks afterwards to check on the status of your IUD.
The benefits – In the long term, it has provided me with an inexpensive and long lasting form of birth control. I chose a non-hormonal Paraguard copper IUD, so I don’t have the typical side effects of most birth controls available. However, if you feel more comfortable using a hormonal birth control, the Mirena IUD is able to reduce menstrual cramping and flow, allowing for more manageable periods. For my ladies with fibroids, both can be an option and help reduce certain cases of fibroids. Suffer from endometriosis? There is a 40% risk decrease in endometrial cancer with the use of the Paraguard, and the Mirena has become an effective treatment to the most popularly used leuprolide acetate injections. Considering pregnancy? The ability to become pregnant becomes possible as soon as you have the IUD removed. Avoiding pregnancy? The IUD has proven 99.8 % effective and less than 1 out of 100 women a year will become pregnant on the IUD. The Paraguard IUD can also be used as an emergency contraceptive if inserted 120 hours after unprotected sex. Safe, effective, and cost saving.
So what are the downfalls of the IUD? First off and most importantly, it’s a non-barrier contraceptive, which means no protection from STI or HIV transmission. As Momma always said, “Wrap it up“ – something that is extremely crucial with having an IUD if there’s a possibility of new or multiple partners. As miraculous as it is, it still does not offer the simple but advanced protection of a barrier method. If you do have an STI or get an STI while on an IUD, get it treated immediately. More than likely your IUD will be removed so bacteria won’t travel into your uterus, thus avoiding PID (Pelvic Inflammatory Disease). Other than that, there are a number of uncomfortable syndromes: moderate pain when the IUD is first inserted, cramping and backache, plus spotting. During the first few months of having an IUD, cramps are often the worst – those who have an IUD in place may experience irregular or heavy bleeding. There are also very serious but rare side effects, like developing an ectopic pregnancy, which is when a fertilized egg grows outside the uterus, usually in a fallopian tube. Other serious risks include the IUD slipping out of place, the IUD imbedding or pushing through the wall of the uterus, and serious infection. These again are all are rare, but like any major risks, something to consider.
My own IUD has been something of a life-changer. Three years into having it, I don’t have the constant fear of developing the blood clots in my legs that I was once prone to, nor the depression caused by the excess hormones in my body, the all-night vomiting, or the scare of a broken or slipped condom. I’m able to enjoy sex more now without the extra anxieties. It’s a real privilege to be able to feel that way. To find out more information on whether or not an IUD might be a good choice for you, visit your local clinic or doctor, or check out more information on IUDs at Planned Parenthood’s breakdown of contraceptives. Until next time, stay safe and stay protected.
Editor’s note: This is Persephone Magazine’s 2000th post. Gitter IUDs for all!