Everybody wants a set it and forget it type of birth control. However is putting a piece of plastic in you the correct thing to do? I actually stopped taking birth control all together 6 months ago. I don't like being on medication and i wouldn't stick plastic in me for 5 to 10 years.
Seventies style resurfaces frequently—how could we not borrow inspiration from Bianca Jagger in that snow-white Yves Saint Laurent trouser suit? The decade that dripped in glamour and gold lamé never fully strays from our collective fashion consciousness.
But fashion aside, there’s also a women’s health trend that’s remained in the dust of our disco past until quite recently. Ladies, let me reintroduce you to the newest version of a contraceptive device straight from the ’70s: It’s called the IUD (or intrauterine device).
The ABC of IUD
The IUD is a small piece of T-shaped plastic that is inserted into your uterus. It’s a simple and effective “set it and forget it” method—the insertion takes “as little as 2-5 minutes,” says women’s health nurse practitioner and certified nurse midwife Lorri Walker, and then protects you from pregnancy for 5 -10 years (depending on IUD brand).
Two types of IUD are available in the U.S.: Mirena, which releases a small dose of levonorgestrel (progestin hormone) and is effective for five years, and the non-hormonal copper ParaGard, which lasts up to 10. Both methods inhibit sperm by killing it or altering its ability to move.
Mirena thickens cervical mucus, which makes it difficult for sperm swim to their intrauterine destination. It also keeps the uterine lining thin, which discourages egg implantation.
The copper in ParaGard causes the uterus and fallopian tubes to produce sperm-killing fluid (which sounds scary, but it really isn’t—it’s just a mix of copper ions, white blood cells, and other naturally occurring chemicals).
Why Is It So Effective?
The key to IUD efficacy is that it eliminates user error and it doesn’t interfere with sexual spontaneity.
“I feel like it’s a no-brainer: You don’t have to think about it, you don’t have to do any preparation, you don’t have to take a pill everyday or whip out the condoms,” says Walker.
In fact, a May 2012 study suggests that women who used the pill, the patch, or the ring were 20 times more likely to have an unplanned pregnancy than those who used long-term options like IUD or contraceptive implants (such as Implanon, which is inserted under the skin).
How Do I Know If It’s The Right Method For Me?
The first thing to ask yourself is what kind of relationship you’re in. Even if you’ve signed on for the contraceptive magic of a Mirena or ParaGard, it’s important to remember that neither protect against sexually transmitted infections (STIs). You’ll still need a condom if you’re not in a monogamous situation where you’ve both been tested for STIs.
The copper-containing ParaGard is a better option for those who want something non-hormonal and who don’t have a history of heavy menstrual bleeding or cramping (as it may exacerbate these conditions). With ParaGard, women will continue to cycle normally—and if they don’t have a history of super heavy or painful periods, “the increase in these symptoms is usually not debilitating,” says Walker.
Mirena, on the other hand, “has a very, very low dose of hormone that is wonderful for providing contraception and treating conditions like heavy bleeding,” says Walker. Tracey, 35, a consulting chef who switched to the Mirena after “years on the pill” says, “I really like that one of the side effects was making my periods lighter or non-existent.”
Why Is My Mom Worried She’ll Never Meet Her Grandchildren?
One type of IUD was responsible for the method falling out of favor in the 1970s. The Dalkon Shield (which featured small “teeth” on either side designed to tether the device into the uterus) was removed from the market in 1974, after causing a slew of severe pelvic infections leading to infertility and, in some cases, death. By 1986, after tsunami of litigation, only one company was still manufacturing IUDs.
And even though today’s IUDs have a safer design, women are now screened for STIs before insertion (which may have been the pelvic infection culprit), and current research shows no link with infertility and IUD use—the faulty Dalkon Shield still casts a dark shadow. Only 5.5% of women in the United States use IUDs, despite the fact they are proven both effective and safe.
“It’s just old pieces of information,” says Walker. “I worked at Planned Parenthood for many years, and [we] used to say that you needed to have a child first before getting an IUD. You had to prove you were able to conceive. Further research has disproved that notion.”
Is The Insertion Process Painful?
Insertion pain can be compared to menstrual cramping, but your experience will depend on your personal pain tolerance. Anxiety and never having delivered a baby vaginally may also create a slightly more uncomfortable experience.
Explains Walker, “[An IUD] is generally easier to place when someone has had a child because the cervical opening is more relaxed.” That said, this doesn’t mean you have to suffer in silence if you’ve never given birth—Walker adds that medications can be given to soften the cervix, and pre-procedure ibuprofen can decrease pain. Women can also expect a few days of menstrual-like cramps post-procedure.
Ali, 30, who is currently childfree, admits her insertion wasn’t totally painless, but was definitely worth it: “I was really tense and anxious. But for me, to have something so low maintenance that I don’t have to worry about for 5 years? I would do it again in a heartbeat. I can’t imagine taking a pill every day again!”
If It Won’t Hurt Me—Will It Hurt My Wallet?
Get ready for some initial sticker shock—IUD insertion can run anywhere from $500-$1,000 without insurance. But realize that once you’ve paid the up-front cost, you won’t spend another dime on contraception for 5 or 10 years. Over time, the IUD is most likely the least expensive long-term birth control option out there.
If you’re insured, check to see what your plan covers. You may escape with just a small co-pay—or without paying anything, as in Ali’s case. “When I realized my insurance covered it 100 percent, I got pretty excited. I had been paying $35 a month on the pill! An IUD for 5 years is a $2100 savings!” Co-pay free IUDs may soon be the reality for an increasing number of women thanks to changes recently enacted by the Affordable Care Act. And, if you find yourself uninsured, investigate options like Planned Parenthood for the lowest out-of-pocket price.
If My Wallet is Safe—What About My Partner?
The “T” shape of the IUD ensures that the device (which is not embedded into the uterus) does not slip from it’s resting place, and a plastic string is attached to the end which is trimmed to hang slightly outside your cervix. The strings allow your provider (or you) to check to make sure the device is not displaced.
“The only concern I had was the strings,” says Tracey. “Will my partner be able to feel them when we are having sex?” Walker says the strings tend to “get moist and pushed off to the side. You can find them if you’re looking—but most intimate encounters are not a scavenger hunt!” Both Ali and Tracey report that their (quite) contented partners have never detected their IUD.
And What Happens If My Biological Clock Stops Ticking And Starts Clanging?
Some of you might get to the point in life where you want try your hand at professional stroller pushing. Returning to fertility after having a ParaGard is easy—according to Walker, you are able to get pregnant immediately after getting the device removed.
Mirena takes some advance planning. “With Mirena, it can take up to a year for your periods to come back,” Walker explains. “Allow some time for your periods to resume and for your hormones to balance.”
But, until the day dawns that you actually want to trade in your trouser suit for a thousand-dollar jogger stroller (or “travel system” as it’s now called)—IUDs offer a birth control method that allows a little room to forget.