Everything You’ve Ever Wanted To Know About The IUD
We’re approaching the New Year, and it’s the perfect time to make a move if you’ve been thinking about trying a new form of birth control. Many women are passing on traditional forms of birth control like the pill or the shot and turning to long-term and low maintenance options like the intrauterine device, or, IUD.
Unlike other birth control options, this unique form of birth control can come with or without a hormone insert and when taken out, there is an immediate return to ovulatory cycles and pregnancy can occur very shortly after removal.
Although IUDs have been around for a long time, many women are not very familiar with them. According to the American College of Obstetricians and Gynecologists Practice Bulletin and the National Survey of Family Growth, “the use of IUDs has increased over the past decade, from 1.3% in 2002 to 5.5% in 2006–2008.” Due to their increase in popularity and low failure rates, women are becoming more open to trying this insertable form of birth control. According to the bulletin, “IUDs have a reported failure rate at one year of 0.8 per 100 women,” and “a 10-year failure rate comparable with that of female sterilization (1.9 per 100 women over ten years).”
In addition to their low failure rates, women also love IUDs because they’re low maintenance. For many women, taking a pill every day, getting an injection every three months or changing a patch every three weeks can be cumbersome and these routines frequently get lost in the shuffle of day-to-day life. The IUD is inserted in the doctor’s office and once inserted, can last up to 10 years.
To be safe, backup forms of contraception like condoms should be used for “seven days after insertion of the IUD unless these devices are inserted within five days of initiating menses, immediately after childbirth or after abortion, or immediately upon switching from another hormonal contraceptive.” Of course, as doctors, we know that our patients want to know about side effects. With the IUD, the most common adverse effects reported are abnormal bleeding and pain.
While IUDs have a low failure rate, just as with any other form of birth control, pregnancy can still occur. The chance of pregnancy occurring while an IUD is inserted is less than 1%. If a woman gets pregnant while the IUD is inserted, the OB/GYN will likely counsel her to have it removed. The risks of having it removed include miscarriage and bleeding; however, keeping the IUD inserted will also increase the risk of miscarriage and septic abortions. The further along the pregnancy, the greater the risk of a miscarriage.
Another concern is ectopic pregnancies. While having an IUD does not increase the risk of an ectopic pregnancy, if a woman gets pregnant with the IUD in place, that pregnancy is more likely to be an ectopic one.
There are two types of IUD’s: hormonal and copper. They both have great profiles but different personalities. Before continuing, we should also note that there is no difference in management with the copper IUD vs. the hormonal IUD.
The Paragard is an IUD that is copper based and has no hormones within the insert. It is a wonderful option for women that desire a reliable form of birth control that is super-effective and non-hormonal. Its maximum duration in the uterus is ten years, and it can be taken out sooner if so desired.
Bleeding will be the same for women who use the Paragard, as there is no hormone embedded in the device. Women who have a history of breast cancer, blood clots in the legs or lungs would benefit greatly from this IUD.
The Mirena contains the hormone progesterone and has a small amount of it released every day while it is inserted. It can remain in the uterus for a maximum of five years. When that period is up, it can be taken out and replaced with another IUD or another form of birth control. It contains no estrogen, so it has fewer side effects than the pill like breakthrough bleeding, for example.
Once the IUD is removed, there may be a short period of spotting for up to 12 weeks. This is due to hormonal balance. The progesterone in the hormonal IUD is now gone, and the estrogen is free to work on the uterus as it did before. While this is happening, the body is attempting to achieve its normal balance and, therefore, causes spotting.
Are IUDs right for you?
Although the pill is the most popular form of birth control, the IUD is a great, long-acting reversible form of contraception and is the fourth most popular form of birth control. Numbers are expected to rise as more people are educated on IUDs, and women hear about other women’s experiences. In the past, the IUD had some negative press; however, these issues have been cleared up. It is no longer blamed for increasing the rate of pelvic infections, and can now be used by women who have not had children before. So what will you decide to use as birth control in 2016? Know your options, talk to your healthcare provider, and find what works best for you.
To learn more about Dr. Jessica Shepherd, follow her on Twitter at JShepherd_MD and visit the Her Viewpoint Community on Facebook.