What is an IUD?
It is an intrauterine device, also called an IUS (intrauterine system). It is a t-shaped flexible plastic device inserted into the uterus with 2 strings attached to the bottom of the device that hang into the vagina.
Why don’t more women use the IUD?
The intrauterine device (IUD) is highly effective and widely used by women throughout the world, except in the United States. Here IUDs are used by fewer than 3% of reproductive-aged women.
In the 1960s and 1970s the IUD was very popular in the United States. Due to the defective construction of one IUD – the Dalkon Shield - that was introduced in 1970, there was a high incidence of pelvic infection. Unfortunately, the Dalkon Shield problem tainted all IUDs and ever since, consumers in the United States have inappropriately regarded all IUDs as a cause of pelvic infection.
Recently there has been renewed interest in IUDs as a reversible, long-acting, and effective contraception. And with careful screening and technique, the IUD is very safe.
I’ve heard that there are different kinds of IUDs?
There are three IUDs approved by the FDA: the copper IUD (Paragard) and two progestin-releasing IUDs (Mirena and Skyla). IUDs depend for contraception on the general reaction of the uterus to a foreign object. In addition, the copper of the Paragard is spermicidal, and the progesterone in the Mirena and Skyla IUDs change the cervical mucus and lining of the uterus.
Why would I choose one IUD rather than another?
The Paragard contains no hormones and lasts for 10 years. For the first several months after insertion, periods may be longer, heavier or more uncomfortable.
The Mirena works for 5 years and is approved by the FDA to ease menstrual bleeding. Periods become lighter and less regular and less painful.
The Skyla IUD, approved by the FDA in January 2013, works for three years. It has a narrower inserter and slighter smaller body. It may be more appropriate for a woman with a smaller uterus or one who has not had a child.
My friend said that the insertion of the IUD is painful.
You may have mild to moderate pain when the IUD is put in, especially if you have never been pregnant. Talk to your health care provider about ways to make insertion more comfortable. You can take Ibuprofen 30 minutes before your appointment to help with cramping.
How do I know if I’m a good candidate for the IUD?
Your health care provider will review your medical history and ask you to have a pelvic exam. The exam will include tests to rule out cervical cancer and sexually transmitted infection. This testing is done to lessen the chance of infection at the time of the IUD insertion. You will want to limit sexual partners and use condoms consistently to avoid pelvic infection with the IUD.
Are there serious complications with the IUD?
It is possible, although rare, that the IUD could pass through the wall of the uterus during insertion. The health care provider will know this immediately if it happens.
The IUD can slip out of the uterus. Sometimes it comes out all the way and sometimes it comes out only part-way. You may find the length of the strings becomes shorter or longer, or you feel the plastic of the IUD at the cervix.
And it is possible to develop a pelvic infection. This is most common during the first three weeks after insertion.
How expensive is the IUD?
The IUD only costs money at the beginning and then you have a 3 or 5 or 10-year method. You will need to check with your insurance company to see how much of the device and insertion are covered. The cost is usually between $500 – $1,000. If you have the comprehensive Student Health Insurance or the Wilce Care Supplemental Insurance, the IUD cost will come out of your $2,000 yearly allowance.
If you have any questions about birth control, come in and talk to the Women’s Services staff at the Student Health Center. We will help you find the best one for your lifestyle.
Beth Askue, MS, CNP
Student Health Services
The Ohio State University