To IUD or Not To IUD? For many women looking for long-term contraception, that is the question. I, for one, have been mulling over this issue for months. I have three very small children and am not looking to have more… as far as I know. I’m still relatively young, and making a permanent change seems premature for me. However, my sex drive and psyche have appreciated the reprieve from a daily dose of hormones, so I don’t know that I want to re-introduce the pill (nor am I confident that I would remember to take it at the same time every day).
Before we get into the details, let’s cover the basics. What is an IUD and how does it work? IUD stands for “Intrauterine Device” and is a small T-shaped device implanted in the uterus by a doctor. IUD’s come in two basic forms — either with copper wire threaded around the T, or a hormone emission system. The most popular IUD’s on the market today are the ParaGard (copper), Mirena (hormonal), and Skyla (hormonal). An IUD will typically run you $400-750, but it’s increasingly common that most insurance plans will cover the cost in full.
The ParaGard copper IUD is the most popular non-hormonal IUD. Relative to others, it is slightly larger in size. The device is made of plastic and copper, and the copper from the ParaGard slowly releases into the uterus and acts similarly to a spermicide (interfering with sperm movement and egg fertilization). This type of IUD can be left in for up to 10 years.
The smaller Mirena and Skyla IUDs work by releasing a low dose of progestin, which thickens cervical mucus, thus preventing fertilization. These types of IUDs can be left in for up to 3 – 5 years.
Because IUDs don’t rely on user consistency, they’re the most effective reversible contraceptive on the market, and are actually the most popular method of pregnancy prevention in the world, but in the US only 1.3% of women use them as their primary means of contraception. Since many insurance plans have started covering IUDs, they’ve recently become much more affordable. For these reasons, many physicians say that IUDs are having a moment. I would agree, but even still, there are pros and cons to the decision to get one. Before I insert anything into my body, I like to weigh my options carefully.
Unlike many other forms of contraception (like the pill or a diaphragm), you need a doctor to insert the IUD into your uterus. It’s a short and simple procedure, but IUD implantation can nonetheless be uncomfortable. One woman that I spoke to noted that she had some cramping, but the discomfort was manageable: “It hurt a little but not too bad, a little cramping and bleeding for the first couple weeks but I don’t remember it being a big deal.” While another woman I spoke to had a much more dramatic reaction, saying that insertion felt “similar to some of the worst labor pains.” While it seems that the range of cramping and discomfort can vary, similar to period cramps, this discomfort can be treated with an OTC painkiller like Ibuprofen. You may want to consider taking the day off from work after your IUD implantation so you can go home and curl up with a heating pad and some tea if needed.
After IUD implantation, some women reported that they had some pain or discomfort during sex, but they felt comfortable and back to normal after several weeks. I consulted with Dr. Kara Reynolds, an Emergency Room physician at Indianapolis University Hospital, and she said she’s only seen “a handful of IUD complications [from IUD implantation]… and they were mild.” The most common complaint is that the patient’s partner is poked with the IUD strings during sexual intercourse. Dr. Reynolds noted that this tends to be an easy fix, and most of her IUD interactions involved clipping strings — a simple procedure.
Once implanted, an IUD can last from 3- 12 years depending which type you have. An IUD begins working immediately if inserted within seven days of the start of your period. If you have have a hormonal IUD — like Skyla or Mirena — which is inserted during another time in your cycle, you’ll need to use another form of contraception until the IUD has been in place for seven days. After six months with an IUD, many women experience much lighter, shorter periods with decreased PMS, less bloating, and minimized cramping.
When it comes down to it, the IUD is an excellent option for long term contraception. It’s forgettable, convenient, and doesn’t interfere with sexual spontaneity. Still, a woman’s body is complex, and you know yours better than anyone. Take the time to consult with your gynecologist or physician, and, always do what’s best for you.