If you’re like me, a woman who is concerned about becoming pregnant and the future of her reproductive rights, birth control is probably on your mind. Many women in the U.S. already access various forms of contraception, the most popular being HBC (hormonal birth control) pills. However, women who are unhappy with their current birth control method or aren’t using contraception at all, may not have thought about an IUD (intrauterine device) as a viable option. For those of you who are looking to start a new form of birth control or are worried about what their birth control options may look like in the near future, an IUD may be worth considering.
If you’re feeling hesitant about using an IUD, you aren’t alone. There’s a lot of stigma that surrounds IUDs. Even though current models on the market are FDA approved and deemed safe by health professionals, few women in the U.S. opt for one. There are countless myths and misinformation that discourage many women from even considering IUDs. As someone who is very happy with my IUD, I’d like to share some research I’ve gathered, as well as my own personal experiences, to answer some of the questions you may have.
1. Aren’t IUDs dangerous? Can’t they make you infertile?
Valid question. There’s a permeating stigma that IUDs put you at risk for major reproductive health issues. Much of this attitude has trickled down generations of women, starting with those who witnessed and experienced the Dalkon Shield scare. In the 1970’s, the Dalkon Shield IUD model was released into the market and caused many users an array of health problems, including PID (Pelvic Inflammatory Disease), spontaneous abortions, infertility, and even death. Overall, nearly 8 percent of women who used the Dalkon Shield filed lawsuits against the manufacturers. It was taken off the market and since then, health professionals have been able to identify what went wrong. Current models today don’t carry the same malfunctions and are not only deemed safe, but actually have one of the highest efficacy rates.
For transparency sake, here are the specifics on the health risks of IUDS:
- Depending on the model, irregular and/or heavy bleeding can occur, as well as heavy menstrual cramps. I’ll go into more detail about this later.
- Depending on the model, benign ovarian cysts that clear up on their own may occur.
- IUDS may expel (basically, fall out), but research shows that only 2-8% of users experience this, and usually it will happen within the first couple of months after insertion. I will also talk more about this later.
- Research has found no evidence to support that IUDs cause PID or infertility in any user (whether they have been pregnant before or not).
- Ectopic pregnancy and miscarriage may occur in the very unlikely case of conception. However, the chance of these health issues is no higher than if you were to conceive while not using any contraception.
- Perforation may occur (the IUD punctures the uterus), but it is also very rare.
Clearly women who are interested should talk to their physicians to make sure that an IUD is right for them, but most women (with uteruses) are “eligible” for one, so to speak. Unless of course your doctor is also misinformed about IUDs or doesn’t know how to insert one. Then you may not get the green light. If your doctor says you shouldn’t get one due to one of the misconceptions discussed in this article, I suggest getting a second opinion.
2. What if I pull or push out my IUD somehow?
Also a valid question. A few hours after my IUD insertion, I had to poop, but I suddenly felt scared. “What if you’re not supposed to be bearing down or straining so soon after?” Livejournal may be out of season, but IUD Divas has been a great resource for me, especially during the first month when you may have a lot of questions or just want to know about others’ experiences.
I was also afraid that I would pull out my IUD because I use a menstrual cup–especially since I’ve read that your IUD is more likely to expel during your period (since your cervix is more dilated). However, as long as you’re using your cup correctly, there shouldn’t be any problems. Even research shows that using internal period products (cups and tampons) doesn’t increase the chance of expulsion.
Turns out, it’s pretty hard to make your IUD expel. While expulsion does happen, it’s rare, and will generally happen within the first couple of months. This is why your doctor will schedule a a follow-up appointment with you at least six weeks post insertion. There’s no way to really predict whether or not it’s going to happen (research doesn’t suggest that some women are more at risk than others) but with regular string checks, you should be able to recognize if it does happen.
Basically, you can put stuff in you and push stuff out of you without expelling your IUD, so don’t stress out about it.
3. But can I get frisky though?
Well duh, that’s kind of the point. The IUD is placed high in the uterus, so unless your partner is going through your cervix and into your uterus (ouch) you’ll be just fine. Your partner should not feel the strings with their penis, however, they will probably feel them with their fingers. The strings are comparable to fishing wire and shouldn’t go too much longer past your cervical opening. If they feel too long, it may be because your doctor didn’t cut them short enough. But, no worries, they can trim them as needed.
Like with anything, though, listen to your body. Your cervix goes through various stages throughout your cycle. This can sometimes affect how sex feels for many women, including those with IUDs in place. You should never experience pain during sex though, so if that’s the case, make sure to check in with your doc. Speaking of pain…
4. HOW BAD DOES IT HURT TO GET ONE?!
The insertion does not require surgery. It is a simple procedure performed by your GYN in their office. Although very brief, my insertion was comparable to my most intense menstrual cramps, and I had to rest for 10-15 minutes afterward. But, my doctor provided a calming atmosphere and talked me through it. My partner was there holding my hand, and I remembered to breathe. Being calm and relaxed is really important. Your doctor will tell you to take at least 800 mg of ibuprofen an hour before your appointment, but those are purely for pain relief. If you can get your hands on something to calm your nerves beforehand, I recommend doing so.
Throughout the next couple of days I experienced mild cramps and discomfort, but otherwise it was fine. Your doctor will most likely do the procedure while you’re menstruating (because your cervix is more dilated during that time), so for me it was just like any other period. With that said…
5. What’s my period going to be like?
So this depends entirely on your individual body as well as which model IUD you use. If you’re using a hormonal IUD (like Mirena or Skyla) then your periods will most likely be light or nonexistent. As for a non-hormonal IUD (the copper Paragard) there’s a bit of an adjustment period.
Many women experience heavy cramps and bleeding for the first few periods after insertion. My first cycle after insertion was definitely a doozy. I experienced my worst cramps during ovulation. For my actual period, the cramps were mild, but my flow was heavy and long–like 11 days long! But, most women report that after 3-6 months, everything goes back to normal.
While your body is adjusting, I suggest taking extra care of yourself during ovulation and menstruation. Get yourself a heating pad, look into some period products that you can love using, and treat yourself to lots of bubble baths and wine. But don’t forget, self-care is important all month long!
6. Since you mentioned different models, which one is right for me?
So Paragard should just hire me as their brand ambassador, because I’ve been telling everybody about how happy I am with mine. Paragard is the only non-HBC available, other than condoms. Condoms are effective, but they’re not always reliable (they can break, fall off, or be forgotten). Plus, if you and your sexual partner don’t need to use an STD preventative, you may want the option to go without one. If you’re interested in a reliable, non-hormonal pregnancy contraception, Paragard is your best (read: only) bet. However, if you would prefer using HBC, there’s also Mirena and Skyla.
There are many other differences to consider between the three models, like size, side effects, and timespan. The Paragard has a bad rep for some of the more uncomfortable side effects (heavy cramps and bleeding) but it’s the longest-lasting contraception, boasting 10 years of protection. Mirena lasts five and Skyla three. While depression and mood changes are symptoms associated with Mirena and Skyla, they aren’t with Paragard, due to the lack of hormones. This, plus the long timespan led me to choose Paragard. While on HBC pills, I was often moody and depressed, plus my libido was negatively impacted. What’s the point in using contraception if you don’t even want to get it on? Plus, with the new presidency, I’m worried that my BC options will become limited within the upcoming years, so having the Paragard gives me peace of mind.
As far as their similarities, all three models have the same T-shape and monofilament string. Historically, other model shapes and string variances correlated with the health issues previously discussed. All models are also inserted and removed the same way and have the same low risk of expulsion and perforation. And, best of all, they are all highly effective and easy to maintain. Unlike pills, rings, and patches, an IUD takes a minimum of three doctor’s visits (insertion, six-week check-up, and removal) and one monthly string check that you can do yourself. This means there’s no need to worry about changing it out monthly, forgetting to take it daily, or getting prescriptions refilled.
7. Are there any barriers that could prevent me from getting or keeping an IUD?
STIs and STDs
Like I mentioned before, most women with uteruses are “eligible” to get an IUD. If you have a sexually transmitted bacterial infection (like chlamydia or gonorrhea) you’ll just need to treat it and wait for it to clear up first. IUDs don’t protect against STIs, so make sure you’re being safe with partners who have unknown statuses, partners with positive statuses, and/or multiple partner sexual experiences/relationships. However, if you contract an STI while using an IUD, you shouldn’t have to remove it. Of course, consult with your doc as needed.
If you’re pregnant and want to carry it to term, don’t get an IUD. While it’s highly unlikely, if you happen to become pregnant while you have an IUD in place (usually this occurs when you have unprotected sex after it expels), make sure to get it removed right away as it can cause health problems. Otherwise, if you can handle the adjustment period, you shouldn’t have to remove it until you’ve reached your time cap. Also, unlike other forms of BC, you can conceive fairly quickly after IUD removal. So, if you still aren’t interested in pregnancy after removal, be prepared to get another inserted or use an alternate BC right away.
Because IUDs use low to no doses of hormones, people who struggle with acne may want to go with HBC pills or something with higher doses of hormones, since these have been proven to help keep skin clear. However, if you have never been prescribed HBC for acne-related issues, then your skin will stay the same on an IUD.
Many health insurance plans partially or completely cover the cost of IUDs (for now anyway). However, if you are uncovered or undercovered, the cost may be a barrier. You can request a free quote from Paragard to figure out what your bill may look like. My partner split the cost with me, which helped tremendously. If this is an option for you, consider asking. Over the course of ten years, I will have spent less on a monthly basis for my IUD than I would have with HBC pills. The upfront cost was high, but in the long run it is more cost efficient.
There are also some doctors who don’t insert IUDs because they are unfamiliar/uncomfortable with the process or their hospital/clinic doesn’t carry them. I had to go through three doctors before I could get mine! So, you may find yourself making several phone calls and dealing with lengthy wait times for appointments.
8. Maybe IUDs are awesome?
YES! At least, they are for many people who use them. I hope that after reading this you’re more confident in at least considering that an IUD could be a birth control option for you. I’d love to hear any questions you may have and welcome IUD users to share their own experiences in the comments below!