You've probably heard a lot about IUDs lately. And with all the buzz this birth control has been generating, you couldn’t be blamed for thinking that IUDs, or intrauterine devices, had just hit the market.
In fact, IUDs came into use around the 1950s. And though less than 1 percent of women who used contraception in the early 2000s had one, that stat has been steadily rising ever since. Call it the comeback kid of contraception: Today, it's estimated that around 7 percent of women have an IUD, and the rate nearly doubled between 2006-2010 and 2011-2013 — thanks to safer designs, growing awareness and an effectiveness rate that elbows out most other forms of contraception.
But even as IUDs grow in popularity, there are still a number of common myths and misunderstandings about how they work. So to clear up the confusion, we consulted four gynecologists and reviewed the latest research to find out what every woman really needs to know about the device:
1. There’s more than one type of IUD.
In a nutshell, IUDs are small, T-shaped devices that are inserted into the uterus through the cervix to prevent pregnancy.
But while they’re all commonly referred to as IUDs, there are actually two different versions you can choose from.
- Hormonal: These IUDs contain progestin, which thickens cervical mucus and blocks sperm from swimming up to an egg. Of hormonal IUDs, Skyla, Mirena and Liletta are the options on the market. They generally work the same, although Skyla and Liletta last for around three years, while Mirena is good for five.
- Copper: For a hormone-free option, there’s also a copper-based IUD called Paragard that lasts up to 10 years, but can be associated with heavier periods.
2. IUDs are one of the most effective forms of birth control available.
With a failure rate of less than 1 percent, IUDs are pretty much the most successful form of birth control out there. And unlike more widely-used methods — think condoms or the Pill — there’s little room for human error.
“Why are IUDs so close to being 100 percent protective? Because it takes compliance right out of the equation,” explains Dr. Angela Jones, an OB/GYN in New Jersey. “Once it’s in, it’s in.”
In fact, a 2015 study found that IUDs were by far the leading choice among female family planning providers who use contraception themselves — a pretty big endorsement of their effectiveness and safety. Which leads us to:
3. They're considered to be very safe.
Not surprisingly, the idea of a device sitting in their uterus for up to a decade leads many women to worry about health risks. “I’ve seen patient inquiries about IUDs steadily increase, and the first question I always get is regarding its safety,” says Dr. Francisco Arredondo, an OB/GYN based in Texas. “Yes, IUDs are safe.”
Back in the '70s, some IUDs were linked to pelvic inflammatory disease, and they got a bad rap for many years after. But as Dr. Arredondo points out, that was due to poorly designed older models, where the strings that hang down through the cervix were thicker and braided. “Today’s IUDs have very thin strings that don’t allow an infection to move elsewhere," he says.
In fact, a 2013 study published in the journal Obstetrics & Gynecology found that less than 1 percent of women today — regardless of their age or type of IUD — experienced any serious complications from an IUD.
4. But no, they won’t protect you against STIs.
It’s worth noting that an IUD won’t at all safeguard against a sexually transmitted infection. “If you have multiple sexual partners, condoms are essential," explains Dr. Alyssa Dweck, an OB/GYN in New York. "If an STI is contracted while using an IUD, the risk of pelvic inflammatory disease and subsequent infertility can follow."
Bottom line: Always use a condom if you’re at risk for STIs.
5. Almost everyone can use an IUD.
Somewhere over the last few decades, IUDs got a reputation as birth control for older women who had already had children. The truth? “Almost everyone can use an IUD,” says Dr. Arredondo. "It doesn’t matter if you’re already a mother, never wanting to have children or just waiting for the right time.”
In fact, the American Academy of Pediatrics recently released new guidelines that recommend IUDs as the first choice of contraception for teens.
IUDs are also a good option for women who can’t use birth control containing estrogen, as well as those concerned about privacy, notes Dr. Corinne Menn, an OB/GYN in New York and Maven practitioner. “There are no pill packs lying around or having to go to the pharmacy.”
Bonus: An IUD can also be removed at any time, and fertility often returns much faster than if you were to go off of the Pill.
6. They’re expensive — but your insurance will likely cover all costs.
In the past, the steep upfront fees made many women shy away from IUDs; the full cost can hit close to $1,000.
But that's largely changed, too. Thanks to new requirements in the Affordable Care Act, an IUD has to be covered with no out-of-pocket expenses by most insurances. In other words, you can likely have the procedure done for $0.
7. The procedure will probably be unpleasant.
Depending on your own body, tolerance and whether or not you’ve birthed a baby before, most women say having an IUD procedure can be anywhere from slightly uncomfortable to downright painful. That's mostly because your cervical opening has to be dilated a few millimeters to allow room for the IUD to be placed, explains Dr. Menn. And that's, well, not pleasant.
“I love having an IUD, but the biggest negative was the pain associated with the procedure," says Tina K., 24, a graduate student in New York City who had the Mirena IUD placed earlier this year. “I wasn't warned about it ahead of time. I had to stay at the doctor's office for about an hour afterwards because I felt very lightheaded, dizzy, and crampy.”
And it’s those fears that may be holding a lot of women back: A 2014 Kinsley Institute study found that 76 percent of women don't consider an IUD because of their fear of pain and needles.
Still, most health professionals say the procedure is manageable, especially if you plan for it. “I typically encourage my patients to take a high-dose nonsteroidal, such as ibuprofen, about 30 minutes prior to placement,” says Dr. Jones. Having the procedure done while you’re on your period can also make insertion easier, since your cervix is already naturally open.
Dr. Menn recommends that her patients bring headphones and zone out to their favorite tunes. “The good news is it only takes about five minutes, it’s done in the office, and most of the pain is gone once it’s inserted," she says. "And then you can forget about it."
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