Birth Control Breakfast

This morning while I ate breakfast I poked and pulled and fiddled around with an IUD.  Housemate brought several of them home from a contraceptive workshop she went to this week.  She's very into the IUD.  She even has a little silver lapel pin that looks like an IUD. 

I was very skeptical.  I kept making a face, a sort of uncomfortable grossed out wince, when she was talking about the IUD and how great it is.  I don't trust it, it sounds too invasive, it sounds like it hurts.  Can't it go drastically wrong and make people sterile?  Just, ick.  But of course my curiosity, plus my respect for Housemate's medical judgment, made me ask questions.

What's so great about an IUD?  Here's what I learned. It is as effective as sterilization, and it is immediately reversible. When you have it in, you are as unlikely to get pregnant as if you have had your tubes tied. (And of course, "tubes tied" is a misnomer -- your tubes are permanently, irreversibly CUT.)  99.8% effective.  When you take it out, you can start trying to get pregnant right away -- there's no time lapse due to hormones, etc.  Surgery, obviously, is expensive and dangerous and irreversible.  The IUD is inexpensive, safe, reversible, and works just as well.  It's better than the pill, from the standpoint of efficacy, and there's no room for human error.  You can't forget to take it.   There are no hormonal side effects. (Hormonal side effects are sometimes good, and sometimes bad.)  It's about $400 to get screened and pop it in, which over its life is pretty cheap. 

It works because there is a little tiny coil of fine copper wire wrapped around the flexible plastic shaft of the T-shaped gizmo.  The copper ions kill sperm and damage the lining of the egg, so fertilization can't happen.  The mechanism of action is just the presence of copper in the uterus.  I'd imagined that there was something more physically destructive going on, that an IUD had something sharp that was cutting or breaking tissue.  Not true. There's nothing sharp on it at all, even after I pulled and twisted and tugged and bent the sucker. 

Housemate is fired up about the IUD for social reasons.  I guess 25% of women who choose contraception in this country are getting sterilized, and 1% use the IUD.  The proportions are different in Europe, where there was no Dalkon Shield and no fear about the method.  She thinks that's needlessly expensive, risky, and dangerous.  Right now poor women are disproportionately less likely to be offered the IUD as a choice.  The prevalence of homone based birth control means a lot of women are peeing out synthetic molecules that impact hormones, and it's not clear what having those substances in the water does to people or the natural world.  The IUD's been maligned in this country, falsely, because of irrational fear. The defect in the Dalkon Shield had to do with the string, and that's been fixed.  That product been off the market for 30 years, and safe, proven IUDs have been around and available for a dozen years or so, but doctors and clinics still rarely suggest or even mention the alternative to patients.  That seems silly.

 

Comments

[Womanofthelaw]

I've always been afraid of the IUD but I thought I was laboring under accurate medical advice. Maybe not. I thought there was a risk of puncturing and infection? From the information you conveyed, perhaps my heebie jeebies about the IUD are outdated and/or inaccurate. It is interesting that medical professionals don't ever bring it up.

I'm glad you posted about it.

[CM]

A friend of mine got a serious infection from an IUD. It just seems like a bad idea to me to have a foreign object implanted inside yourself, unless it's necessary to keep you alive like a pacemaker.

[Patrick]

My wife & I were true believers in Depo-Provera. We had only 2 problems with Depo: (1) it made my wife "moody" (intentionally understated) for about 48 hours after she got the shot, and (2) despite the allegation that it is 99.9% effective, we now have a 2 1/2 year old son.

[dgm]

something about putting "wire" and "uterus" too close together just seems wrong. plus, like cm, i'm skeptical of putting foreign objects inside with the intent to keep them there for a long time; it makes me think of those stories where former surgery patients discover gauze pads or scalpels that the doctor forgot to remove from the surgery site.

[emma goldman]

First off, the problem w/ the Dalkon Shield was the string, yes, but also the shape of the device; it had an unfortunate tendency to embed, IIRC. That is, the device itself may have caused some problems, and the wicking string brought bacteria home to roost in those problems.

On the other hand, I had an IUD (a loop, which may no longer be available?) for about seven years, I think, and had no problems with it. I loved it, as a matter of fact. It had no copper, though; it was all-plastic. It's not for the women who are squeamish about touching themselves, however; one must check regularly to make sure the string is in the right place and the IUD hasn't come out.

Downside: Insertion was extremely painful (LOTS of bad cramping) and the first two periods after insertion were quite bad (heavy bleeding AND cramping), but after that it was fine. (Pain may be less intense with the smaller copper-covered ones?) Eventually, my gynecologist recommended removal, because the string appeared to be irritating my cervix somewhat; she would have put another one in after a few months, if I'd wanted that, but I switched to a diaphragm anyway.

[emma goldman]

Incidentally, I remember reading somewhere that putting things inside the uterus is an old method of preventing pregnancy--at least with camels. No idea whether it's true.

Also, there used to be some question of whether IUDs were associated with higher rates of ectopic pregnancy; no idea if that's been dis/proven.

[turboglacier]

Getting your man to have a vasectomy is an excellent alternative to either tubal ligation or IUD. Personally, I wish I could get my vasectomy now, while I'm still young enough to enjoy it, and then have my kids when I'm older and have nothing better to do than raise them. Unfortunately, it doesn't work that way.

[Tess]

Interestingly, when I was first investigating birth control (I live in the UK) I asked about non hormone options as I am chemical wary and I was told that they would not fit a coil ("English" for IUD) for anyone who had not yet had children. I have no idea why !

[PG]

Tess,
I wonder if it's easier to put an IUD into a woman who's given birth and whose uterus thus may be shaped or sized differently than a woman who hasn't. Also, if they're wary of the IUD's causing infertility, it seems like a less terrible side effect if the woman already has children. Doctors generally refuse to sterilize women who have no children on the theory that they eventually will regret not being able to have children.

[Rayne of Terror]

My OB said IUDs are not recommended for women who have not had a child because they are more likely to expell it. But a friend was able to shop around for an OB who would do it and she's now a huge proponent of IUDs. I asked my OB about getting one at my 6 week postpartum check up and she was all for it. She said I'm the ideal candidate and to let them know when to order it. But when you are breastfeeding it is difficult to know when your period is going to be and that is when they insert it, so I don't have one yet.

[Monjo]

Id never have a vasectomy for a woman. If she doesnt want children, she should take responsibility. And If I want children and the woman Im with doesn't, I'd move on.

Birth control can only be a woman's issue since they desire for complete control over abortion. Cake and eating it, comes to mind.

The IUD/coil seems like a good bet. 99% effective, so still use condoms if worried about STDs or pregnancy (eg having intercourse at olvulation); it doesnt have hormonal nonsense like the Pill - which I believe is gender-bending males; easy to remove?

Still, Im no expert in these matters. I don't worry cos if I get a woman pregnant then I'd be as happy as larry.
Out of interest did you have eggs for breakfast?

[Theresa]

I have the Mirena IUD in. My midwife ( I live in the US) says that is the current Birth control of choice. And I have a girlfriend that loves it. I hate it. My sex drive is zip, which is NOT normal for me, I'm crankier than a bear woke up during hibernation, and over-sensitive to boot. I've bitten too many heads off lately. Yes, it is effective, yes my periods did stop, and yes it allows you the freedom of whenever, wherever without mess or fuss, but it simply doesn't work for me. So, continue to encourage women to try it, because it will work for many and is certainly better than getting cut!

[April Clarke]

I had one for eight years and have decided that the only reason our doctors don't push IUD's more is because there is no big pharmaceutical kickback for selling them. I have friend's making their husband's go and get vasectomies- but if I won't let my husband tell me what sort of contraception to use how could I turn around and force him under that same knife? Oh, and Mr. "CM" If the brakes in you car DIDN'T WORK would you recommend them to others? After I have our second child I'm going back to the IUD for as long as I need it. Knives are for apples.

[April Clarke]

P.S.
Just be sure to get the one that is Non-Hormonal. Some IUD's are embedded with unnecesary and sometimes harmful chemicals.

[miseryIUD]

I currently have a nonhormonal IUD and it's misery. I've had it for a year and a half now, and my periods are so heavy and painful I just made an appt. to pull the plug. I wanted something without the hormones and thought this was the ticket. I've tried every type of B.C. (pills, ring, shot, etc.) and they all have their side effects (acne, weight gain...) Really talk to you doctor before making this decision, especially if you haven't given birth before.