When a friend first told me she used an IUD (intrauterine devices), I was suprised. To me, the letters were scary. They indicate middle-aged women with children, medical procedures and news headlines linking IUDs and infertility. But my friend boasted about her IUD, so I decided to do some research.
After my mother’s generation witnessed scandals related to a dangerous earlier version of IUD called the Dalkan Shield in the 1970s, they were reluctant to use the method of birth control. As a result, women my age have also avoided IUDs, despite the fact that their level of effectiveness is higher than the pill or the ring, and they have now been used safely for over two decades. Once inserted, IUDs can last for five to10 years, making them more cost-effective than methods that require monthly purchases. Most interestingly to me after my messy break-up with Nuvaring, IUDs are one of the only highly-successful, non-hormonal contraceptive options available. After chatting with my friend, I thought my quest for a birth control that didn’t screw with natural reproductive cycles was finally over! But even IUDs provide no simple answer.
There are currently two forms of IUD on the market; a non-hormonal device called Paragard made of copper (a substance causing the body to create an environment toxic to sperm), and a newer plastic insert called Mirena that secretes progestin. Both T-shaped devices prevent sperm and egg from meeting, acting as a barrier to fertilization in addition to changing the composition of the uterine lining and preventing implantation. Both are 99.4 percent effective, completely reversible, and allow natural ovulation. Both require a health care provider to insert the product, a minor medical procedure that nonetheless carries risks of infection, uterine perforation, or expulsion. Neither product protects against Sexually Transmitted Infections (STIs).
The Mirena IUD is more widely recommended, specifically because it’s the only birth control clinically shown to reduce menstrual bleeding. (Progestin helps to thin the uterine lining, meaning there is less to shed each month.) Due to the constant levels of progestin, the Mirena is slightly more effective, resulting in only one pregnancy in 1000, versus four in 1000 for the Paragard. Paragard is noted to cause heavier bleeding and cramps in some women, making it less popular, and even causing 12 percent of users to ask for the IUD to be removed.
Now, those of us seeking non-hormonal birth control are left with a quandary! Is maintaining a chemical-free body worth menstrual discomfort? Is the Mirena, only recently available, better than tried and true copper IUDs, proven effective for more than 20 years? Why are doctors and pharmaceutical companies working so hard to pump our bodies with synthetic material? Stay tuned for more discussion.