What is the truth about IUDs?

Over the past few weeks, the safety and usability of IUDs have been brought up multiple times among friends, classmates, as well as, in a recent article in the women’s magazine fitness that promotes the use of Skyla. It is interesting that a contraceptive method that has been around for decades is still being questioned and misinformation still spread.

What is an IUD and how does it work?

IUDs, or intrauterine devices, are a form of long-acting, reversible birth control. They are commonly made of flexible plastic and shaped like a ‘T’, but inserted in the form of an ‘I’ with the arms down. Upon placement of the IUD, the provider will pull a string so the arms pop out and the device stays in place. When the device is removed, the arms fold upward as it is pulled out of the uterus.

There are two types of IUDs: copper and hormonal. The copper IUD, or the Paragard, works by preventing the movement of sperm toward an egg. It is hormone-free so it does not interfere with a woman’s normal cycle, although a common side effect is heavier and longer periods. The copper IUD is effective for up to 10 years, but can be removed at any time for any reason including wanting to become pregnant. There are two main hormonal IUDs on the market at this time: Mirena and Skyla. Mirena was FDA approved in 2000 and is effective for contraceptive use up to 5 years. Skyla was recently introduced in 2013 and is effective for up to 3 years. Like the Paragard, these IUDs can be removed at any time in an effort to become pregnant. Both Mirena and Skyla work in a similar manner by releasing small amounts of a progestin hormone called levonorgestrel. This hormone prevents pregnancy by thickening cervical mucus thereby inhibiting movement of sperm, as well as, thinning the lining of the uterus. A woman’s period may stop or become infrequent when using a hormonal IUD (although spotting is common in the first few months).

The rumors:

  • If you haven’t had kids, you can’t get an IUD.
    • False!! This myth may have begun because people thought a pre-child cervix would not be large enough to insert an IUD, however, the IUDs are very small and can be easily inserted before having kids!
  • An IUD can “flip your cervix”.
    • False!! There is no literature on this and it is physiologically impossible!
  • Teenagers should not get the IUD.
    • False!! Again, this may have stemmed from the belief that teenagers are too small for an IUD to be placed in the uterus. The IUD is so small that it can be easily placed in skinny teenagers, too!
  • IUDs will cause you to become sterile.
    • False!! Women can become pregnant immediately after the removal of the both types of IUDs (depending, of course, on fertility).
  • If you get frequent yeast or vaginal infections, the IUD is not a good choice of contraception for you.
    • Although the official websites of these IUDs do not specifically mention yeast infections, they do say not to use these products if you get “infections easily”. This is very vague so if it is a concern of yours, you should speak more about it with a healthcare professional.
  • The IUD is very painful to insert.
    • The placement of an IUD is not comfortable and cramping may be experienced while it is being inserted. The pain commonly subsides once the IUD is in place which takes only a few minutes. Many healthcare professionals suggest taking 800mg of Ibuprofen prior to insertion. If an IUD sounds right for you, you should not let a few minutes of pain deter you!
  • You or your partner can feel an IUD during sex.
    • (Mostly) false!! IUD strings may feel course in the first month or so after insertion and there is a possibility you or your partner will feel the strings during sex. The strings will become softer over time and soon no one will notice them! If you ever feel the IUD, however, it may be out of place and you should see your healthcare provider immediately.

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