Monica Zangwill, MD, MPH
"It's easy to forget a pill every day and it's time-consuming to use something every time you have sex," says Christina, a 36-year-old married mother of three children. "I just wish there were more birth control options for women." Like many married women in their 30s and 40s, Christina wonders if there is an easier alternative besides surgery to remove her uterus or a daily pill. One alternative is an intrauterine device, more commonly known as an IUD.
The modern IUD is a very small T-shaped piece of plastic that is inserted into a woman's uterus by a doctor. It is about as thin as a toothpick and as long as a small paper clip. Two short pieces of specialized thread hang from its end through the cervix so the doctor can easily remove it when it is no longer needed. The IUD prevents pregnancy just as well as
birth control pills
and is considered very safe.
There are two types of IUDs available, copper and hormonal. They mainly work by disabling movement of the sperm into the tube so it can't meet with an egg. The hormonal IUD thickens cervical mucus, which also interferes with the sperm's mobility. When a sperm and egg can't meet, pregnancy can't occur.
In some women, a hormonal IUD may prevent an ovary from releasing an egg.
There are IUDs available that contain a small amount of the hormone progesterone. A benefit to this type of IUD is it may help decrease menstrual bleeding and reduce cramping and discomfort in women who have heavy periods.
IUDs are a good option for women who are being treated for cancer, because they are effective and reversible.
Also, because the IUD lasts 5-10 years, it is also extremely cost-effective. The greatest cost is having it put in initially, but after that there are no other expenses.
Another benefit is that, unlike when using the pill, you do not need to remember to take something every day.
There may be some mild cramping at the time of insertion. After the insertion, all a woman has to do is check that she can feel the threads at the end of the cervix once a month after each menstrual cycle. Rarely, the IUD might come out with menstrual blood or float higher into the uterus, so checking the strings makes sure it is still in the right place. Side effects with the copper IUD can include increased cramping and bleeding but the new progesterone-releasing IUD usually eliminates that side effect.
Remember that using and IUD doesn't protect you or your partner from sexually transmitted diseases. To do that you need to use a male latex condom every time you have oral, vaginal, or anal intercourse.
If you are thinking about contraception, talk to your doctor about all of your options.
American Congress of Obstetricians and Gynecologists
Family Doctor—American Academy of Family Physicians
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
IUD. Planned Parenthood website. Available at: http://www.plannedparenthood.org/learn/birth-control/iud. Accessed August 31, 2015.
Long-acting reversible contraception (LARC): IUD and implant. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/Patients/FAQs/Long-Acting-Reversible-Contraception-LARC-IUD-and-Implant. Accessed August 31, 2015.
Intrauterine device (IUD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.. Updated August 16, 2015. Accessed August 31, 2015.
3/31/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Patel A, Schwarz EB, Society of Family Planning. Cancer and contraception. Release date May 2012. SFP Guideline #20121. Contraception. 2012;86(3):191-198.
Last reviewed August 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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