The intrauterine device, or IUD, is a T-shaped device that is inserted into a woman's uterus to prevent pregnancy. It can be implanted in a doctor's office, has an amazing success rate of nearly 100 percent, and is the most popular form of reversible contraception in the world, with over 85 million users. However, in the United States, only 1.3 percent of women use the IUD as birth control.
The reason? Many believe that the IUD is a victim of bad PR in the U.S., due in large part to the Dalkon Shield, a similar-looking device that was promoted as a revolutionary form of contraception in the 1970s. Unfortunately, the Shield's makers did not thoroughly research its potential design faults, and the infamous multifilament string (as opposed to a safer monofilament one) caused users to fall victim to pelvic infections, internal scarring and even infertility. Class action lawsuits brought against Dalkon's A.H. Robins Company totaled over $1 billion and forced it into bankruptcy.
Such a traumatic ordeal has made today's IUD relatively unpopular in the U.S.—even with women who weren't yet born during the Dalkon Shield crisis. It's also led to misconceptions that continue to keep American women away from the IUD, even as those in other countries embrace it. Dr. Mary Jane Minkin, clinicalprofessor of obstetrics and gynecology at Yale University, would like to see this change.
Dr. Minkin admits that the IUD is "wildly popular" in Europe and Asia, and says that the IUD can greatly benefit women. "It's a good idea to revisit what you're using contraceptively," says Dr. Minkin. She cites the sponge as a prime example. "The sponge isn't perfect, and someone with good fertility is better off with an IUD." Also, in terms of overall health, an IUD is safer than birth control pills for smokers. "There's no doctor that would advocate smoking, but if you're a smoker over 35, the pill greatly increases you chance of cardiac disease."
IUD in Real Life
Francesca, 30, had her daughter in 2001, only to see her marriage fall apart soon after. "I couldn't imagine having a child as a single mother, but I didn't want to go the drastic route of having my tubes tied. So I tried the IUD, and it worked like a charm. I didn't have to remember to take a pill, fill a prescription every month, and one of the best things was, I didn't get my period." When Francesca remarried in 2005 she decided to have the IUD removed.
Though rumors abounded that the IUD caused sterilization (another consequence from the Dalkon Shield fallout), "The doctors told me I could potentially get pregnant soon after it was taken out, and they were right—11 months later I had another beautiful baby girl!"
Jordan, 24, is also an IUD fan. "I had heard all these crazy things about the IUD, but I could never remember to take my pill on time, or I'd lose it. This led to me getting pregnant when I was 19. So I knew I needed something that could just do the job without much work from me. It's now been three years and I'm still very happy with it—I can't believe more women don't use it, though I'm glad I do."
There are two forms of IUD that are available in the United States: the ParaGuard and the Mirena. The ParaGuard is coated in copper that incapacitates the sperm. In can be left in the uterus for up to 12 years. The Mirena is a hormonal uterine device that "makes cervical mucus thicker and hostile to sperm. And if the sperm make it past, the Mirena releases progestin to kill it." It can be left in for up to five years. And for those who think that IUDs cause heavy periods and cramping, think again. "Twenty percent of women who use the Mirena have no bleeding after a year, and the other 80 percent have periods that only last one to two days," says Dr. Minkin. If used correctly, fewer than one out of 100 women will become pregnant with an IUD.
The IUD insertion can be done in a doctor's office, and takes only a few minutes. "Before we insert, we measure the length of the uterus, in what is called the 'uterine sound'. You have to have a certain length uterus for it to fit in," says Dr. Minkin. This means that the IUD often fits better for women who have already had at least one child. Either way though, it's best to have a fitting done mid-cycle, when the cervix is most dilated. If you are interested in learning more, visit plannedparenthood.org or mirena.com.