IUDs are OK, Say OB-GYNs

The American College of Obstetricians and Gynecologists has officially endorsed intrauterine devices (IUDs) as contraceptives for healthy women and teens.

Currently, there are two types of IUDs on the market: the Mirena, which releases hormones and may be worn for up to five years before removal, and the ParaGard, which is made of copper, doesn’t contain any hormones and can be left in for up to ten years. Both are incredibly effective at preventing pregnancy—less than 1 out of 100 women will get pregnant each year if they use the Paragard or the Mirena IUD, according to Planned Parenthood. Yet IUDs account for 5 percent of contraception used by women in the U.S., compared with about 15 percent worldwide.

Early IUDs were recalled for causing ectopic pregnancies and pelvic inflammatory disease (PID) and, as late as 2005, the ACOG only endorsed IUDs for women who had already given birth and were at a low risk for sexually transmitted diseases (though the Mirena and the ParaGard have been approved by the FDA since 2000 and 2005, respectively). A January 2011 study from Yeshiva University found family physicians are often uncomfortable talking about IUDs with patients, think their patients would not be open to learning about IUDs, or have gaps in knowledge about IUDs themselves. All this surely contributes to the reason IUDs have remained only a marginally popular birth control option for women in the U.S.

I’ve been wanting to get an IUD for a while, but every time I’ve tried, I’ve encountered either resistance from my gynecologist, or my insurance company (docs who warned me not to if I wanted to have kids, insurers who would only cover hormonal, not copper, IUDs for no apparent reason). Let’s hope these new recommendations will make it easier for women to get IUDs, get them covered by insurance, and get accurate information about them.

Next week, in honor of this new endorsement, we’ll look a little closer at IUDs—history, myth, fact, what the docs say, and what you say. If you’ve got any IUD experiences or opinions to share — love or hate it? copper or hormonal variety? did your doctor encourage or discourage you from getting it?—please comment below! Or email me elizabethnolanbrown@gmail.com.

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    • Laura Cooley

      I have Merina.. the plastic hormone one. I am ok with my IUD. Not 100% happy but it seems to be doing the job. I got one when I was 4 months post my last baby and have had it for a year and a half. My cycle started as soon as it was put in despite exclusively breastfeeding. I now have 2 weeks of very light spotting and two weeks of clear. If it wasn’t already in I would go back to the nuvaring.

    • nicole

      I had a mirena put in 1 month ago, my doc encouraged me to get it, and she said she personally prefers mirena over copper because she has doubts about the efficacy of copper. I had been on the pill with no problems, and figured that a hormonal IUD with a smaller and specific dose would ease me off the pill and would at least decrease the whole-body hormone dose.

      I love it so far! I haven’t had kids and I won’t want any with my partner for another 3-5 years so it’s perfect. I’ve heard that some docs will give you crap about getting one if you’re not in a long-term relationship, supposedly because multiple partners increases risk of STIs and the IUD can make you more susceptible to infections traveling into your uterus and ovaries. But that’s very rare and not well documented. Before I got it in, I also heard that it’s very unusual in women who have never had kids because it may hurt to put in if you’ve never had a vaginal birth, but mine went in fine with just a small amount of discomfort.

      I’ve been spotting a bit and am now on a very light period but supposedly things even out after a couple of months. I’ve never tried nuvaring, shots, patches, or anything other than the pill and condoms, but personally I think the mirena is perfect for not even having to think about it, and for being easily reversible. Most women are apparently able to get pregnant within 3 months of having it taken out so I’m pleased about that too. Feel free to email me with questions! nicolediaznelson@gmail.com

    • Rebecca H.

      I had a Mirena IUD for approximately 2 years, prior to having any children, and I loved it! My blood pressure was elevated due to taking the pill for several years, and my PCP encouraged me to try the IUD because it wouldn’t affect my BP as much.

      I was one of the lucky few to completely stop getting my period (which was a side-effect I was totally happy with!). I did have some initial minor cramping for about a week after it was put in. I also found the insertion process to be extremely painful, but only for about 5 seconds. All-in-all, it was completely worth it. I had a great experience with it, and while it was in, I completely forgot it was there…which essentially is the point. Once I had it removed, I was able to get pregnant almost immediately, and am now in my 7th month of pregnancy with my first child!

      Every woman is different, so it may not be for everyone…but it was definitely great for me!

    • Dani M.

      I also have a mirena…my ob was pro-mirena – she has one too – after the birth of my second child. I love it because I don’t have to remember or think about anything – it’s just there. And I don’t have much of a period anymore – which is AWESOME…but I did have about three months of constant spotting, which was annoying, and the placement was painful…and they had to go back in and trim the wires – they were left entirely too long and were actually poking me – yowzers. Another family member had to have hers surgically removed because they cut the wires too short and could no longer find them to remove them. Getting the thing removed is a scary thought since it involves yanking it out of it’s lodging. I wonder about its efficacy – but I haven’t had any more surprises since having one, so I guess it is working. The copper ones – I would question its efficacy as well…something about slowign down the sperm? My ob said it causes heavier periods…I understand the no-hormone thing though. My insurance is pro birth control of any sort, so it was totally up to me. Given that choice – little to no period or even heavier periods, I opted for none.

    • Laura B.

      Two days ago, I had the copper IUD put in (Paraguard). The reason I chose Paraguard over Mirena was due to the fact that I did not want hormonal birth control at all. I have migraines with aura, which are thought to increase your risk of having a stroke if you are on birth control pills, so I chose to have the non-hormonal IUD. My gyn did think I was a little odd to request Paraguard as opposed to Mirena, even confused when I said I was fine having heavier periods. She definitely tried to push Mirena, telling me that on Mirena, my periods would lighten, even stop, but I was still adamant to get Paraguard. Overall, I did feel like my gyn was a little opposed to me having it, saying that if I was thinking about having children in a year or two, then not to bother having the IUD. I’m almost 30, and told her that I wouldn’t start thinking of having children until I was at least 35, and she seemed satisfied with that. I did leave the consultation feeling a little deflated, as if my gyn did not want me to have it. But I decided it was the best choice for me, so made the appointment despite the bad feeling from my gyn.

      The insertion of the IUD was painful, but only for a short time, and within about 5 minutes, it was done. The past two days I have experienced a constant period-like pain and get the random twinge and bad cramps in waves, but it passes. My hot water bottle has helped a ton! I’ve only had slight spotting since the insertion, nothing a panty liner can’t handle. As the days pass by, the cramps are getting better. My gyn said that it was normal to get cramps and spotting, and once my body was adjusted to the IUD, things should even out. She said the cramps may continue for 6 to 12 weeks. The nice thing about this, is that my health insurance covered the Paraguard 100%.

      Being from the UK, I find IUDs commonplace, my mother and friends having had them. It’s far less common here in the USA to find people who have had them or want them. There’s too much negativity and misinformation around. Just last week when I told a friend that I was getting it, she was surprised and told me that she’s heard it causes infertility – which I promptly told her the facts and explained that it didn’t. They don’t see an IUD as an option either – most don’t even know how it prevents pregnancy and don’t bother finding out the facts, therefore it’s off the table immediately. I’ve had many friends tell me that IUDs are great, and once you get over the initial cramps from your body adjusting to it, they tell me that it’s totally worth it.

    • Salman

      I had a Mirena IUD for approximately 2 years, prior to having any children, and I loved it! My blood pressure was elevated due to taking the pill for several years, and my PCP encouraged me to try the IUD because it wouldn’t affect my BP as much.
      thanks by salman
      stroke from