The American College of Obstetricians and Gynecologists has officially endorsed intrauterine devices (IUDs) as contraceptives for healthy women and teens (regardless of if they’ve given birth before). In honor of that, we want to get a little more informed about this lesser-known form of birth control, so we’ll be posting about IUDs and contraception options all week here at Blisstree. Today, I talk with Manhattan-based doctor Margaret Kearns-Stanley about IUD insertion, side effects, hormones and more.
Do you agree with the new recommedations, that IUDs are safe for women who haven’t yet had children or who have multiple sexual partners?
Yes. There are very few people I think really should not have an IUD.
What do you tell your patients who are considering getting an IUD?
The benefits of the IUD are what I try to explain. The most important thing is ease of use. And it’s safe. Most of the time, I recommend it because of its ease of use, efficacy and the fact that it is safe.
How does someone decide between the Mirena (which relies on hormones to prevent pregnancy) and the ParaGard (which is made of copper and contains no hormones)?
Hormones are the biggest factor here. For anyone who cannot take or doesn’t want hormones, the copper is much better. But for most people, hormones aren’t really a negative thing. The hormones don’t seem to affect moods and other things as birth control pills might. Women often like the Mirena because they don’t get very heavy periods, or sometimes they don’t get much of a period at all. The Mirena is also a little shorter use, five years as opposed to 10 (for the ParaGard).
A few Blisstree commenters said the IUD is painful when it’s inserted, that they had cramps and bleeding using it, and one even said she had watery cysts and bad skin because of it. Is this common?
When it’s inserted, it’s usually does cause cramping initially, but for most women this doesn’t continue much beyond insertion. The risk of (the Mirena IUD) affecting your skin because of the hormones is there; the copper IUD never would. In all the patients I know that have had an IUD, I haven’t had many people take it out because they didn’t like the side effects; I can think of one patient. I would say that in my experience, side effects haven’t been a big problem, but it is a potential problem. And with the Mirena, in the first few months irregular bleeding and spotting is the other problem, which also usually improves.
Is it true that an IUD can only be inserted at a certain time of your menstrual cycle?
Well, historically we did it during a woman’s period to make sure she isn’t pregnant, and because sometimes it’s easier to insert then, because the cervix is really open. But it doesn’t have to be inserted then, it can be any time during the cycle. If you’ve had children, the cervix is open enough that it doesn’t really matter. For women who’ve never had a child, sometimes the procedure is a little more painful for them because the cervix is tight, and that’s what the period might help with.
Is there anything women can do about the pain that comes with insertion?
Prior to having it inserted, the best thing to do is take Aleve or Motrin or some type of anti-inflammatory, about a half hour before the procedure.