Intra-uterine devices: not just for mothers

 

I pride myself on being well-informed about all forms of birth control available, and soon-to-be available, in the United States.  It was established that intra-uterine devices, or IUDs, were only available to women who had ad at least one baby.

Relatively recently a woman in her late teens told me she was considering having an IUD inserted.  I informed my young, ignorant friend that since she had never had a baby that she could not get an IUD.  Silly, silly woman.

Only she was right and I was wrong.  Very wrong.  It is true that for quite some time the IUD was only prescribed for women who had had at least one child.  The belief was that only a uteris that had carried a child was large enough to accommodate an IUD, which is a T-shaped instrument that is inserted into the uteris to provide pregnancy prevention for as long as twelve years.  However, studies have shown that so long as a uteris is within a certain size range that an IUD can be successfully inserted to provide years of pregnancy prevention.  The device can also be removed by a medical professional at any time if a woman wants to become pregnant, or if she wants to use an alternative form of birh control.

There are two different types of IUDs available in the US.  The copper IUD can be left in for as long as twelve years, though most literature you will read will indicate a ten year lifespan.  It has no hormones, but works by making the uteris a hostile environment for both sperm and eggs.  When a woman has a copper IUD in place she will likely have heavier periods and more severe cramping than without the device.  Copper IUDs are good for women who prefer to have a non-hormonal form birth control, and who prefer the comfort of a monthly period that indicates she is not pregnant.

The hormonal IUD releases progesterone throughout the time it is in place, for up to seven years.  The literature available usually indicates that these devices are effective for up to five years, but studies for up to seven years have shown a continued pregnancy prevention rate of 99%.  Along with making the uteris hostile to sperm and eggs--thereby preventing fertilizaion--the hormone in this type of IUD prevents the lining of the uteris from building up to allow an egg, should it become fertilized, to find purchase in order to develop into a fetus.  This type of IUD will cause a woman to have lighter and fewer periods and little cramping.  Her periods may stop altogether, or she may experience periodic, and unpredictable spotting.

Neither type of IUD prevents the transmission of STIs, so barrier methods, male and female condoms, should still be used if a woman, or her partner, is not 100% monogamous.  Having an IUD in place increases the chaces that a woman will develop pelvic inflammatory disease (PID), not from the device, but from sexually transmitted infections that can cause PID. 

A woman with an IUD has to be diligent about checking to make sure the divice is properly in place, which requires reaching into the vagina with clean fingers to make sure the filament strings, which end just outside the cervix, can be felt.  If the strings cannot be felt, or what feels like the end of a pen can be felt, the divice is not properly in place and medical attention should be sought and alternative forms of birth control used.