IUD (thing)

And now for a more objective look at the IUD:

The IUD - or "Intrauterine Device” – is an inert device placed inside of a woman’s uterus and is used to prevent pregnancy. The actual mechanics of pregnancy prevention are unknown – while it is entirely possible that the IUD does not allow a fertilized egg to implant on the wall of the uterus, it is also possible that it creates an environment especially hostile to the sperm or egg, killing them before fertilization occurs, or it could thicken the cervical mucous which would keep the sperm and egg from meeting. However, if you are concerned about preventing a fertilized zygote from implanting, an IUD would probably not be the best choice for you.

IUDs are generally small devices about the size of a quarter made out of long lasting materials like plastic and copper and are produced in a variety of shapes. Today those sold in the US are generally a “T” shape – the arms of the “T” fold down for easier insertion through the cervix. Attached to the bottom of the “T”is a monofilament (think fishing line) that hangs out of the opening of the cervix so that it can easily be removed later by the physician (the filament generally cannot be felt by the woman or her sexual partner).

The IUD is not very widely used in the United States because of the Dalkon Sheild, an IUD produced in the 1970’s that caused 12 deaths. It is believed that the string that hung outside of the cervix (used for removal) acted as a wick for bacteria because it was braided. It is for this reason that the strings are made of monofilament today.

The cost of an IUD is around $300 but they remain effective for 5-10 years and the pregnancy prevention rate is +99% - even higher than the pill with perfect use . Five years is how long a progesterone-treated IUD is expected to last, and 10 is for a copper IUD. The advantages to having a progesterone IUD (like Mirena) is a decrease in menstrual pain and bleeding, and the advantage to a copper one is long-lasting birth control without the hormones – however one disadvantage is that the main side effect is increased menstrual flow and cramping.

A doctor’s visit is required to have the IUD inserted, and it is inserted through the cervix using a tube, which is predictably painful – but not enough to require more than a few ibuprofen. However, some feel this is a very small price to pay for hassle-free birth control for the next decade. After the given amount of time another doctor’s visit is required for the removal of the IUD.

Possible complications include the IUD expelling itself from the uterus (it is recommended the woman check the string after every period to see that the IUD hasn’t moved or been expelled), becoming imbedded in the uterus, or puncturing the uterus. The latter two complications are pretty rare, thankfully. If these side effects sound shocking, consider that one of the rare side effects of the pill is heart attack and stroke. It is also likely that if you become pregnant with the IUD in (remember, no birth control method is 100% effective - except abstinence of course) the fetus may be aborted, or you might experience an ectopic pregnancy, and IUDs do not protect from sexually transmitted diseases (STDs or STIs) - period.

However, scary as it sounds, the IUD is successfully used by millions of women around the world as a long-lasting, cheap (in the long run) alternative to hormonal birth control or more permanent solutions like tubal ligation.