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Intrauterine devices are the second-most common form of contraception used worldwide, but they are not a favorite in the United States by any means only five percent of women who use contraceptives choose intrauterine devices.

That's a shame, because IUDs are extremely effective. Here are the pros and cons of intrauterine devices.  There are two types of intrauterine devices:

  1. The copper coil (Paragard)
  2. The hormone-releasing coil (Minera)

About the copper IUD

The copper-releasing intrauterine device is made largely out of plastic. It is T-shaped, and is partially covered in copper. These devices can remain in place for up to 10 years. Less than one percent of women experience unplanned pregnancies while they have the copper IUD in place. While the precise way in which the copper IUD works is not known, we do know that it prevents pregnancy in several ways. The very presence of this device causes an irritated, inflammatory reaction within the uterus, in turn interfering with the formation of the uterine lining that is essential for the implantation of fertilized eggs. The copper IUD may also interfere with the development of eggs. Finally, the copper parts of the device shorten the life of sperm. Because of the copper coil's ability to prevent the implantation of an already fertilized egg, this intrauterine device can also serve as emergency contraception and long-term birth control all in one.

The Mirena coil

The Mirena IUD is a plastic, T-shaped device like the copper IUD. It also contains a small tube of levonorgestrel, a progestin, that it releases into the uterus every 24 hours. Because of its hormone-releasing properties, the Mirena can remain in place for only five years, compared to 10 years with the copper coil. It is slightly more effective, though: the failure rate with this system is only 0.1 percent, making it 99.9 percent effective. The presence of progestin means that the Mirena IUD thickens the user's cervical mucus, making it harder for sperm to get through to the uterus. Additionally, it thins the uterine lining over time, making implantation almost impossible. Many Mirena-cycles are anovulatory, but not all.

Myth-busters

Contrary to popular belief, IUDs do not cause ectopic pregnancies. Did you know that women who use an IUD are actually less likely to experience an ectopic pregnancy than women who either don't use birth control at all, or use other contraceptives? An intrauterine device will block the entry to the fallopian tubes, making it highly unlikely that sperm will ever get in there. One IUD that was popular in the US in the past, the Dalkon shield, was banned because it caused Pelvic Inflammatory Disease (PID) in many women. This device contained many strings at the bottom, making it easy for infections to spread from the vagina into the uterus, and then to other parts of the reproductive system. Modern IUDs do not pose this danger. Previously, it was thought that IUDs may lead to infertility. Since this theory was popular, many (many) studies have disproven this. Back when this theory was still an issue, healthcare providers suggested that only women who already had children have an IUD inserted. This is no longer necessary an intrauterine device can be a suitable birth control method for any woman, whether or not she has had kids.

Is an IUD right for you?

Women who want the most effective birth control method possible, with the lowest failure rate of all contraceptives, may be good candidates for having an IUD placed. Women of any age and with any number of children can benefit from a form of contraception that does not need daily, monthly, or semi-monthly engagement. An IUD could be the right choice for a woman who wants long-term, but reversible contraception. Women with heavy periods may benefit from the Mirena IUD specifically, since it progressively reduces the thickness of the uterine lining reducing the volume of bleeding. Both forms of IUD also reduce the risk of endometrial cancer, because of the thinning of this lining. Now, let's take a brief look at the side effects that are associated with IUDs:

  • Irregular menstrual bleeding
  • Total absence of menstrual bleeding
  • Perforation of the uterus during insertion (this risk is eliminated by having a competent healthcare provider insert your IUD)
  • Missing threads

When is an intrauterine device not an option? Women who have a currently reproductive infection, or who have just had sepsis or an abortion, should wait until these issues are cleared up before having an IUD placed. If you have undiagnosed vaginal bleeding, the IUD is not an option until you have a proper diagnosis. Uterine abnormalities and cancer are not compatible with an IUD either.

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