considering an IUD?

the most healthy behavior is to stay in the clear

In the aftermath of the recent election, and the potential repeal of the Affordable Care Act, many women are considering long-acting reversible contraception options (or, LARCs for short).  By taking advantage of one of these options in the next couple of months, their pregnancy preventing effects will last years after a loss of health insurance or decreased insurance coverage.  

The most common LARC is the IUD, or intrauterine device (also sometimes known as an IUC or intrauterine contraceptive).  In my experience as a sex educator, IUDs are often misunderstood, so I thought it would be helpful to provide some easy-to-understand information about this EXTREMELY effective birth control option.  

How effective, you ask?  MORE THAN 99% EFFECTIVE.

Cot DAMN, that's effective!  Especially in comparison to methods like birth control pills which are closer to 91% effective with typical use or  male condoms that are about 82% effective with typical use.  And I don't know about you guys, but from someone who is absolutely terrified of getting pregnant unintentionally, increasing my chances of that by 9 or 18 times is damn near paralyzing.  OK, great, so IUDs are effective, but what are they?

An IUD is a small, t-shaped plastic device that is inserted by a clinician into the uterus.  There are two types of IUDs - hormonal and non-hormonal.  Each type prevents pregnancy in different ways.

  • Hormonal IUDs prevent pregnancy the same way other hormonal methods (such as the birth control pill, patch, or Depo shot) do.  The IUD releases hormones that prevent your ovaries from releasing an egg, also known as ovulation.  If there is no egg in the uterus, there is nothing for sperm to fertilize in order to cause pregnancy!  (there are a few other things that happen biologically as the link at the end of the post if you are interested in learning more details about how contraceptive methods work)
  • Non-hormonal IUDs are wrapped in copper.  The copper repels sperm, making it nearly impossible for sperm to get into the uterus and thereby fertilize an egg.  

You may have heard of brand names of IUDs - ex. Mirena, Skyla, Paragard, etc.  Paragard is the only non-hormonal IUD on the market, the others are all hormonal.  The hormonal IUDs differ in size and amount of hormones that are released, so deciding on which to use should be a decision made in cooperation with your doctor.  

IUD interuterine device

IUD insertion can be uncomfortable.  It involves laying on a table with your feet in stirrups and a speculum opening your vagina just like a normal GYN appointment.  

The clinician has to insert it through a tiny hole (called your os) in the cervix.  This is the hole that dilates, or opens, during childbirth and during a period to allow the blood and tissue in the uterus to flush out.  This dilation of the cervix is what causes cramping, so it is not uncommon to feel similar cramping (not likely as bad as childbirth, potentially worse than a normal period) during and for a bit after IUD insertion.  Two tiny strings hang out of the cervix after the IUD is inserted.  

PAUSE!  These strings hang out of your cervix but INSIDE your vagina... you can feel them if you stick a finger up toward the top of your vagina.  They are NOT dangling out between your legs like a tampon string.  

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Once an IUD is inserted, it can be left in for several years - anywhere between 3 and 12 depending on which IUD you choose (aka hopefully longer than Trump's presidential term, LOLZ!)  It does have to be removed by a clinician, but can be taken out whenever you wish.  

One of the reasons why it is so effective is that there is nothing - I repeat, NOTHING -  the user has to remember to do on a daily, weekly, or monthly basis in order to make sure that it's working.  With the hormonal IUDs, many women experience changes in their menstrual cycle, and periods typically become lighter and shorter or nonexistent.  Some chicks (like myself) think this is a super kickass bonus side effect of this contraceptive method.  For others, it makes them nervous not having the monthly reassurance that they aren't pregnant.  

If you have questions about IUDs that I missed, as always feel free to holler at me through my Ask the Sexpert form, or by commenting below if you're not shy!  Contraceptive Technology is also an EXCELLENT scientific resource on all things birth control.  

What did I miss in this post about IUDs?  What else are you guys wondering about?   There's so much info out there, it's hard to sort through what's accurate and what isn't.  What would you want to see more about on Sex, Love & All the Feels?

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