The Intra-Uterine Device (IUD): The Resurgence of an Excellent Long-Term Birth Control Method

The IUD is a small device inserted into the cavity of the uterus at an in-office visit.  It can remain there for five to ten years depending on the type. This method of birth control is long lasting and essentially maintenance free.

When choosing a birth control method it is important to consider how easy it is use, negative side effects, and any potential risks to your health. Although the two most commonly used IUDs, ParaGard and Mirena, have been extensively studied and proven to be extremely safe, misconceptions have continued since the 1970s when a particular IUD called the Dalkon Shield caused considerable side effects and complications.

Up to 25% of women in Europe use the IUD as their primary form of birth control, where less than 10% of contraceptive users in the U.S. use the IUD. We hope this article provides our patients with enough information to reassure them that the IUD is an excellent method of birth control.

How it works:

Although the method by which the IUD provides birth control is not completely known, there is good evidence that it works in a number of ways.  One of the ways both IUDs work is by causing a response in the uterine lining which inactivates sperm. The Mirena also releases the hormone progesterone which reduces the ability of sperm to effectively penetrate through the mucus of the cervix and inhibits it from getting into the uterus.

Safety:

Both of the IUDs now available (ParaGard and Mirena) are extremely safe. The IUD is safe for women of all ages, including young women who have never been pregnant. There is no higher risk of infection or injury, and once removed there is no impact on conceiving and carrying a normal pregnancy.

Side effects:

ParaGard, in a small percentage of patients, may cause a mild increase in menstrual bleeding. The Mirena emits progesterone and small amounts can enter into the blood stream even though it is much less than the birth control pill.  A small percentage of patients may experience water retention and/or emotional changes.

The World Health Organization and The Society of Family Planning have evaluated over 23,000 cases, and both state that the IUD is very well tolerated with minimal side effects.  Both organizations highly recommend their use.

Effectiveness:

The IUDs afford 99.5% contraceptive effectiveness.

Benefits:

1. both IUDs afford very effective contraception
2. cost effective
3. provide long term contraception
4. require no maintenance
5. the Mirena has been shown to be very effective in markedly reducing unexplained heavy menstrual bleeding
6. there are also some studies which have shown the Mirena to be effective in reducing the pain in patients with known Endometriosis

We feel that our patients should consider the IUD as a priority form of birth control regardless of their age.