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  • Expand Your Contraceptive Options: Consider the IUD

    IMAGE "It's easy to forget a pill every day and it's time-consuming to use something every time you have sex," says Christina Brooks, a 36-year-old married mother of three children. "I just wish there were more birth control options for women." Like many married women in their 30s and 40s, Christina wonders if there is an easier alternative besides surgery to remove her uterus or a daily pill. One alternative is an IUD.

    What Is an IUD?

    The modern IUD, or intrauterine device, is a very small T-shaped piece of plastic that is inserted into a woman's uterus by a doctor. It is about as thin as a toothpick and as long as a small paper clip. Two short pieces of specialized thread hang from its end through the cervix so the doctor can easily remove it when no longer needed. The IUD prevents pregnancy just as well as birth control pills or getting your tubes tied and is considered very safe. There are two types of IUDs available now. One type has a thin copper wire wound around it that helps to disable sperm. The other releases small amounts of hormones.

    How Does It Work?

    Many women have avoided using the IUD because they thought it prevented implantation of a healthy fertilized egg. In contrast, studies have shown that the IUD works mainly by preventing fertilization between the sperm and the egg. The IUD causes mild inflammation in the lining of the uterus, which disables incoming sperm.
    "Healthy sperm never get up into the tubes," says Kristin Dardano, MD, assistant professor of obstetrics and gynecology at the Baystate Medical Center in Springfield, Massachusetts. "So they never actually meet an egg and fertilize."

    Some IUD Perks

    There are IUDs available that contain a small amount of the hormone progesterone called Mirena. A benefit to this type of IUD is it may help decrease menstrual bleeding and reduce cramping and discomfort in women who have heavy periods.
    Also, because the IUD lasts between five and ten years, it is also extremely cost-effective. The greatest cost is having it put in initially, but after that there are no other expenses.
    Another benefit is that unlike when using the pill, you do not need to remember to take something every day.

    Using an IUD

    "It is a fabulous option," says gynecologist Judi Hersh, MD, of Bridgewater, New Jersey. "It really is one of the best methods to choose in a woman who has completed her childbearing, is in a monogamous relationship, [and] is looking for a method that's pretty permanent, but for whatever reason chooses not to proceed with sterilization for herself or her partner."
    Dr. Hersh says there may be some mild cramping at the time of insertion. After the insertion, all a woman has to do is check that she can feel the threads at the end of the cervix once a month after each menstrual cycle. Rarely, the IUD might come out with menstrual blood or float higher into the uterus, so checking the strings makes sure it is still in the right place. Side effects with the copper IUD can include increased cramping and bleeding but the new progesterone-releasing IUD usually eliminates that side effect.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org/

    American Congress of Obstetricians and Gynecologists http://www.acog.org/

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/index%5Fe.asp

    Women's Health Matters http://www.womenshealthmatters.ca/

    References

    The intrauterine device. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq014.ashx. Accessed December 6, 2011.

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