Pros and Cons of IUDs

Originally posted at re:Cycling, blog of the Society for Menstrual Cycle Research, November 1st, 2012 

Who among us wants to invite a T-shaped piece of plastic or metal to live in our uterus for the next 5 to 10 years, just for fun? No one! But if it’s to prevent pregnancy that’s a different story.  IUDs may be uncomfortable and annoying but women still use them because they are so dang effective.

There are many ways to prevent pregnancy.  Abstinence, Condoms, the Fertility Awareness Method, Birth Control Pills…and more.  One form of contraception that has grown in popularity in recent years is the Intra-Uterine Device (IUD). One study found that teenagers who use Long-acting reversible contraception (LARC) had fewer unplanned pregnancies. IUDs and sub-dermal implants are two LARCs. In light of this study doctors have been recommending IUDs to teenagers as the most effective form of contraception. In the past it was commonly held that only women who had already had children would be good candidates for IUDs, but today they are recommended for women regardless of whether or not they’ve had children. These devices are very effective at preventing pregnancy, and some even work without hormones. For many women the IUD is a great option, effective contraception that they rarely have to think about.

But IUDs are not all butterflies and rainbows.  I had one briefly, even after knowing my mom’s horror story with the Dalkon Shield in the late 60s.  At the age of 27, I was done with the pill and all hormonal contraception, and as I didn’t have a history of heavy periods, my doctor said that the Paraguard would be a good choice for me.  So I got one. And…I freaking hated it! For the first three weeks after it was inserted I had cramps so severe that even with intense pain killers, I found it hard to go about my life without thinking I was dying and/or wishing I was dead.  My light 3-day periods turned into heavy 10-day affairs with crippling cramps the entire time.  An additional unexpected and unpleasant side effect was a sudden inability to reach orgasm during sex. (Anyone else ever have this side effect?)

The one good thing about having the IUD was that one time when I sneezed while on my new heavier period and blood exploded out of my vagina like a gunshot wound, which I found HILARIOUS! But I digress…

A friend of mine says this about her Paraguard:

“Here is the thing that is really driving me crazy about my goddamned IUD — my crotch has no idea what it’s doing anymore, and hence neither do I.”

Her cervical fluid is all out of whack, there is no longer any discernable pattern, so she doesn’t know where she is in her cycle.  So, while she is using the IUD for contraception, and doesn’t need to chart her fertility for contraceptive purposes, the monthly cues her cervical fluid usually gives her about where she is in her cycle are no longer there.

She also brought up a study that found elevated levels of Mast Cells in the endometrium of women with IUDs.  Mast Cells are what your body produces when it’s having an allergic reaction, like if you get hives after eating shellfish.  So, are IUDs actually producing allergic reactions in women’s uteruses?  That would probably help prevent pregnancy, but what about the woman who has to live with this every day?

Ultimately I had my IUD removed after 4 months, because I couldn’t stand it any more.  All that blood and pain, and lack of orgasms, in a word, sucked!  I really feel for women who have periods like this normally, it’s the worst!  I was not going to subject myself to this if I didn’t have to.

Thinking I had fully exhausted all medical contraceptive options, I was resigned to using condoms or other barrier methods for the rest of my life.  Luckily I didn’t have to do that! I soon found out about the Fertility Awareness Method and started charting my fertility. I can now have unprotected sex with my husband when I’m not fertile, and use barrier methods only when I am fertile.  It’s the best possible solution for us.

IUDs are very effective, but as my story shows, having one in your uterus can be pretty gnarly.  In general, I am very glad that IUDs exist. The side effects of today’s IUDs are minimal when compared to the ones in the 60s and 70s. But that doesn’t mean that they are the magic bullet of contraception.  For me and many other women the Fertility Awareness Method is a wonderful contraceptive. I want more women to hear about it so it can be brought to light as a serious contender for mainstream contraceptive use.

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