Consider This: The IUD

By HANNAH ZEAVIN

April 19, 2010

Con­ver­sa­tion about the IUD (intrauter­ine device) is lim­ited and often based on a series of false­hoods.  I had never heard of a safe IUD until three months ago, when I was sit­ting in my kitchen with my boyfriend and his friend Emma.  Emma and I have both found oral con­tra­cep­tives (the Pill) dif­fi­cult.  We’ve both lost energy and felt less (which is worse, we agreed, than the more typ­i­cal side effect of feel­ing more).  Plus, nei­ther of us liked bear­ing the bur­den of tak­ing the Pill.  It was not the prob­lem of remem­ber­ing to take or not take the Pill, but the sense of oblig­a­tion.  If my part­ner does not have to take a pill that makes him unrec­og­niz­able to him­self, then why should I?  It was this lack of feel­ing like our­selves, phys­i­cally and emo­tion­ally, that led us both to the IUD.

Pri­vate doc­tors rarely rec­om­mend the IUD to women of the age group 18–26.  It is seen as a type of semi-permanent birth con­trol for mar­ried women who have already had the chil­dren that they want.  This per­cep­tion may explain why I thought that it was a defunct and unre­li­able form of birth control.

After telling my doc­tor about my part­ner, I asked her what she would say if I were her daugh­ter.  She said, “Use con­doms” but, bar­ring that, “let’s go with the IUD.”

An IUD is a one-inch T-shaped device that sits at the cervix.  The IUD acts directly and exclu­sively on the uterus, mak­ing it unin­hab­it­able to sperm. Strings (not felt by either part­ner dur­ing sex) come through the cervix so that the device is remov­able. An old brand of the IUD asso­ci­ated with high rates of infer­til­ity in the women who used them is largely respon­si­ble for the stigma the device car­ries.  How­ever, it is wrong to assume that both types of FDA-approved IUD come risk-free.    The more tra­di­tional IUD (or Para­Gard IUD) is made out of cop­per and can last twelve years.  A pos­si­ble side effect for women who use this type is a heav­ier period (up to a 50% per­cent increase). The Mirena IUD locally releases a small amount of prog­estin.  It lasts five years, and one side effect is a lighter period (or a stop in peri­ods altogether).

The IUD is looked down upon as a pos­si­ble method of birth con­trol in young women.  In some cases, that makes sense.  The IUD is not a wise choice for women at risk for expo­sure to sex­u­ally trans­mit­ted infec­tions (STI’s).  Like the Pill, the IUD does not pro­tect against STI’s.  If you aren’t going to use a con­dom in con­cert with the IUD, you should skip it.  There is also the ques­tion of fer­til­ity. For me, part of repro­duc­tive health includes fer­til­ity.  I take birth con­trol now, but want a child later.  STI’s and IUD’s are a hor­ri­ble com­bi­na­tion for fer­til­ity.  Every STI that can lead to pelvic inflam­ma­tory dis­ease (gon­or­rhea, syphilis, chlamy­dia), if con­tracted while using the IUD, raises a woman’s risk of infer­til­ity.  This is because the removal strings lead past the nat­ural bar­rier between the vagi­nal canal and the uterus.  STI’s in the uterus are dis­as­trous for repro­duc­tive health.

I am in a sta­ble, long-term rela­tion­ship. I felt that my part­ner and I could be respon­si­ble to the risks that come along with the IUD. I wanted to feel like myself: not apa­thetic about my body.  After telling my doc­tor about my part­ner, I asked her what she would say if I were her daugh­ter.  She said, “Use con­doms” but, bar­ring that, “let’s go with the IUD.”  I chose the Mirena ver­sion, under the hope­ful assump­tion that in five years my part­ner will be the one on birth con­trol.  The IUD can be right for you, or not.  My only advice is to think about the IUD, talk about it with your part­ner, and take a seri­ous dose of Tylenol Extra Strength before you go in.  It hurts.  This is no pap smear.  I vom­ited and had to wait an hour before going home.  Emma, too, felt light-headed and dizzy.  She also expe­ri­enced the strange side effect of think­ing her cervix had grown to the size “of a nose.”  But, as Emma told just a week after get­ting her IUD, “My cervix feels like a mil­lion bucks, and you can quote me on that.”

Han­nah Zeavin is a sopho­more in Yale Col­lege. She is a staff writer for Broad Recog­ni­tion.