Intrauterine contraceptives devices (IUDs) are becoming the contraceptive of choice among women. According to a report by the Center for Disease Control and Prevention, 7% of women 15-44 years old reported using an IUD in 2011-2013 compared to just 1.5% in 2002. The use has increased nearly five-fold in the last decade.
IUDs are small, T-shaped devices made of flexible plastic. They are inserted into the uterus to prevent pregnancy by preventing sperm from entering the uterus and joining with an egg. There are two types of IUDs on the market in the US: copper (ParaGard) and hormonal (Mirena or Skyla). ParaGard contains copper, which acts as a spermicide. Mirena and Skyla release a small amount of the hormone progestin, which thickens cervical mucus and also blocks sperm from joining the egg. The progestin may also prevent women from ovulating (releasing an egg), thus preventing pregnancy. ParaGard needs to be replaced every 10 years, Mirena every five years, and Skyla every three years.
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Although not as popular as oral contraceptives, IUDs are one of the safest and most effective methods of birth control. They have a failure rate of less than 1% (compared to a 9% failure rate of the pill) and fewer side effects or risks. IUDs and hormonal arm implants are the most effective reversible forms of birth control. The only of form birth control that is more effective is nonreversible sterilization.
IUDs are one of doctors’ most preferred methods of birth control. One study found that 40% of family practitioners surveyed currently use IUDs. The American Academy of Pediatrics recommends them as the primary form of contraception for sexually active teens. The American College of Obstetricians and Gynecologists listed them as the most effective form of birth control with minimal risks and recommended them specifically for sexually active teens.
However, one serious risk associated with IUDs is that if the device is not inserted correctly, it could move and perforate the uterus. Although it’s less painful than it sounds, it is still potentially life threatening. It’s very rare for the IUD to move, but movement can be prevented by checking the location of the strings every few months after it is first inserted.
There is also a low risk of expulsion, in which the body rejects the device and expels it out of the vagina through the cervix. Expulsion is thought to be caused by the body not being acclimated to the device in the uterus or progestin released by the device. This risk is slightly higher for women who have not undergone childbirth or have small cervices. This has perpetuated a myth among providers that it is unsafe for young women to get an IUD. However, Skyla was designed to be smaller and release less hormones than Mirena, which lowers the risk of rejection from the body without reducing the device’s effectiveness. This is just one of many improvements that have been implemented to ensure that IUDs are safe for women of all ages.
In addition to the myth of IUDs being unsafe, a large deterrent from getting an IUD is the price. They cost an average of $345, although they are often covered partially or completely by insurance. In the long run, IUDs are more cost effective because they last years without replacement and average from about 50 cents to a dollar a day.
In March 2015, the FDA approved a new IUD called Liletta, which has already been on the market in Europe and was designed to be cheaper than current IUDs available. IUDs are already arguably the best method of contraception on the market today, and their use will undoubtedly continue to rise as they become more accessible to women.
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