I used to know it as “the harpoon.” During sex ed at school, the school nurse came and showed us girls an array of different contraceptive methods, complete with the usual diagrams and bananas and such. The IUD was, back then, probably the most intimidating option of the lot, met with shudders and squeals from myself and the gaggle of 14-year-olds: a metal coil, inserted into the vagina, and left there for up to five years. At that point, most of us were still afraid of tampons, so I guess you can go figure.
Fast-forward a few years and I was six months into a relationship: tired of condoms, unwilling to get pregnant and apprehensive about going back on the Pill. I saw my GP who patiently talked me through my options: pills, condoms, femidoms, implants, injections. And finally, the IUD (Intrauterine Device)—that little coil that promised a 0.02-percent chance of getting pregnant whenever the BF and I got down to it at the weekends. Suddenly the scary metal harpoon sounded a lot more appealing.
In the end, I decided to go for it, and a few weeks later I found myself lying down on a bed covered in a sheet of blue tissue while a stranger inserted a (rather large) plastic funnel between my legs. I couldn’t help but feel a little undignified, of course, but the process was painless, easy, and—once I realized that the nurse had probably seen hundreds of other lady parts over the course of her career—far less embarrassing than I thought it might be. For about a day or so after I walked out of the surgery, I felt something not dissimilar to monthly cramps, but after that went away I have never regretted the IUD and, actually, I loved it so much that I’d willingly recommend it to any woman seeking contraceptive clarification. Deciding to have an IUD was undoubtedly an unknown “eureka” moment.
So what’s the big deal? Well, it’s worth noting that there are two forms of IUDs: one containing hormones and one (the copper IUD) without hormones. The copper IUD can stay in place for up to ten years; less than four in 1000 women will conceive when using this method, because copper is toxic to sperm. It’s a perfectly safe, comfortable contraception that many women who are wary of hormone-based contraceptives opt for.
I went for the Mirena, which is a hormonal IUD containing a form of progestin. This IUD prevents conception by damaging or killing sperm, and—OK, stop chewing if you’re eating—it makes the mucus in the cervix extra thick and sticky, so sperm can’t get through to the uterus. Unpleasant, perhaps, but effective. It also makes the lining of the uterus a more inhospitable place for a fertilized egg to implant (and grow), by preventing it from growing as thick as it should. So, overall, it’s a very effective method of contraception: Statistically, less than two in 1000 women will become pregnant while using the hormonal IUD. So far, sounds good, right? It gets better. Unlike other hormone-based contraceptives, it does not cause weight gain—and, in 90 percent of cases, it reduces heavy menstruation. In some women, it actually prevents periods altogether (I was one of those lucky few). Doctors have assured me that this is perfectly fine and that the menstrual cycle returns to normal once the IUD is removed.
That’s not to say there aren’t risks associated with both forms of the IUD. First and foremost is the fact that neither form of IUD will prevent against any form of sexually transmitted infection and disease. The copper IUD may increase the chances of “spotting” between periods, menstrual bleeding or cramps. For both forms of IUD, there is also a risk of “expulsion:” i.e. the device is pushed out naturally, which happens to around five in 100 women. In this instance you would no longer be “covered” for birth control without a condom. Also, there is a risk of “perforation,” where the IUD will get stuck in or puncture the uterus. This is extremely rare, however, and when it does happen, it is almost always during the insertion process. And, of course, the IUD avoids all the risks associated with hormone-heavy contraceptives such as the Pill.
Now, a quick disclaimer: I’m not a doctor, and I’m not particularly well-qualified to give an education on birth control. However, my experience with the IUD has been a wholly positive one, and it surprises me that relatively few other women consider it when choosing a contraceptive. Both forms of IUD are definitely worth some thought: Once inserted, they tend to be very reliable and may actually provide freedom from the side-effects associated with hormonal contraceptives.
Ultimately, though, the right birth control is a very personal choice, and it pays to be aware that there are many forms of contraception out there that you might not have considered, or may have been wary of in the past. Different methods work differently for different women; your doctor will be able to talk you through the best methods for you based on your preferences and lifestyle. But whether you’re in Starbucks or the surgery waiting room, have a browse through these links and get informed:
For more info:
Contraceptive comparison chart (this is brilliant: a succinct but thorough guide to birth control)