Ever since the invention of the birth control pill- colloquially known as “The Pill”- women have been given the advantage of having great control over their sexual and child-rearing destinies. And now, with the advent of birth control devices and procedures, such as the Intrauterine Device (IUD), women have even more flexibility and options when it comes to the birth control that they choose to use.
Â What is an IUD?
An intrauterine device, or IUD, is a form of reversible birth control. The IUD comes in the shape of an uppercase “T” with a plastic string that hangs off the bottom end and is inserted into the uterus in such a way that the arms of the “T” rests on top of the opening of the uterus and the plastic string tied to the end hangs down through the cervix and into the vagina.
IUDs prevent pregnancy by physically or hormonally preventing the fertilization of an egg by a sperm. There are, two types of intrauterine devices, both of which are manufactured in this general shape with the same goals: the copper IUD and the hormonal IUD.
TheÂ copper IUDÂ is essentially an IUD with a copper wire around the stem of the “T”. It has been estimated that a copper IUD will stay in place and remain effective for at least 10 years, although it is recommended that women check on a monthly basis whether or not the string that hangs down has shifted, or is shorter or longer than it usually is. The copper IUD is more commonly used than the hormonal IUD, as it is one of the most effective, long-lasting, reversible forms of birth control available. ParaGardÂ® is the only FDA-approved copper IUD available.
TheÂ hormonal IUDÂ is an IUD that utilizes the hormone levonorgestrel- a synthetic form of progestin- which is housed within the cylindrical stem. The “T” is coated with a regulatory layer that releases the levonorgestrel directly into the uterus. Unlike the copper IUD, the hormonal IUD typically remains effective for only 5 years or so; however, it is slightly more effective at preventing pregnancy than the copper IUD. MirenaÂ® is the only FDA-approved copper IUD available.
Both types of IUDs will need to be inserted and removed by a qualified, licensed medical practitioner and will be inserted only after a comprehensive pelvic exam has been performed. As long as the woman is not pregnant, either type of IUD can be inserted at any point of a woman’s menstrual cycle, even while she is actively menstruating, but it is typically best to insert an IUD right after a woman’s period has ended, as this is the time when her cervix is softest and she is the least likely to get pregnant. It only takes a few minutes to completely insert either IUD into a woman’s uterus.
Â What makes an IUD effective?
IUDs basically work by preventing the fertilization of an egg either by impeding the sperms’ ability to physically reach the egg or by creating an environment that damages or kills sperm. It is also believed that IUDs work to prevent a pregnancy from taking place by also affecting the lining of the uterus, making it more difficult for a fertilized egg to implant itself on the uterine wall.
Copper IUDs are effective against pregnancy because copper is lethal to sperm, acting as a natural spermicide within the uterus. The presence of copper in the uterus also encourages the increased production of white blood cells, prostaglandins, copper ions, and other enzymes in the uterus and fallopian tubes, a combination that is poisonous to sperm in particular, thereby rendering any sperm in the uterus unable to cause a pregnancy.
Hormonal IUDs are effective against pregnancy because levonorgestrel has the ability to essentially immobilize sperm, making them unable to physically reach the egg. Levonorgestrel can also cause the lining of the cervix to thicken, impeding the sperm’s ability to reach the egg. In some women, hormonal IUDs may prevent eggs from being released by your ovaries, but this is not the mechanism through which hormonal IUDs are deemed effective, although the prevention of released eggs will decrease the risk of pregnancy further.
The hormonal IUD is slightly more effective than the copper IUD at preventing pregnancy- the copper IUD has a failure rate of approximately 0.6% whereas the hormonal IUD has an estimated failure rate of about 0.2%.
IUDS are also generally considered as an effective method of birth control because their effectiveness does not depend on any actions taken or not taken by the patient. For example, the birth control pill is only as effective as stated if the patient remembers to take it exactly as prescribed; failure to do so will reduce its effectiveness. IUDs on the other hand will continue to provide continuous birth control, with no regimen needed on the patient’s part.
Â Who is a good candidate for an IUD?
Women who want a method of birth control that is long-lasting and reversible with almost no effort at all should consider using an IUD. (Copper) IUDs are especially useful for women who cannot, for some reason, use birth control methods that use hormones, usually estrogen, like the birth control pill. Women who are simply putting off getting pregnant, and are not seeking a more permanent form of birth control, are also good candidates for IUDs as IUDs are one of the most easily reversible forms of birth control.
In order to begin using the IUD as their chosen method of birth control, women should make sure that they are not pregnant and that they are in at least average health. Even though a woman might be in average health, the IUD may not be effective- or the right method of birth control for her- if she:
- Has had any previous pelvic infections
- Has had cancer of the uterus or the cervix
- Has an STD (even if there are no signs of symptoms)
- Has a history of ectopic pregnancies (which are pregnancies that occur when fertilized eggs implant themselves in any place other than the uterus)
- Is having sex with more than one partner
- Is having sex with a partner who is having sex with more than one partner
At Complete Healthcare for Women, we understand that when it comes to birth control, you have many options, and likely, many questions. If you are considering starting a birth control method, or are considering switching birth control methods, and would like to learn more about Intrauterine Devices and its effects, please contact us at 614.882.4343 to set up an appointment. Same day appointments are available!