Sex & fertility
IUDs and other non-hormonal methods for birth control
by Marcy Holmes, NP, Certified Menopause Clinician
A lot of women in their 30’s and 40’s grew up hearing horror stories about safety
issues during the early days of the IUD (intrauterine device). But nowadays the
IUD is one of the most effective forms of birth control (only abstinence ranks higher!)
and poses little to no side effects for most women.
There were two main problems with the old IUD’s. First was the flawed design of
the Dalkon Shield, which led to higher rates of pelvic inflammatory disease
(PID). Second was that we then blamed other IUD’s for cases of PID. I recently overheard
someone say at a medical conference, “We now know the IUD doesn’t cause PID — bad
boyfriends do!”
Play it safe — the IUD, STD’s, and PID
Research suggests that the risk of PID associated with IUD use is mostly limited
to the first 3 weeks after insertion— especially high if a woman has a preexisting
but unknown Chlamydia infection. Fortunately, it’s uncommon thereafter.
So be sure to share any concerns with your healthcare provider— both before and
after IUD insertion, and get routine follow-up.
Remember — with the exception of condoms, contraceptives do not protect you against
sexually transmitted diseases. STD’s are a significant, growing health risk to women
of all ages, including menopausal women, either through partner infidelities or
new sexual encounters.
Learn how to minimize your risks from our article on
safe sex — these commonsense principles work well for women of all ages!
References
That may seem glib, but there’s a kernel of truth in it. The IUD problems of 30–40
years ago were in IUDs that had a different design and that probably were given
to many candidates with multiple partners. At that time, medicine did not have effective
testing for Chlamydia — the infection that is the cause of most PID and infertility.
Intrauterine systems
IUD’s today are designed with more thought and much better understanding. To move
away from the IUD stigma of the past, some manufacturers now refer to their designs
as an intra-uterine system, or IUS. New technologies have made them a great
option for many women, particularly perimenopausal
women and mothers who don’t want more children. The ideal candidate for
an IUD is an infection-free woman in a monogamous relationship, who has had at least
one pregnancy (for ease of insertion), and whose uterus is free of fibroids.
At our practice we regularly prescribe the 10-year copper ParaGard IUD and the 5-year
Mirena IUS. The T-shaped copper device is usually our first-line choice for women
with a history of blood clots or coronary events. We have found that the Mirena,
which releases a synthetic progestin hormone internally, works well in certain cases
where a woman has heavy bleeding, possibly due to its thinning effect on the uterine
lining.
We also prescribe the NuvaRing, a 21-day vaginal insert that conveniently delivers
a consistent, very low dose of birth control hormones — without requiring your digestive
tract and liver to deal with them first. We’ve found that the low dose and steady
release of this product make it a viable alternative to pills for women who have
symptoms like hormonal headaches. Another plus that some women note is that they
maintain their vaginal moisture better with the NuvaRing than with oral contraceptives.
I think an intrauterine system is an excellent option for a woman who is accustomed
to the sexual spontaneity that the Pill affords. Once it’s in, a woman can forget
about it — mostly. There are a number of additional considerations that may or may
not apply to you, so if you’re interested talk to your practitioner. And if you
do choose an IUD, be sure to keep your follow-up visits!
Other nonhormonal birth control options for women
Barrier methods like condoms, the diaphragm, and the new Today Sponge (yes, it’s
back!) are other relatively reliable birth control methods that don’t rely on hormones.
The patent for the Today Sponge was bought out, and it is now manufactured in New
York State. Initially it was only approved for sale in Canada, but the Sponge has
been available in the USA and FDA-approved since April 2005.
For women who have had as many children as they wish and those who don’t want children,
surgical options include tubal ligation (having your tubes “tied”), or, for the
male partner, vasectomy.
The choice is yours
With so many things to consider when choosing a birth control method, we want to
help women find contraceptive options that work well for them. Each woman has unique
needs to consider, so I’ve developed a three-step approach to that many women have
found very helpful in making these important choices. For additional guidance, read
my article on choosing a
birth control method.
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements,
our exclusive endocrine support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at
1-800-798-7902. We're here to listen and help.
Related to this article:
References & further reading on IUD’s
and other hormone-free birth control options
Last Modified Date: 04/19/2011
Principal Author: Marcy Holmes, NP, Certified Menopause Clinician