by Marcelle Pick, OB-GYN, NP
Some of you may remember the frightening stories related to the safety of IUDs (intrauterine devices) shortly after they were introduced many years ago. Since that time, the IUD has become one of the best methods of preventing pregnancy and it now comes with only minimal risk of adverse consequences for most users.
Years ago, there were two issues with the early IUDs. One was the incredibly poor design of the Dalkon Shield. Because of the design, it caused a huge increase in the incidence of pelvic inflammatory disease (PID). Many women thought that all IUD’s caused PID. It is now known that pelvic inflammatory disease is not caused by intrauterine devices. It has more to do with partners, and the infections that may occur because of exposure to various infections.
The type of IUDs that woman experienced problems with 30 to 40 years ago were designed differently than the products that are available today. Also, it’s good to keep in mind that IUDs may have been more readily prescribed for women who were already at risk for chlamydia, the infection that causes most cases of PID (Pelvic inflammatory disease). A good example of this is someone that has multiple partners. Years ago we didn’t have an effective way to test for this infection, so PID got severe before it was detected and the IUD was blamed, not only for the severe infection, but also for the resulting infertility in some women. Today we have tests that determine chlamydia quickly and women get treated immediately without developing PID.
Your Intrauterine Choices
The IUDs that are used nowadays are much better designed than in the past. In an attempt to get past the bad reputation IUDs had years ago, some companies are now referring to their products as IUS or intra-uterine systems. These newly designed devices provide a great birth control option for many women, especially for women who are approaching perimenopause and other women who want a convenient, easy method of birth control. Good candidates for IUDs are women who are free from infections, who are in a relationship with only one partner, and who have no uterine fibroids. IUDs often are easier to insert for women who have been pregnant at least once.
At Women to Women, we often suggest the 10-year copper ParaGard IUD and/or the 5-year Mirena IUD. The ParaGard is the IUD we prescribe as a first option for patients who have had blood clots in the past, or have a history of cardiac problems. We often find that the Mirena, which releases a synthetic progestin hormone in the uterus, may be a good option, especially if the patient experiences heavy blood flow during menses, and even heavy irregular menses. More than likely this occurs because it affects the uterine lining and makes it thinner.
An IUD provides a wonderful choice for those who are used to the spontaneity that oral birth control offers. After insertion, you can, for the most part, ignore that it’s there. If you think you may be interested in this option, speak to your medical provider to find out a few more key points. If you do decide on an IUD, it’s vital to keep your follow-up appointments.
Another wonderful birth control method we often prescribe is the NuvaRing, a 21-day vaginally inserted device that provides a constant and specifically measured, very low dose of birth control hormones. Since the hormones are delivered vaginally, your gastrointestinal system and liver do not have to metabolize them first. We’ve discovered the slow and consistent release and the low dose of hormone required make this product an excellent alternative to oral birth control for patients who have troubling side effects such as hormonal headaches. Another benefit some users notice with the NuvaRing is that vaginal dryness, common with oral birth control, is not as problematic. The only issue some women complain about is that they don’t like having to insert something in their vagina, but most women can overcome this and love this method.
Alternative Non-Hormonal Choices
Condoms and diaphragms are technically known by the term “barrier methods.” The “Today Sponge” is also back on the market, which is also a barrier method. These are fairly trustworthy ways of preventing pregnancy and they don’t rely on the use of hormones. The Sponge is currently being produced in New York State. At first it was only sold in Canada, but the Sponge is now available in the United States and it has been FDA-approved since the early spring of 2005. Many love the convenience of the sponge and were very upset when it was taken off the market. The good news for many is that it is now back.
For those who have decided that they don’t want to have children, or do not wish to have more, surgical interventions remain a choice for either the woman, or her partner. A woman may have her fallopian tubes surgically “tied,” in a procedure known as a tubal ligation, thus preventing pregnancy. Her male partner may choose to undergo a surgical procedure known as a vasectomy.
The Choice is Up To You
There are many factors to be considered when a woman is deciding which method of birth control is right for her. At Women to Women our goal is to help women find the method that fits them the best. Every person is a unique individual with her own needs. It’s good to take a look at several factors when making birth control choices and finding the one that fits you the best.