What it is:Ã¢â‚¬Â¨
An intrauterine device (IUD) is a T-shaped pliable plastic rod with an attached thread that measures just over an inch long and is inserted into the uterus through the cervix. There are three kinds on the market: One type is hormonal and lasts up to five years; the second type delivers a lower dose of hormones and lasts up to the three years; and the other uses copper and lasts up to 10 years. Ã¢â‚¬Â¨Ã¢â‚¬Â¨
What it does:
Ã¢â‚¬Â¨ While non-hormonal IUDs are made from copper, which acts as a natural spermicide, hormonal IUDs gradually release small doses of the synthetic hormone levonorgestrel—the same stuff in emergency contraceptive pills. Both options thicken your cervical mucus, which creates a hostile environment for embryo implantation and prevents pregnancy, says Laura Corio, M.D., a Manhattan-based gynecologist
There are two main types of IUDs:
Progestin-releasing IUD (Mirena, Skyla): Ã¢â‚¬Â¨Like other progesterone-based forms of contraception, this device causes the cervical mucus to thicken, which keeps sperm from reaching an egg. The hormone also thins the uterine lining, preventing an egg that does get fertilized from implanting. The Mirena lasts up to five years. Skyla, which was approved by the FDA in 2013, delivers a lower dose of hormones, is slightly smaller, and last up to three years.
Copper-coil IUD (ParaGard, made by Barr Pharmaceuticals):Ã¢â‚¬Â¨ This IUD slowly releases copper ions for up to 10 years. Copper inhibits sperm and the egg's ability to implant in the uterine wall. Ã¢â‚¬Â¨Ã¢â‚¬Â¨
Ã¢â‚¬Â¨Although just 2 percent of American women use IUDs, of those who do, 99 percent report being satisfied. Once the device is inserted, nothing has to be done except a monthly self-check to make sure the string is still in place. Ã¢â‚¬Â¨Ã¢â‚¬Â¨
Plus, the IUDs currently on the market are more than 99 percent effective at preventing pregnancy. A recent study also found that IUDs are safe and effective for women of all ages—including teens. Finally, you can remove it whenever you want by visiting your doctor's office.
Which is better?
It depends. If you crave a lighter, and possibly nonexistent, period, Mirena may be the way to go. Because it thins the uterine lining, there's less blood, says Ross Marchetta, M.D., an ob-gyn in Akron, Ohio. (Skyla hasn't been on the market long enough to know for sure how it affects menstruation, but the benefits should be similar to Mirena.) By contrast, the copper ParaGard can make bleeding and cramps worse by irritating the uterine lining, so ParaGard might not be for you if you already have severe cramps. However, if you want to avoid pumping artificial hormones into your body, ParaGard is a more appealing option. Ã¢â‚¬Â¨Ã¢â‚¬Â¨
The main downside of IUDs is infection. While the risk is low, the devices can make existing ones—specifically, chlamydia and gonorrhea—much worse. About one in 100 women report infections in the first 20 days after getting an IUD, usually because bacteria have crept in during insertion. Those infections can generally be treated with antibiotics. So finding a skilled doctor to perform the procedure is crucial. While all gynos are trained to do it, it's a good idea to ask how often she inserts IUDs. Two or more a week is reassuring.
While it's very rare, women who've never been pregnant could possibly expel the IUD. Reason: Before pregnancy, your uterus and cervix are smaller and less pliable, so your body might resist having a piece of plastic resting there. However, only about 2 percent of women have this problem, and newer versions like Skyla are specifically designed to fit the less flexible uterus of a woman who hasn't given birth.
The most common side effects associated with using the ParaGard IUD are cramping and heavy bleeding in some women. Women using the Mirena IUD may initially have irregular periods and bleeding. After a few months, you may experience lighter periods or no periods at all. Ã¢â‚¬Â¨Ã¢â‚¬Â¨
So why do IUDs have such a sketchy reputation? You can blame it on an old version called the Dalkon Shield, an IUD popular in the 1970s. It was pulled from the market in 1974 because it played a role in thousands of infections, such as pelvic inflammatory disease (PID) and sepsis. The conditions caused infertility in some women and have been linked to at least 17 deaths. But in 1974, the pocket calculator was considered high-tech—so comparing the old IUD with today's versions is like pitting Pong against Halo. Ã¢â‚¬Â¨Ã¢â‚¬Â¨
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