Anyone who knows me knows how much I love my IUD. I regularly mention within five minutes of meeting someone what an awesome form of birth control I think it is and why they should consider getting one – to date, I have convinced five people to get IUDs and I consider this a public service. I had my first IUD inserted when I was sixteen, which lasted for five years, and last summer I had that one replaced with a ten year IUD that will last until I’m thirty-one!
There’s a lot of fear and misconceptions around IUDs that I want to dispel as I truly believe that it could be a great choice for so many people, if only they knew about them or how they worked. Of course, it must be said that I am not a doctor so this is only my experience and the information that I have gleaned from six years of IUD usage and lot of conversations and research of my own. Obviously, if you want an IUD you need to contact your doctor and discuss in more detail if it would be the right choice for you.
How do they work?
IUDs are T-shaped devices that sit in your uterus. There are some strings that hang through your cervix and into your vagina that you can reach up and feel to make sure the IUD is still in place. The hormonal Mirena IUD releases low dose progestogens into your reproductive system and the copper IUD is, unsurprisingly, covered in copper which is toxic to sperm and thickens your cervical mucus to make it harder for sperm to enter the uterus.
Why should you consider getting one?
IUDs are one of the most reliable forms of BC out there, being as reliable as sterilisation. If placed correctly, IUDs are over 99% effective so it extremely unlikely that you will get pregnant while you have one.
There are two types of IUD – Mirena (hormonal) and copper (non-hormonal) versions, with the Mirena IUD also been known as an IUS. I have the copper coil (another name for an IUD) as the number one priority for me in my contraception – aside from making sure I don’t get pregnant – is that it is hormone free. Even before more and more reports of the serious mood effects of hormonal BC started surfacing, I knew that I didn’t want to disrupt my menstrual cycle. This is totally my personal preference – I feel very lucky to have super regular periods and I value getting my period each month, as I know I’m not pregnant and can see if anything changes and take note of it. I like knowing my PMS symptoms, knowing when I ovulate and knowing my cycle, it makes me feel in touch with my body and I’m thankful to not need to give that up in order to protect myself against unplanned pregnancy. While I can’t speak from personal experience, I know many people who have had problems with hormonal BC (though also many who haven’t!). If you are someone who does struggle with hormones, then please consider a copper IUD. It gives you all the benefits of hormonal birth control, with none of the mood side effects.
The copper coil can have its own side effects though, of which heavier, more painful periods is one of the most common. For this reason, the copper IUD is often not recommended if you struggle with particularly heavy or painful periods (this is why it’s important to discuss with your doctor what’s right for you!). However, the Mirena IUD, which has hormones in it, can apparently still lessen the side effects of hormonal BC as the hormones are localised to your abdomen and not flowing around your body (though I haven’t actually read the research on this). From my experience, my periods were bit heavier and longer for the first four cycles after insertion and then went completely back to normal, so while some people may struggle it is possible that you could have no side lasting effects.
No need to take a pill every day – once it’s in there, it will work 24/7 until you have it removed or it expires (provided it is correctly placed). For this reason, longer acting forms of contraception, like IUDs and the implant, are often preferable for people whose schedule may vary wildly day to day.
My first IUD lasted for five years and my current one will last ten! No need to get your injection redone every few months, take a pill every day or even get your implant replaced every three years. Once it’s been inserted you can basically forget about it for half to a whole decade.
As far as I know, there’s no convincing evidence that any current form of birth control doesn’t restore fertility, unless there is a separate underlying issue. However, many forms of hormonal BC take some time to leave your system, which doesn’t happen with an IUD! As soon as it’s removed, you’re fertile.
Fears and myths
In terms of fear and misconceptions surrounding IUDs, the biggest one I hear is that people are afraid of the insertion process. Look, everyone’s procedure and pain tolerance varies, so there’s no way to know exactly what your insertion will be like. However, to add a positive experience to the discussion, both of my insertions were totally fine. They each felt like a long (10-20 seconds) period cramp and that was it, mildly uncomfortable but not really painful. I have friends who had experiences like mine and others who say it was one of the more painful experiences of their lives. The more relaxed and calm you are, the less it will hurt, but for me it’s a no brainer that 30 seconds total of being uncomfortable is worth it for fifteen years of stellar birth control. If you think an IUD would be the right choice for you, please don’t decide against purely because of the insertion. For many people it is not that bad and by making sure you have a friend with you and a doctor you trust you can make sure the experience is as stress-free as possible.
Another myth is that they are only for people who have given birth. This is just not true. I had my first IUD inserted when I was sixteen and had never been pregnant. It’s true that certain sizes might not fit when you’re smaller, but they can just painlessly measure the size of your uterus and determine which is the best fit for you.
I can be pretty intense about my IUD but honestly I feel it is rare to have a totally stress-free journey with my birth control. I put this down primarily to thinking about what mattered to me and finding the BC that best suited my needs. For example, if one of your primary needs from your BC is no periods then clearly the copper IUD would be a disastrous idea. However, I feel many people aren’t given the option of an IUD – I had to ask for one at sixteen, no one suggested it to me – or avoid getting one due to fear. If you want one, please explore and ask your doctor – I’ve never regretted it and hopefully neither will you.
Bonus fact: IUDs also work as emergency contraception if they are inserted up to five days after unprotected sex!