Should You Actually Get an IUD Right Now?
Last week's surprising election results have left women wondering what the Trump administration will mean for reproductive care. Currently, birth control pills and IUDs, among the most popular forms of contraception for women, are covered, if not free, under the Affordable Care Act. Donald Trump has made it clear he'd like to repeal that.
As such, many women have taken to Twitter urging each other to consider getting an IUD — a T-shaped intra-uterine device that prevents pregnancy. IUDs are extremely effective contraception devices (like, 99.9 percent effective), and they can last anywhere from three to 12 years, depending on the type you select. Women tend to agree insertion is uncomfortable but tolerable.
There are two basic types of IUDs, copper and hormonal. Copper IUDs (like ParaGard) cause a change in the chemistry of uterine fluids, which then kills sperm. Hormonal IUDs (like Mirena, Skyla, Liletta, and new kid on the block Kyleena), release progestin, which stops ovulation.
But regardless of the future of your health-care options, should you really go ahead and book your insertion appointment? Despite the political climate, it's always a good idea to consider putting something inside your body carefully before pulling the trigger. Cosmopolitan.com spoke with Dr. Terri Vanderlinde, FACOG ob-gyn, and Eric Marlowe Garrison, clinical sexologist and sex counselor, about who might not be a great candidate for this type of B.C.
1. If it's your only method of birth control.IUDs are not effective at preventing the transmission of STIs. So if you're in a non-monogamous relationship or not using a barrier method of contraception like condoms, an IUD probably doesn't make sense as your primary method of birth control.
2. If you have severe, disruptive cramps.Many women go on the pill to avoid debilitating cramps. Certain types of IUDs, like ParaGard, don't help mitigate cramps the way birth control pills do. Some can even make it worse. Dr. Cheryl Chastine, previously told Cosmopolitan.com, "ParaGard's primary side effect is heavier period bleeding and more cramping, which most commonly lasts for the first six months." But there's a silver lining. You might fare better on a hormonal IUD like Mirena, where some patients report experiencinglighterperiods and cramping altogether.
3. You've had breast cancer."There are some forms of breast cancer that respond to progesterone, and because progestin mimics that, you would not want to have that in your system. It can cause it tometastasizeand grow," Garrison says. Even though it's a relatively small amount, progestin is found in hormonal IUDs, so a doctor would likely recommend avoiding it. But even if this applies to you, you'd probably be OK with a copper IUD.
4. If you have Wilson's disease.According to Garrison, Wilson's disease is a disorder that causes a person to be unable to metabolize copper, so it builds up in the system instead. If you have Wilson's disease, you couldn't use a copper-based ParaGard, but you could likely tolerate a hormonal Mirena instead.
5. If you have certain types of uterine fibroids.No matter what type of IUD, if you have uterine fibroids — noncancerous growths in the uterus — you may want to look elsewhere for your birth control. According to Dr. Vanderlinde, though, this is only in a specific instance. If the fibroids are in the muscle of the uterus and don't impact the lining, you're safe to use an IUD. If they're in the inner lining, however, it can impact the expulsion rate of the IUD. Basically, those fibroids can change the shape of your uterus, and therefore make it hard for the IUD to stay in place, aka work.
6. Your uterus is too big or too small.Garrison says an ultrasound can reveal that a woman's uterus might not be the ideal shape for a T-shape IUD. Gynefix, however, is a frameless IUD — it doesn't have the two little "arms" of the T. It's a piece of string with copper beads on it that basically free-floats with a barb that keeps it in place, like a chandelier hanging. Right now, it's only available in England, but there's hope it may make it to the U.S. eventually.
7. The idea of something inside your body just freaks you out."Internal xenophobia," according to Garrsion, is real. Xenophobia, as this election has taught us all too well, is the fear of things perceived to be foreign or strange. If the notion of foreign bodies inyourbody gives you anxiety, be it pacemaker or IUD, listen to that fear. The process might just be too emotionally stressful to reap the benefits.
8. If you have abnormal bleeding.It's not necessarily an IUD-deal breaker, but Vanderlinde says you'd need to get that checked out by a doctor before insertion. It could be a sign of something more serious, like endometrial cancer.
9. If you have an STI.Before getting an IUD, you need an STI test, which you can get at the time of insertion. Getting an IUD with an existing STI in your system can be really dangerous. If you place an IUD into an infected cervix, that can spread the infection, potentially leading to pelvic inflammatory disease.
10. If you're pregnant.Since the copper IUD actually acts as an emergency contraceptive device, you definitely don't want to insert one if you're pregnant.
All things considered, the margin of women for whom an IUD is not a good fit is pretty small. And even if your condition precludes you from one type of IUD, you might be a good fit for another. While you should never rush into a decision about your sexual health, Dr. Vanderlinde has some sobering counsel: without insurance, "the Mirena, for example, costs ,000 dollars. No one's going to be able to afford these. It's a very scary thing looking at women's health after these election results. I'm scared the unintended pregnancy rate is going to skyrocket.
Video: How Intrauterine Device Prevent Pregnancy? - Manipal Hospital
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