Despite a reputation for being dangerous, the Intrauterine Device (IUD) is a
viable birth control method that is available in two forms: the drugs Paragard
and Mirena.
Generally speaking, an IUD is a t-shaped piece of plastic or metal that is
inserted into the uterus by a doctor, usually during a woman’s menstrual cycle,
while her cervix is open. A small string extends down into the vagina. Once
inserted, an IUD may remain in place for 5 to 10 years, providing extremely
effective pregnancy prevention. Next to combination-hormone oral contraceptives,
the IUD is the most effective form of birth control. It works by creating a
hostile environment, preventing fertilized eggs from implanting in the walls of
the uterus. Instead, the fertilized egg is expelled during the woman’s next
menstrual cycle.
Mirena also makes use of levonorgestrel, a hormone also found in oral
contraceptives. A benefit of the IUD is its convenience; once inserted, it
requires no attention for years. Though the initial cost of the device is higher
than most other forms of contraception, it is generally a lower-cost option in
the long run.
The IUD was removed from the market in 1979, but current IUD options are
considered safe and effective. Unlike oral contraceptives, there is no increased
risk for IUD patients who smoke or have high blood pressure, and it can be used
safely by breastfeeding women or women who are recently postpartum or
postabortion.
There is some evidence that an IUD can guard against endometrial cancer.
Risks are rare but can be serious. First, the IUD may be expelled by the
body. This usually happens within the first few months of use and is not harmful
to the patient. The IUD cannot travel to other parts of the body and will exit
via the vagina, leaving the patient unharmed but vulnerable to unplanned
pregnancy. The most serious side effect is perforation (if the device penetrates
the wall of the uterus). This usually happens during insertion and is very rare
but may require surgery to repair damage. The most common side effects are
cramping, spotting, and heavy or irregular periods, which tend to subside after
a few months of use.