Tuesday, February 19, 2013

What's the Deal With IUDs, Anyway?

According to the Association of Reproductive Health Professionals, intrauterine devices, or IUDs, are over 99% effective. Worldwide, IUDs are the second most popular form of birth control, right after sterilization. While American IUD use is on the rise, (2% in 2002 compared to 8.5% in 2009), the numbers are still low. In fact, almost a third of American women are on the pill, a method that with typical use (not taking your pill at the same time every day or missing pills) is only 92% effective. That means that 8 in 100 women who are on the pill will get pregnant each year, compared to less than 1 in 100 women with an IUD. So why aren't more women using long-acting reversible contraceptive methods like IUDs?

Because of the Dalkon Shield. In 1971, an IUD called the Dalkon Shield was marketed nationally. At this time, no government regulation of medical devices existed, and no laws were in place to prove medical efficacy. Because of this lack of regulation, Dalkon Shield IUDs were poorly and inconsistently designed, and never tested before implanted into over 2 million women. Many complications occurred, ultimately leading to 17 deaths and thousands of women left infertile or chronically ill. And even though IUDs like the Lippes Loop and Copper T-200 were available, the media heavily publicized studies that showed the dangers of the Dalkon Shield. According to this CDC report, women using the Dalkon Shield were found to have a five-fold increase in risk for Pelvic Inflammatory Disease compared to women using other IUDs.

Dalkon Shield

Here's the thing- that was the 1970s. According to The American Congress of Obstetricians and Gynecologists, IUDs are the most effective reversible contraceptives available, are available and safe (many improvements from earlier versions [Dalkon Shield]) for women of all reproductive ages, and complications are rare. IUDs are inserted by a physician one time, they last for five to ten years depending on which IUD you choose, and are removed by a physician. (IUDs can also be taken out by a physician before these time frames in the event that you want to become pregnant.) Compare this to methods like birth control pills which must be taken once per day by the user at the same time to keep their high efficacy rate; that's burdensome! The fact is, birth control methods that take less human effort are the most effective. Here are your choices for IUDs today:                 

Paragard is a non-hormonal IUD that prevents pregnancy by preventing sperm from reaching and fertilizing an egg. This method last for 10 years. People who choose Paragard may experience heavier and longer periods. IUDs do not protect against sexually transmitted infections, and it is important to use condoms until you and your partner have been tested.


Mirena is a hormonal IUD that prevents pregnancy by thickening cervical mucus, inhibiting sperm from reaching an egg, and by thinning the lining of your uterus. This method lasts for 5 years. People who choose Mirena may experience irregular periods, shorter periods, or not having a period at all. IUDs do not protect against sexually transmitted infections, and it is important to use condoms until you and your partner have been tested.


An IUD may not be the right option for you, and I encourage you to explore all of your options by visiting Bedsider.


  1. I think that another major factor in the obscurity of IUDs in the US is the fact that they are less profitable. Consider the difference between a one-time $500 charge for a Paragard IUD that will last 10 years and expensive birth control pills which must be purchased on a regular basis for decades. There's just more money to be made off of the pill. When I lived in England, I was surprised to find that IUDs were super popular and they had several options to choose from. It made sense, considering that they have a national healthcare system which focuses on driving down costs. I have had two Paragard IUDs under my TriCare health plan, which is also a universal/single-payer type of system. I love my Paragard and feel great about having such an effective form of birth control that is hormone-free and lasts as long as I want it to last. I really wish they were more popular here.

    1. Hey Nichole,

      I think that's a really good point. Another factor to consider is that when doctors do not know how to implant IUDs (possibly because of their lack of profitability...), they tell women that IUDs are not an option. There is also a misconception that you can't be nulliparous and have an IUD. I think the first step in making contraceptives like IUDs more popular in the states is dispelling the myths about their risks and making upfront cost more widely accessible.

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