Your Doctor's Fave Contraception

By Mia Abrahams

Over the past few weeks, we’ve gone into the nitty-gritty about what happens to your body during your cycle. But, as we know, a whole bunch of us use birth control, and still want to know what the hell is going on with our bodies! Last week, we took a look at the pill, and this week we’re movin’ on down to the IUD. According to Planned Parenthood, IUDs and implants now represent the third most commonly used category of reversible contraceptives among women ages 25-44 (after the pill and condoms).

There are two types of IUDs (Intrauterine Uterine Devices): copper and hormonal. The IUD is a small, T-shaped gadget that is inserted into your uterus by a doctor or nurse (check out our previous blog post on IUD insertion— although it is different for every body, it can be super painful). Once it’s up there, that’s it! You don’t have to think about it again until it’s time to get a new one (or you want to get pregnant). The IUD is 99% effective in preventing pregnancy, but like with the pill, it does not protect against STDs (so if you’re sexxxin’ someone new, wrap it up!).

Strangely enough, there aren't a lot of "IUD gifs"— so enjoy this Leslie Knope moment instead.

So, how does a copper IUD work?

The copper IUD (ParaGard is the brand you can buy in the US) can protect you against pregnancy for up to ten years (!!!), but, of course, you can have it removed at anytime and get back to baby-makin’ business. Copper is to sperm what garlic and holy water are to vampires — super-repellent.

Remember chemistry? Well, once the copper is all up in there, the copper ions spread through your cervical fluid and uterine fluids, and when those fluids come into contact with sperm—BAM!—sperm vanquished. Cool, huh? Oh, and don’t worry, the spermicide-y copper is at a really low and safe level for your body.

Copper prevents the movement of sperm, and, even if a sperm Fast and the Furious’s its way into your uterus and fertilizes an egg, the copper will prevent the implantation of the fertilized egg. You’ll still ovulate, and you’ll still get your period if you have a copper IUD (unlike the pill, there’s nothing preventing your natural cycle of hormones), but it may be heavier, or more painful, particularly in the first couple of months.

So, how does a hormonal IUD work?

The hormonal IUD, eg. Liletta, Mirena, Skyla, and Kyleena, (also the names of your new fave dragon-slaying desert warriors on next season of Game Of Thrones) are effective for anywhere between three and five years, depending on the brand (The Cut has a handy chart that shows the dosage and protection time of each IUD brand). They all work by releasing a low amount of the progestin—the synthetic version of the naturally produced progesterone—called levonorgestrel.

To recap (because, damn, sex ed feels like a long time ago) pregnancy happens when a lucky sperms swims up your vagina, into your uterus, and fertilizes an egg that has been released during ovulation. Levonorgestrel prevents pregnancy by thickening the cervical mucus, creating a physical barrier to stop sperm from reaching (and fertilizing) your eggs. Levonorgestrel also thins your uterine lining, which makes it more difficult for any fertilized egg to become implanted (annnd less uterine lining means your periods might feel lighter and with less cramping - yay).

Unlike the pill, the hormonal IUD doesn’t usually prevent ovulation. The pill, in contrast, does prevent ovulation. The hormones in your IUD mostly stay in your uterus (eg. not in your bloodstream), which means it doesn’t affect your whole hormonal cycle like the pill.

As above, plus Elaine. 

What are the side effects?

There are a whollllle lot more blog posts needed to fully encompass everyone’s experiences, positive and negative, with the IUD. But, in short, the main side effects of the IUD can be spotting between periods, much heavier or painful periods (especially with the copper IUD), and the device becoming dislodged or uncomfortable. Your period may also become much lighter, or stop altogether.

As always, there’s no one-size-fits-all approach to contraception. Arm yourself with information and choose what’s right for you. If you’re new to the IUD, or thinking about getting one, make sure to chat with your doc or healthcare provider to choose the best brand/option for you, and keep an eye on your symptoms the first couple of months so you can let your doctor or healthcare provider know if anything is worrying you. You *don’t* have to put up with pain and discomfort. Period.

For many of us, the IUD is a great birth control option— it’s effective, convenient (did I take the pill this morning? shit), cost-effective (depending on your insurance ofc, but it’s a one time payment for many years of contraception, yipeee), and reversible! And it’s seems like the people who would know agree — women’s health care providers are three and a half times more likely to choose IUDs.

I’d love to hear from you. Are you currently using the IUD? What has your experience been like? Are there any more aspects of contraception you’d like clarity on in future blog posts?