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Contraception

4 common IUD myths dispelled

The intrauterine device (IUD) is the most effective, reversible form of contraception – the failure rate is 1%. For the record, the pill has a failure rate of 3-15% depending on how good a pill taker you turn out to be!

Unfortunately, IUDs are underused in the United States; less than 3% of American women use this method compared with 20% of women in Europe.

Why are American women less likely to use an IUD? There are many misconceptions about the IUD, most likely related to the Dalkon shield, a very unsafe IUD that was available in the 1970s and should never have received FDA approval. Modern IUDs (the ParaGard and the Mirena) have been well-studied and have excellent safety records.

So let’s dispel some IUD myths:

Myth #1: The IUD can give me an infection in my uterus.

Untrue. The risk of getting an infection in the first three months after an IUD is inserted is less than 1%. IUDs also do not increase the risk of acquiring a sexually transmitted disease (STD) if you are exposed after it is inserted. However, an IUD should not be inserted if a woman has untreated gonorrhea or chlamydia. If you are at risk for STDs, get tested a week or two before you plan on having the IUD inserted (you can drop off a urine sample and avoid and gyno visits and an extra copay).

Myth #2: The IUD will scar my tubes and make me infertile.

Untrue. A large study published several years ago in the New England Journal of Medicine looked at more than 1,500 women who had infertility due to scarred fallopian tubes – there was no relation to past IUD use. A previous infection with chlamydia is the biggest risk factor for this form of infertility. STDs scar tubes, plain and simple.

Myth #3: Only women who have been pregnant can have an IUD.
Also untrue. IUDs are safe and effective for all women regardless of their pregnancy history. However, the uterus must be a certain size for an IUD to fit. For most women who have never been pregnant the IUD will fit just fine, but doctors always check before insertion just to make sure. This is generally not an issue for a women who has been pregnant as the uterus never quite shrinks back down to its former size (just like everything else!).
Myth #4: The IUD causes heavy, painful periods.
There are two different  IUDs: the ParaGard, which is made of copper and effective for 10 years, and the Mirena, which contains the hormone progesterone and is used for 5 years. For some women, the copper IUD may cause slightly heavier bleeding and more  cramping, but for many it has no negative effect. Therefore, a ParaGard might not be the best choice if you are already a pad + tampon kind of girl and have stock in Kotex. The Mirena IUD will give you lighter periods, and if you are in the lucky 50% of Mirena users, no periods at all. This is because the hormone progesterone thins out the lining of the uterus reducing menstrual flow.
If you need contraception (and if you are having sex, you do) ask your doctor about an IUD. In less than 10 minutes you can have 5 to 10 years of worry free contraception! There are no pills, rings, or patches to forget or use incorrectly. Very little hormone from the Mirena gets in your blood stream, but if you are a no-extra-hormone-thank-you-very-much kind of gal, the ParaGard (copper) IUD is hormone free! Really, it just doesn’t get much better than that.


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Discussion

23 thoughts on “4 common IUD myths dispelled

  1. I’ve had a Mirena IUD for 3.5 years, and absolutely love it. I only have a period every other month, and when I do, it’s generally no more than light spotting. It’s so nice to not have to worry about birth control, and the cost for me was $40. Compared to monthly pill prescriptions, that is unbelievably cheap!

    Posted by alanaransley | April 22, 2011, 7:57 pm
  2. I’m very happy to see this write up. I have also been using Mirena for 2.5 years. I used to have horribly irregular, heavy, painful periods, and I actually stopped menstruating completely. I could go on and on about why it was such a great choice for me.

    When I told my gyn I wanted one I was prepared for a huge fight – I was 25 and I’ve never been pregnant. He was open to the idea and never gave me a problem, but I’ve had to repeatedly justify my choice to my internist. She still acts like it’s bizarre for someone who isn’t married and doesn’t have children already.

    Posted by Victoria | May 27, 2011, 7:46 pm
  3. I had an iud (paraguard) for 5 years I got it remove and 2 months later bacame pregnant that pregnancy result in a blighten ovum.I then got pregnant 5 months later which is now and I just had a miscarriage all the docters want you to believe that the iud has nothing to do with it but it has everything to do with it.I have a 8 year old and a 5 year old 2 healthy pregnancies all of the sudden once I got an iud and now its remove I cant hold a baby, I would encourage anyone who is thinking of a getting an iud and might possibly want kids in the future not to do it

    Posted by Katrina | January 17, 2012, 2:18 pm
  4. Well, Katrina, Dr. Gunter has the actual medical facts, but if we’re talking anecdata — it took me over two years to get pregnant the first time, at age 33 (which included a miscarriage at 6 weeks, a fact I only mention for completeness’s sake). After my daughter’s birth, I got Mirena, and LOVED it (no periods, no baby when I didn’t want one). When she was three, we decided to try for another baby, and the first full cycle after the Mirena was removed, I got pregnant again at 37. The result of that problem-free pregnancy is snoozing on my chest right now, having just finished his third bf’ing of the morning — and my second Mirena is safely tucked into place so that he doesn’t get a younger sibling because we are DONE. So there’s that.

    Posted by Gleemonex | February 14, 2012, 9:41 am
  5. Interestingly, the Mirena inserts still say that their IUD is “recommended” to be used in women who have already had children. Their rationale is that most of their FDA approval stems from research where subjects had already had at least one delivery, but to the layperson it could certainly look like “you shouldn’t get one, People Without Kids!” Planned Parenthood inserts them into nullips all the time, including me, and I seem to recall a statement somewhere that the IUD (prolly Paragard) is the most common form of contraception worldwide (WHO perhaps?). So the underuse of IUDs, especially Mirena, in the US may be unwarranted.

    Posted by Phledge | February 22, 2012, 10:58 pm
  6. Thanks for the great info on IUDs. I’ve thought off and on about getting one. I’d go for the copper if I did. The idea of having a foreign object in me gives me the hebe-jeebies. So I appreciate your factual information. As I was reading a few questions came to mind.

    If someone had a history of cervical dysplasia, HPV and/or ASCUS would either of the strings cause irritation to the cervix possibly increasing the risk of an abnormal pap smear?

    How does a doctor determine if the uterus is the appropriate size for an IUD?

    How is the IUD inserted? I’m assuming that the T shape must be flexible to get in and out of the cervical canal. Is anything used to stabilize the cervix during insertion?

    If one was going to have an IUD inserted, is any time of the cycle better than another? My thoughts were along the lines of during the fertile time of the month, the os appears to be more relaxed and open plus there is additional lubrication available due to the increase in cervical fluids (fertile mucus).

    Because the string travels from the IUD through the cervical canal into the uterus, its commonly thought that this string can be a highway of sorts for bacteria to travel upon through the inner os which is supposed to help protect the uterine environment from the outside world. Is the protection that the inner os is supposed to convey overstated? Since clearly it appears that pathogenic bacteria (chlamydia for example) is able to enter the uterus to cause PID and damage the oviducts.

    Posted by Sister Z | March 8, 2012, 8:48 am
  7. Gleemonex keep in mind that you were using Mirena and Katrina used Paraguard. Different items, one containing copper and no hormones (Paraguard), and the other containing hormones (Mirena).

    Posted by Sarah | July 15, 2012, 1:47 pm
  8. I have 2 boys…9 and 6 yrs old. I’ve decided to removed the IUD after having in on for almost 5 yrs. it was removed Aug 2011 and Hubby and I are ttc without no luck. I concieved in Dec 2011 but sadly ended in miscarriage at 5wks, another miscarriage in June2012 at 6 wks and we’ve been trying ever since with no luck. So for some reason I currently blamed it on the IUD i’ve been wearing for almost 5 yrs. If you want kids in the future, do not use IUD birth controls. PERIOD!

    Posted by Confused Mom | July 18, 2012, 12:25 pm
  9. My husband have been trying for almost 2 months now. When I had that piece of crud in me I had cysts like no other. Of course the docs are going to say its not the iud since they get a nice check from the drug company. Yes it can cause scarring.

    Posted by Jenn | August 23, 2012, 9:46 pm
  10. IUD’s cause abortions. They create a hostile environment in the uterus so that a fertilized egg (A baby) cannot implant in the uterus. If a baby is able to implant the device has the ability to scrape it off of the uterine wall. If you are prolife you would never want to use an IUD.

    Posted by carolyn | December 1, 2012, 6:59 pm
    • I challenge you to find me a study that confirms this belief. A study published in a peer reviewed journal. To prove this, the study will need to include uterine lavage (washings) from women with IUDs to look for embryos.

      Posted by Dr. Jen Gunter | December 1, 2012, 8:43 pm
      • My uterus and tubes scarred beyond belief from this torture device, is that a good of enough study for you?

        Posted by Jenn | December 16, 2012, 9:18 pm
    • @carolyn: Sounds like you’re pro-fetus, not pro-life. If you cared about life maybe you’d care about the individual’s decision to use birth control and the reasons that surround it. Take your ignorant, uninformed garb somewhere else.

      Posted by md | February 11, 2013, 1:41 pm
  11. Plus that lovely lawsuit plastered all over t.v.

    Posted by Jenn | December 16, 2012, 9:28 pm
  12. I’ve had a paragard in place for a little over a year and I’m currently having some menstrual problems (my family history is a rotten one unfortunately). I’ve been looking for other paragard experiences and came across your blog. From other posts on the net, I’ve seen women have all of these problems with paragard ranging from hair loss, mood swings, yeast infections, cramping, backaches etc. I’m certainly not a doctor (nor do I play one on TV) but how does a very very small amount of copper create all of those problems? I’m assuming that they wouldn’t be a viable birth control option if the amount of copper was too high. Does the paragard really create all those problems or do some women take to it better than others?

    Posted by Audrey | January 14, 2013, 10:21 am
  13. People keep asking me if my IUD will move around in my uterus and puncture it. Can you debunk this?

    Posted by erinjayne | July 27, 2013, 6:05 pm
  14. I got the paragard after having my second child- didn’t think I wanted any more kids but to be on the safe side I didn’t get my tubes tide and went with the “worry free 10 yrs contraception” in August 2010 at my six week post delivery appt. Right away experienced serve pelvic pain that I was told was normal and would go away. Also, very heavy menstrual cycles that would “go away”. I eventually just coped with it. August 2011- I found out I was pregnant w my third child and my IUD was in place(confirmed with ultrasound). They told me they had to remove it- afterwards told me my child had a 50/50 chance. During the yr I had it I was also losing hair like crazy! I assumed it was due to stress until I started reading and it ended up to be a common “symptom of this non hormonal iud”. Not to mention I had a huge blood clot that was caused by this iud (medical fact!) along with cyst. So before anyone goes and listens to a dr that only has positive things to say about paragard – please do your homework! They’re probably getting paid from this companies!!!

    Posted by Overthebs | November 10, 2013, 10:03 am
  15. Hi iv had the marena in for 6 months now. For the first month and a half I had sever heavy bleeding constant. Then it stopped. Now at the six month mark I have gotten a period and pretty bad pains. Should I be concerned. I had the marena inn once before for over a year and this never happened. Any advice or opinion is welcome. Have a gp appointment booked just wanted to know If anyone had personally been through this. Thanks

    Posted by tiffany | August 12, 2014, 6:34 am

Trackbacks/Pingbacks

  1. Pingback: What is the most effective method of birth control? « Dr. Jen Gunter - August 11, 2011

  2. Pingback: If governments were really serious about reducing abortion IUDs would have no co-payment « Dr. Jen Gunter - February 29, 2012

  3. Pingback: When can you get an IUD after and abortion and why it matters « Dr. Jen Gunter - March 7, 2012

  4. Pingback: On being child-free « a windycitygal's Weblog - May 2, 2012

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