IUDs: Are They Safe?

Birth control is often a topic of contention in the United States. Political factions argue over questions like, “Who should have access?” and “Should it be free?” State and federal governments clash with communities on whether or not children should be educated about types of contraception, and if so – at what age, and in what context? Politics and policy aside, misinformation and ignorance about birth control has created a naïveté in the way many people think about (and use) contraception. Accordingly, some of the most important questions that crop up during these discussions are not political, but medical: What types of birth control are the safest, most effective, and healthiest to use?

In the past several years, many types of contraception have either appeared new in the marketplace or have increased in popularity. These options run the gamut from pills to vaginal rings, injections to hormonal implants. 2012 was also the year of breakthroughs in male-oriented birth control methods – with safe, reversible procedures and hormonal pills on the horizon. And for women, one of the one of the most rapidly-growing trends in birth control selection, worldwide, has been the intrauterine device – or the IUD.

“IUD” is a term that bears the weight of its previous incarnations’ reputations. While they date back to the early 1900s, IUDs are particularly well-known for their use in the 1960s and 1970s and – unfortunately – the negative circumstances that arose alongside their usage. The structural design of the IUD was much different than it is today; instead of sitting solely within the uterus, IUDs also crossed into the vagina. This structure was the cause of many cases of pelvic inflammatory disease. Additionally, the Dalkon Shield, a particular device marketed in the 1970s, gained recognition by its harmful results – including infection, infertility, and even death. After 300,000 lawsuits were filed against the makers of the device, IUDs quickly fell out of favor with the American public. They were labeled as dangerous forms of birth control to be avoided at all cost.

This reputation may have colored your current idea about IUDs. The generation of women coming of age in the 1970s was warned heavily about the perils of the IUD; no woman – particularly women who had yet to have children – should gamble with using a device that ran the risk of possible infertility. This older generation has (perhaps justifiably) propagated the tale of the deadly IUD and has largely been responsible for the horror stories that are still relayed to a younger generation of contraceptive users. But what is the state of the IUD in 2013? It’s regaining popularity, so is it safe? And have the designs been reconfigured and improved?

There are two types of IUDs currently available in the United States. One option is a non-hormonal, copper-based IUD called ParaGard. Copper acts as a natural spermicide when placed in the uterus, and prevents fertilization by affecting sperm mobility (so they never meet with an egg). The ParaGard has the desired benefit of being non-hormonal, which is a strong pull for women who are unable to use hormonal contraception (or, at least, desire to avoid hormonal manipulation). Most other forms of effective birth control employ hormones, so the ParaGard gives women options they wouldn’t ordinarily have. The most common negative side effects include heavier periods and cramping.

The second form of IUD is of the brand name, Mirena, which secretes low doses of hormones daily. Like Paragard, Mirena is placed in the uterus and will remain there for a number of years. (Currently, it’s been approved for five years – though some studies say it remains effective for seven.) Unlike ParaGard, Mirena has been shown to relieve heavy periods and decrease negative symptoms of menstruation.

In addition, both forms of IUDs have been proven to be a highly effective means of preventing pregnancy. With an average of .01% failure rate, IUDs have a similar contraceptive success rate of tubal occlusion. Essentially, the only forms of birth control with a higher success rate than IUDs are abstinence and sterilization. They’re also long-term, hassle-free alternatives to pills or options with heavy up-keep. And yes, they are now safe. Not only are they safe for women who already have children, recent studies have shown they’re also safe for a younger generation of birth-control users. (Even teenagers.) Any hesitation (on the part of either doctors or patients) to embrace IUD use due to harmful health concerns has been proven time and time again to be based on incorrect and outdated information. IUD use has even been linked to decreased cervical cancer risk.

So are there any negatives?

IUDs aren’t necessarily recommended for individuals who have multiple partners or practice unprotected sex. Sexually transmitted infections, if left untreated, can result in infertility for IUD users. There’s also a risk of uterine perforation, though the risk is small. Some individuals may experience expulsion of their IUDs, but this process isn’t harmful for the individual.

The truth of the matter is that IUDs are no longer outdated contraceptive models with the negative connation the Dalkon Shield had in the 1970s. They are now new, improved options that are giving millions of women the freedom to control and manage their own bodies, and their growing popularity is proof of their effectiveness and positive attributes. It’s time we put aside the horror stories of IUDs of the past and recognized that the IUD is a birth control alternative that’s here to stay.

Angie Picardo is a staff writer for NerdWallet. Her mission is to help consumers stay financially savvy, and save some money with the best bank CD rates.

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