Should you IUD?

The once-controversial contraceptive deserves a second look.

Published February 2, 2006 7:13PM (EST)

A flood of reader letters in response to yesterday's Broadsheet post about women's growing dissatisfaction with birth control pills has got us thinking seriously about IUDs (intrauterine devices) -- those highly effective, but largely misunderstood, contraceptive devices that offer women long-term protection against pregnancy without hormonal side effects like weight gain, loss of libido and blood clots.

IUDs, while extremely popular globally (with more than 85 million women using them worldwide) have yet to be embraced by American women, in part because of lingering fears concerning their safety. (In 1976, a common IUD known as the Dalkin Shield was recalled after it was linked to uterine infections in thousands of women and dozens of fatalities.) But in the three decades since then, huge strides have been made in the development of harmless, reliable IUDs -- which makes us think more women should be giving them a second look.

The two most popular options on the market right now are the ParaGard, a copper IUD that can be left in place for up to 12 years and is completely nonhormonal, and the Mirena, which is made of plastic, contains a small amount of the hormone progestin and is effective for five years at a time. According to Planned Parenthood, "both kinds of IUDs work by preventing sperm from joining with an egg by affecting the way they move. The hormone in Mirena increases effectiveness. It thickens cervical mucus, which provides a barrier that prevents sperm from entering the uterus. It also prevents some women's ovaries from releasing eggs (ovulation)."

As with oral contraceptives, IUDs do not protect against sexually transmitted diseases, so should be used in conjunction with a condom or only by those involved in monogamous, committed relationships. Side effects may include a change in menstrual bleeding and cramping, and in rare instances IUDs may tear or be expelled from the uterus, according to Planned Parenthood.

So, are the new IUDs worth a try? If anecdotal testimony is any evidence, the answer is a resounding "Yes!" Among Broadsheet's friends in women's health -- doctors, nurses and midwives -- IUDs are the contraception of choice. Salon reader and letter writer "hollerhither" writes, "I stopped using the Pill for exactly the reasons [Traister] cited (depression, weight gain, etc.), and after consultation with my doctor decided to go with the Mirena IUD. It offers a localized, low dose of hormones but so far none of the side effects I dealt with when on the Pill. Extremely light periods, high effectiveness rate, and it's good for five years (but can be removed at any time). The procedure was a regular $25 insurance copay plus $25 for the device itself -- a bargain. [And] the Mirena is the #1 form of birth control used by the women in my gynecologist's office -- both doctors and nurses. That alone speaks volumes."

So, tell us, ladies -- do you IUD? What kind of experiences have you had with them? And what should we be asking our doctors? Let the birth control revolution begin!

By Sarah Karnasiewicz

Sarah Karnasiewicz is a freelance writer and photographer based in Brooklyn, N.Y. Until recently, she was senior editor at Saveur magazine; prior to that she was deputy Life editor at Salon. She has contributed to the New York Times, the New York Observer and Rolling Stone, among other publications. For more of her work, visit and Signs and Wonders.

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