Contraception is a topic more important than ever for women who live in an area with a risk of Zika virus. But many women are concerned with the potential side effects and inconvenience of birth control, and would be happy to find a method that was safe as well as reliable. The IUD may be the best solution for many women.
No method of contraception is 100% reliable and totally without risk (pregnancy itself is not without risk), but there is one method—the Intrauterine Device (IUD)—that may maximize a high rate of preventing contraception with a low complication rate. Besides that, while the initial cost is higher, over the long term, it may be one of the least expensive options.
Besides those benefits, the IUD offers the advantage of being reversible; meaning once it is removed, the woman quickly regains her ability to become pregnant again. While sterilization offers the highest rate of success in preventing pregnancy, it cannot be considered reversible.
The IUD offers even another advantage: once the device is inserted, there is no need to worry about taking a pill each day, or inserting a vaginal diaphragm for each act of sex, or remembering to take a shot each month. Once the IUD is inserted, it reliably prevents pregnancy for anywhere from 3 to 10 years, depending on the type of device inserted.
The Modern IUD
The IUD is itself a small (about 3 cm. in length), flexible plastic device, shaped like a T, and inserted by a trained medical professional into the uterine cavity. There, the IUD acts as a mild irritant to the wall of the uterus and surrounding fallopian tubes to prevent the sperm from penetrating the egg, and/or preventing a fertilized egg from implanting in the wall of the uterus. It does NOT cause an abortion.
There are two main types of IUDs: one containing a copper wire, and the other containing a small amount of the hormone progestin, which is secreted very slowly into the uterine cavity. Both copper and progestin make the uterus an environment inhospitable for sperm or for an egg to implant in the uterine wall.
You should discuss with your obstetrician or gynecologist which type would be better for you, as each has advantages. The progestin IUD has the advantage of minimizing (or in some cases stopping) menstrual flow and cramping in many women, but this type must be replaced with a new one in 3 to 5 years. The copper IUD needs to be replaced only every 10 years, but some women report cramping or increased menstrual flow with the copper device.
Both devices have a low rate of failure, meaning, there is only small chance that a woman will still become pregnant while using the device and having otherwise unprotected sex. The failure rate for the IUDs is less than 1%, but compare that with some other contraceptive methods:
Failure rate over one year (the percentage of women who will still become pregnant while using each method):
IUD: less than 1%
Oral contraceptives: 9%
Hormone injections or patch: 9%
Cervical diaphragm or cap: 12%
Male condom: 18%
The main disadvantage of the IUD is the initial expense of the device and the cost of insertion, but after that, at least for a few years, there should be no further expense. In the long run, the IUD may be less expensive than other methods, and with this method, you don’t need to remember to take a pill each day, or insert a device each time you have sex, or go to a clinic for a periodic injection.
So talk to your health care professional and become informed if the IUD would be right for you. SUS covers the copper IUD, and if you have insurance, check what is covered. Finally, remember that while the IUD is a highly successful contraceptive, it does nothing to protect you from DSTs and HIV. If you are using an IUD but having sexual relations with DST/HIV risk, you should ensure your male partner uses a condom, and properly.
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