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Why Aren’t IUDs More Popular?

Thursday, January 30th, 2014

The IUD is one contraceptive device that seems to not be getting a fair shake. Birth control pills, contraceptive implants, condoms, and surgical sterilization are all more popular, despite the fact that most of these methods are either permanent or require perfect usage by the woman – in other words, remembering to take the pill every day at the same time, or being able to consistently use a condom in the heat of the moment. (Disclaimer: you should always use a condom if you aren’t in a monogamous relationship, but if you are, and you know that you are both free of STIs, a contraceptive method that frees you from having to use condoms can be a welcome change.)

An IUD is a small device shaped like a T which your physician must insert into your uterus. There are copper IUDS available as well as hormonal IUDS which release progesterone; both kill sperm and make the lining of the uterus inhospitable to fertilized eggs. Once inserted, an IUD can be left in place and forgotten for five to 10 years, depending on the type of IUD used. (However, it can also be removed at any time the woman chooses.) The IUD’s string hangs out through the cervix to enable the woman and her doctor to occasionally check that the device is still in place correctly.

IUDs may be a great option for sexually active teens, because they don’t require the same level of attention that birth control pills do – you can’t forget to use your IUD. In fact, IUDs are an excellent choice for any woman who may want to become pregnant eventually, but who knows she is a long time away from being ready. In addition, IUDs are extremely cost-effective when used for a period of several years.

The use of IUDs does not interrupt foreplay the way some methods can; it also does not require the cooperation of your sexual partner. IUDs are perfectly safe for women who are breastfeeding, and when an IUD is removed, fertility returns immediately. The bottom line is that IUDs are extremely effective, extremely safe, and extremely easy to use.

In spite of these benefits, less than 4% of women choose IUDs as their birth control method. Why is that? Part of the issue may simply be that doctors are not recommending IUDs with great frequency, and therefore many women may not even be aware of the availability or the benefits of IUDs. Surveys show that many doctors (about 30%) have doubts concerning the safety of IUDs, such as the possibility that IUDs may increase the risk of infection or jeopardize fertility. These were common concerns when IUDs first appeared on the market, but it is now understood that these fears are unfounded and IUDs are safe for use.

– Yvonne S. Thornton, M. D., M. P. H.