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Why The IUD Is On The Rise (And You Might Want One)

(Above: A 7-minute IUD show-and-tell by a leading expert, Dr. Eve Espey)

Full disclosure: I had an intra-uterine device implanted soon after my second child was born, and in my own experience, using an IUD for birth control is something like what Churchill said about democracy: It’s the worst system around — except for all the other ones.

My first few months with a Mirena — an IUD that emits tiny levels of the hormone levonorgestrel — were rife with unpredictable spotting. That certainly got very old very fast. But then the spotting ended, and my periods blessedly all but disappeared, a common Mirena effect. It’s been nearly seven years now, and I’ve been both problem- and pregnancy-free. I even re-upped for a second device when the first one hit its five-year limit.

So that’s my bias when I report that in recent weeks, I’ve noted a striking convergence of signs pointing to a new era of far greater popularity for IUDs. There’s even talk of an IUD “renaissance” — once all but unthinkable after the debacle of a 1970s device called the Dalkon Shield.

The "Mirena" hormone-releasing IUD

In the not-too-distant future, getting an IUD, which costs several hundred dollars, will be universally covered and co-pay-free under new federal insurance rules. The latest numbers suggest IUD use among American women has risen dramatically in the last decade. And the IUD’s safety record is looking so good that recent research finds that the devices can even be implanted right after an abortion or a birth.

“The message is finally getting out there that IUDs are a great option — that they’re highly effective, that they’re long-acting, and they provide reversible, highly effective contraception with just one act,” said Dr. Alisa Goldberg, director of clinical research and training at the Planned Parenthood League of Massachusetts. (That “one act” is having the IUD implanted, a quick office procedure.)

Among the first 2500 women who enrolled in the study, 56% — that’s right, more than half — chose to get IUDs.

“And the message is finally getting out there that the old days — the days of the Dalkon Shield — are long behind us,” Alisa, who’s also director of the division of family planning at Brigham and Women’s Hospital, said. “There are increasing amounts of data showing the safety, the efficacy and the increasing popularity of these methods.”

In a country where nearly half of pregnancies are accidental, “This could have a huge impact on public health,” she said.

No, she’s not in the pay of the IUD makers. She sounds just like many other evidence-based experts on contraception who have been pushing for greater IUD use for years. In fact, it was because I’d read some of their research that I opted for an IUD seven years ago, despite a lingering sense of past disaster.

Now the factors in the IUD’s favor are visibly multiplying. Most recently, new federal rules announced earlier this week, requiring insurers to cover women’s contraception without co-pays, will remove the upfront costs that put many women off IUDs. Continue reading