If a woman wants birth control that works — for years, one of the safest and most effective methods is an intrauterine device (IUD). The IUD is inserted into a woman’s uterus by a doctor and can remain in place for 5–12 years. Its side effects are few, and, with proper use, the IUD is an extremely effective contraceptive. However, it does not protect against STDs.

How the IUD works

The IUD is a small plastic device containing either a hormone or copper that is inserted into a woman’s uterus. IUDs work either by preventing the fertilization of the egg or by preventing implantation of a fertilized egg in the uterine wall. The IUD is inserted into the uterus through the cervix during menstruation, with a small string that hangs down from the end and protrudes through the cervix into the vagina.

The IUD that contains copper can be left in place for up to 12 years. The IUD that releases a small dose of hormones must be replaced after five years.

Advantages of the IUD

The advantage of the IUD is that — apart from checking for the string to be sure it is in place — you don’t have to worry about it. And the IUD does not change either the hormone levels or the copper levels in a woman’s body.

The IUD has faced a lot of controversy, so much so that many women no longer consider it an option. One brand of IUD, the Dalkon Shield, had problems more than 20 years ago and has been removed from the market. Some other manufacturers then pulled their brands out of the American market in fear of potential lawsuits. However, the World Health Organization and the American Medical Association rate the IUD as one of the safest and most effective temporary methods of birth control for women.

Disadvantages of the IUD

Because of the previous controversy and because IUDs are of two basic types — ones that contain hormones and ones that contain copper — definitely speak with a doctor or clinician before making up your mind about whether to use them.

The cost of an exam and insertion ranges from $175 to $500.

Occasionally, the IUD can slip out, and you may not realize that it’s gone. If that happens, you are no longer protected against pregnancy. Therefore, you should regularly check to make sure that the string is in place.

You may have some cramping when the IUD is first inserted, and some women have heavier bleeding for the first few months; a few women may develop a pelvic infection. Even rarer are problems with the IUD being pushed up into the uterus and causing other types of complications.

As with all hormonal methods, an IUD provides no protection against sexually transmitted diseases. If there is any chance of infection from your partner, you must use a condom in conjunction with the IUD.

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