To IUD or not to IUD, that is the question . . .Or, will they let me IUD? Who knows?

December 27, 2005 8:08 PM

[GirlFilter] I know that questions about birth control are about a dime a dozen on here, and I've read most of the stuff that relates to IUDs, but I have some questions that I hope people here can help me with that I don't think have been previously addressed.

For the record, I am 26, have no children and do not want any in the forseeable future. I am on hormonal birth control (Seasonale) and was previously on Alesse. I have been since age 18. I feel that the pills are contributing to a number of problems I am having, one of which means I yell a whole lot, which is really out of character of me, and another is that I've gained weight and cannot get rid of it at all. I want to get away from hormonal birth control altoghether if possible. I'm married, I dislike condoms and diaphragms for the same reasons collectively. I am not crazy enough to want or suggest tubal ligation for myself at this point, and I am 99.9% certain that I'd be denied that anyway.

My questions are as follows:

1) I understand that IUD availability in the US is rather limited (two brands to my knowledge) and of of them is copper and the other has a low dose of hormones. I am also allergic to cheap jewelry. Does this rule out the copper one for me? Should I see an allergist specifically about this, or should my GYN be able to address this with me?

2) The childless thing. How does one overcome this issue with one's doctor? I know if I get too much shit I should change doctors, but given my locale, this may mean I have to switch many times before hitting the reasonable doctor jackpot. My aunt (mother's sister) just had breast cancer this last year; I don't know if that helps my case or not.

I am also, of course, interested in hearing anyone's experiences with IUDs and any information you think might be helpful to me in making this decision. I have to see my doctor within the next 60 days or so, and I'm trying arm myself early and well with information. Thanks!

posted by Medieval Maven to health & fitness (17 comments total)

I could be missing something, but since you're married and don't want children, is there some reason your husband isn't taking care of this for you? My understanding is that vasectomies can be relatively simple outpatient procedures nowadays, and I believe there are even some that are reversible. It also seems to be much less stigmatized for men to not want children than for women, so it would be simpler for him in that regard.

Of course, if your husband wants kids and you don't, that's an entirely different problem...
posted by booknerd at 9:01 PM on December 27, 2005

1. If you are allergic to copper, you cannot get a copper IUD. I'm not sure that cheap jewelry is all copper, though, so you may not be out of luck. But you should check for a copper allergy.

2. I think the childless thing really varies doctor to doctor. Planned Parenthood's official policy is that childless women are eligible for IUDs, so if your doctor wont' do it, that might be the next step. From the research I've done, it seems that the reasons for not giving childless women IUDs are slowly eroding, so if you do want to argue your doctor into something, there's probably research out there to help you.

The thing is, it also seems that the success rate of IUDs is pretty correlated to your doctor's skill in inserting them (both in terms of physical comfort and not expelling them). So I'd be wary of using an unsure doctor for the procedure. (A few things I've read have actually said that a doctor's lack of skill, rather than any more compelling medical reasons, is why they discourage childless women from getting IUDs -- they're just harder to insert.)

As for finding a doctor willing, just ask the receptionist when you call if the doctor inserts IUDs at all, and what her policy about childless women is. Do your screening there rather than having to traipse all over town.
posted by occhiblu at 9:09 PM on December 27, 2005 [1 favorite]

From what I have heard, Family Plannings or Planned Parenthoods are much more apt to give you an IUD, being a rather female-positive and population-sensitive (if that's the phrase that tactfully describes it) organization. And hey, if they give you any shit, throw out the fact that something like 100 million Chinese women use IUDs and it's the most used birth control method in that country.

I'm looking to get an IUD as well and I'm only 21. My current doctor refused it, on the grounds that my uterus isn't stretched from children and that there is a higher risk of IUD expulsion based upon that. I'd rather risk that than having a kid right now, so I'm just going to keep on searching.
posted by sian at 9:16 PM on December 27, 2005

(Hey guys — the vasectomy/no-vasectomy flame war has been done to death in other birth control threads. Let's keep it out of this one and stick to answering the question, K?)
posted by nebulawindphone at 9:49 PM on December 27, 2005

FWIW, my mom is allergic to cheap jewelry. In her case, it's a nickel allergy, which I inherited. (Thanks, Mom!) Maybe yours is too. Or maybe you already know it's a copper thing. Just sayin'.

I know nothing else about this topic. Best of luck, though!
posted by SuperNova at 11:30 PM on December 27, 2005

I'm 25 and have no children and I had no problem getting an IUD (I was 24 when I got it). I got the copper one because I didn't want to deal with the hormones anymore and because it was good for 10 years. I am extremely happy with it and would recommend it to any woman looking for longterm birth control. There is some pain involved with the insertion and my first few periods were extra crampy, but things got pretty much back to normal within 6 months.

In regards to the copper allergy, I looked into this a bit before I got mine. From what I read, if you had a copper allergy you'd be likely to know it already. I also read an easy way to test it would be to get an older penny (when they were made with copper) and tape it to your arm for a while to see if you have a skin reaction. I didn't actually do this myself though.
posted by disaster77 at 12:32 AM on December 28, 2005

Re: Cheap Jewelry allergy -- I know that I'm definetly sensitive to nickel; I'm not altogether sure whether or not the copper factors in. Thanks! Keep it coming!
posted by Medieval Maven at 4:28 AM on December 28, 2005

I've had a couple girlfriends that had issues with birthcontrol pills. Each time the problems: weight gain, depression, etc. disappeared after they stopped using the pill.

Why not just use condoms for a while?
posted by xammerboy at 7:01 AM on December 28, 2005

We should get a group of us nulliparas together to travel to Europe to get the newer, better IUDs. Seriously. Barring that, we should figure out what's happening with the Gynefix, which was submitted for FDA approval in 1999.

Other than that, I think your chances of convincing a doctor are higher if you go for the Mirena, which does have a small amount of hormone, but supposedly fewer side effects than the pill. It's also better tolerated than the copper IUD by women who haven't had kids yet.
posted by footnote at 7:07 AM on December 28, 2005

Also, I wonder if the copper IUD might be more tolerable if you stayed on the pill for a few months after insertion, since the pill reduces cramps?
posted by footnote at 7:09 AM on December 28, 2005

I wonder if the copper IUD might be more tolerable if you stayed on the pill for a few months after insertion, since the pill reduces cramps? - footnote

I hadn't thought of this - maybe it's something to ask your doc about?
posted by raedyn at 7:38 AM on December 28, 2005

A few comments: the hormone in Mirena is locally released, so only a very small amount gets into systemic circulation, so you shouldn't have much of an issue in terms of effects. Do keep in mind that Mirena is meant for staying in place for five years, while the copper-based one (can't recall the name right now) is for 10 years.

Sorry to hear you live someplace where the health care providers are reluctant to provide you with a _reversible_ form of birth control based on whether you've had children or not. I can understand having qualms based on ease of insertion (since a non-parous cervix is more difficult to insert an IUD through), but that shouldn't be a huge deal as far as I'm aware. The copper actually works partially by causing a local irritant effect, so unless you have a severe reaction to copper, I don't think it'd be an issue. Still, check with your gynecologist.

The family history of breast cancer all depends on the type of breast cancer it was -- pregnancy is actually "protective" against certain forms.

Overall, I think IUDs are an excellent form of birth control for women in committed, stable relationships. They're reversible, work _very_ well in terms of a low failure rate, and do not require you to remember to take something regularly, etc.

Note: while I am a health care provider, I do not regularly work with IUDs and reproductive issues. This is not medical advice, but information that I've gleaned through hearing about them. Any decisions you make should be in consultation with your physician.
posted by navsaria at 7:41 AM on December 28, 2005

Not that you're going for this, but to add to the discussion, a friend got a tubal ligation when she was 26 (!!!!!!) - she had to really shop around to a number of doctors before she could find one that would perform the surgery.

Now she's 30. She wants kids. Her family is waiting for her to start popping them out like her sisters do almost yearly. She can't tell them.

Now she and her husband are saving money for the reversal surgery - which isn't an absolute.

We friends don't want to say "I told you so" but it is an unfortunate situation.
posted by k8t at 9:19 AM on December 28, 2005

I can understand having qualms based on ease of insertion (since a non-parous cervix is more difficult to insert an IUD through), but that shouldn't be a huge deal as far as I'm aware.

It shouldn't be a huge deal unless it doesn't quite work. I have a close friend who finally convinced her ob/gyn to help her get an IUD (she had never been pregnant) and she eventually ended up driving two hours to Boston to have it done by someone with a great deal of experience in this. It was an awful, painful experience, and made worse by the fact that her IUD 'rejected' a few months later.

I'm not anti-IUD, and it would actually be my birth control of choice if we were using birth control, but just take the time to talk to your doctor about what things could go wrong and what the signs are of problems. When things go wrong with an IUD they can go seriously wrong.
posted by anastasiav at 9:45 AM on December 28, 2005

My experience with a copper IUD was that insertion HURT LIKE HELL. (I've not had children nor ever been preggers-supposedly it's not so bad if you have been.) It also made my periods much more crampy and painful (not that they were so pleasant before). I took an awful lot of Ibuprofen back then. Eventually the cramping was just too much to take, and I had it removed after about 3-4 years. That didn't hurt as much. I did like the convenience of it vis-a-vis spontaneous sex, though.
posted by scratch at 9:50 AM on December 28, 2005

If you're a man you can sometimes, how do I say, er, "feel" the IUD. But that could have just been a poor placement issue.
posted by iamck at 6:41 PM on December 28, 2005

you can sometimes [...] "feel" the IUD. But that could have just been a poor placement issue. - iamck

I am not a doctor , but I am a woman with an IUD. My doctor told me that my husband should not be able to feel the IUD and if he did, I should come in and have it checked because it might be a sign that I'm going to expell the device. YMMV.
posted by raedyn at 6:26 AM on December 29, 2005