A recent survey of 1600 women aged 18 to 50 found that most had inaccurate perceptions about the intrauterine device (IUD) that a doctor inserts for contraceptive purposes. Two clinical trials of 1169 child-bearing-age women reported the Mirena IUD protected 99 percent from getting pregnant. After IUD removal, 80 percent of women wanting to have a baby were able to conceive within a year. Yet some people still believe misconceptions about IUD safety, how it works and when it’s appropriate.
To get up-to-date on this long-acting reversible contraceptive (LARC), review IUD history and the current small T-shaped types available today. Then discover how the Association of Reproductive Health Professionals and the World Health Organization are replacing falsehoods with proven facts.
IUD Origins and Advancements
The IUD dates back to the early 1900s when it crossed both the vagina and the uterus. Dr. Richter of Germany developed the first IUD from silkworm gut. Another German physician, Dr. Gräfenberg, created the first ring IUD, Gräfenberg’s Ring, from silver filaments. He moved to the United States, where colleagues Dr. Hall and Dr. Stone created the stainless steel Hall-Stone Ring after his death. Japanese physician Dr. Ota developed the silver or gold Precea or Pressure Ring.
IUD use increased in the United States in the late 1950s, thanks to Dr. Jack Lippes. He used thermoplastics, so IUDs could bend for insertion and then return to their original shapes. Lippes also added the monofilament nylon string to facilitate IUD removal. His trapezoid-shaped Lippes Loop IUD was one of the most popular first-generation models. Many other plastic IUD shapes followed.
During the 1960s, U.S. physician Dr. Howard Tatum determined a capital T IUD design matched the uterus’ contracted shape. He and Chilean doctor Jaime Zipper discovered that copper was an effective spermicide. They developed the first T-shaped copper IUD. Tatum’s improvements led to the creation of the ParaGard IUD.
In Chicago, Ill., Dr. Antonio Scommenga discovered that administering progesterone inside the uterus provided contraceptive benefits. Finnish doctor Tapani J.V. Luukkainen produced the Progestasert System, the first T-shaped hormone-releasing IUD. Providing one year of use, it was available until 2001. Luukkainen’s subsequent Mirena IUD, which released levonorgestrel instead of progesterone into the uterus slowly over a five-year period, became available in 1976.
Currently Available IUDs
Copper IUD. ParaGard that contains no hormones provides continuous birth control for at least 10 years.
Hormone IUDs. Two brands contain levonorgestrel, the same progestin hormone in many birth control pills. Mirena is effective for at least five years. Skyla can stay in place for at least three years.
Are You Clear on IUD Safety?
Rumor: Be wary. IUD use can lead to infections and infertility.
Truth: Multiple studies on thousands of women worldwide show using an IUD for birth control doesn’t increase your risk of pelvic infection or lower your chances of conceiving when you’re ready. But if you don’t seek treatment for sexually transmitted infections (STIs), they can scar your fallopian tubes and prevent pregnancy.
Myth: IUDs cause ectopic pregnancies.
Fact: An IUD doesn’t increase your risk of having an ectopic pregnancy, which is when a fertilized egg grows somewhere outside the uterus, usually in a fallopian tube. A study found that women with copper IUDs have a 91 percent lower chance of ectopic pregnancies than those using no contraception.
Misconception: Health alert: IUDs trigger cancer.
Actuality: No scientific evidence links IUDs to cancer. Instead, research found that they minimize endometrial and cervical cancer risks.
Gossip: Your IUD can leave your uterus and travel to organs including your heart and brain.
Reality: Physiologically, the vagina is the only exit route for the IUD.
Do You Understand How IUDs Work?
Myth: By preventing fertilized eggs from implanting in your uterine wall, IUDs cause abortions.
Fact: Research shows ParaGard, Mirena and Skyla IUDs prevent pregnancy by not allowing a woman’s egg and a man’s sperm to meet. ParaGard’s copper ions repel sperm, which prevents fertilization. Mirena and Skyla release a hormone that thickens cervical mucus and thins the endometrium so sperm can’t enter the uterus to fertilize an egg. Conception can’t occur without fertilization.
Rumor: Copper or hormones need to build up in your uterus before your IUD becomes effective.
Truth: Each IUD’s contraceptive action begins as soon as your doctor places the device in your uterus, and it stops immediately after removal.
Can You Determine When IUDs Are Appropriate?
Misconception: If you haven’t had children, you can’t use an IUD.
Actuality: You may use an IUD whether or not you’ve given birth.
Gossip: You must pick another contraceptive if you’ve had an ectopic pregnancy.
Reality: A previous ectopic pregnancy doesn’t preclude you from using an IUD. Studies show it may lower your chances of having another one.
Myth: Immediate IUD removal always is necessary if you develop an STI or pelvic inflammatory disease (PID).
Truth: Contracting an STI or PID is unrelated to IUD use. But seeking antibiotic treatment right away is vital. You may keep your IUD in place if your symptoms improve after three days. If they don’t get better after that time, your doctor may advise removing your IUD.
Trust the Truth
Quit believing these and other IUD falsehoods that you hear through the rumor mill. Reject unsubstantiated inaccuracies and out-of-date information. When choosing a birth control method, trusting current scientific evidence can help you make a well-informed decision.