It’s Time To Give IUDs Another Look
Research and Innovations For decades, the birth control pill has been the go-to choice for a majority of Canadian women looking to prevent unwanted pregnancy or manage their periods.
While this fact comes as no surprise to most, what is astonishing is the pill’s continued popularity given the existence of an option that is more effective and cheaper, and requires little more than a visit to the doctor every three to five years.
The intrauterine device (IUD) is a tiny object that contains copper or levonorgestrel (a hormone) that is inserted into the uterus by a doctor. It’s a long-acting, reversible contraception method that’s widely held among gynecologists and family planning experts to be one of the most successful forms of birth control available. “Using an IUD is as effective as having your tubes tied,” says Dr. Dustin Costescu Assistant Professor and Family Planning Specialist in the Department of Obstetrics and Gynecology at McMaster.
“The real world failure rate of an IUD is two percent, whereas the birth control pill is nine percent. Though the pill remains the most common contraceptive method, if pregnancy prevention is the top priority, women should be thinking about an IUD.”
“Using an IUD is as effective as having your tubes tied.”
OBGYN Dr. Amanda Black is also a proponent of IUDs. “It’s a highly effective and easy method that can be used by women of all ages.” Because a hormonal IUD can last anywhere between three to five years (non-hormonal copper devices can last even longer), one of the main benefits is that, unlike many forms of contraception, the IUD isn’t reliant on the woman using it to work.
“It’s a very forgettable method of birth control,” explains Dr. Black. “Once inserted, you can just forget about it. You don’t have to take a pill every day or go for an injection every month.”
Hormone releasing IUDs
Furthermore, IUDs that release hormones (as compared to the copper ones which do not) are not only effective at preventing pregnancy; they also help women successfully manage negative aspects of their menstrual cycle.
For example, they can decrease cramps and bleeding in woman with heavy periods. Dr.Black also points out that IUDs have the long-term benefit of prohibiting the lining of the uterine from getting too thick, which decreases the risk of getting endometria hyperplasia or endometrial cancer. Dr. Costecsu adds that, because they don’t contain estrogen, they don’t increase the chance of a heart attack, stroke or blood clots.
Given their manifold benefits, why are IUDs so underused by Canadian women? Dr. Costecsu believes one of the main reasons is simply a lack of role models: “Women are more likely to use methods their friends or family have used. Younger women don’t have a frame of reference because their moms or friends didn’t use them.”
Dispelling the myths
Unfortunately, there’s also a great deal of confusion among health care providers about the safety of IUDs. “A major misconception among physicians is that IUDs can increase the risk of infections and infertility. However, the risk of infections is very low and can be managed with general antibiotics.
Studies also show they don’t cause infertility, in fact, fertility returns very quickly once the device is removed,” says Dr. Costescu. He also notes that many doctors and nurses believe that only women who’ve had children can use an IUD, “…when in fact women who haven’t had children can very safely use intrauterine devices.”
“People and physicians are starting to get the message but there’s a way to go yet,” explains Dr. Black. “IUDs are often presented to patients as a second or third choice. But IUDs should be considered a first-line option in birth control—only then can women make an informed decision about what’s best for them as individuals.”