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Everything You Need to Know About IUDs

Safe sex should be every young person’s first thought when deciding to get physical with someone, whether you’re hooking up with someone that you met two hours ago at party (hey, no shame), or are about to christen your new bed with your boyfriend of three years. For us ladies who enjoy being intimate with guys, the nuances of birth control methods and possibility (even if seemingly incomprehensible) of pregnancy are frequently at the forefront of our minds. About a year ago, while scrolling through Eileen Kelly‘s super incredible blog Killer and a Sweet Thang, which centers around love, sex, heartbreak, and other very real topics from which the 21st century youth culture is composed, I stumbled upon an article where Eileen explained her experience with a birth control method that was completely foreign to me: IUDs, or Intra-Uterine Devices. With some quick follow-up research on IUDs , I found that for young people, they are the most effective birth control method currently available, with an impressive 99.9% success rate and no risk of human error. The ease and reliability of IUDs quickly captured my amazement, and I felt an urge to spread the word to anyone else seeking a fool-proof birth control method. So ladies, without further ado, here’s 10 things you have to know about IUDs:

  1. What even is an IUD?

Intra-Uterine Devices are little (less than 1.5 inches long), “T” shaped plastic devices that are inserted into a woman’s uterus by professional doctors or nurses. IUDs are currently available in the U.S. in two different variations–one is covered in copper (brand name ParaGard), and the others (Skyla, Mirena, Liletta) use the synthetic hormone levonorgestrel, a type of progestin. Still, their success rate in preventing unwanted pregnancies remains the same across the board. IUDs are among the most effective long-term birth control methods, a title they owe to largely to their impressive lack of maintenance. Once they’re successfully inserted, there’s virtually nothing you have to do to maintain them except ensure from time to time that they’re still intact.

2. How does it work?

IUDs work by preventing sperm from fertilizing an egg. The copper IUD does so by releasing copper into the uterus, which acts as a spermicide (substance that kills sperm). The hormonal IUD works by releasing the progestin hormone into the uterus, which thickens cervical mucus and prevents sperm from reaching an egg.

3. How long does it last?

 This is one of the most promising, impressive things about the IUD: the hormonal IUDs (Skyla, Mirena, and Liletta) last between 3-6 years, and the copper IUD (ParaGard) lasts up to 12 years. Because of this longevity, women who choose to use IUDs as their form of birth control are freed from the constant worry of remembering to take birth control pills or fretting with partners about condom use.
    4. What if I don’t want it for that long? Can I get it removed?
Yes! IUDs are 100% reversible, meaning that you can choose to have it removed at any time. Like the insertion procedure, the removal process is to be done by a professional doctor or nurse. Seriously, don’t try this at home, it could do serious damage. Besides, IUD removal is generally easier, faster, and less painful than insertion. Also, it’s important to remember that you do not need to have your IUD removed/switched if you start having sex with a new partner. This is a myth.
   5. What is the insertion process like?
After your doctor explains the procedure to you and answers any questions you may have (if you have any questions/concerns, tell your doctor! they are there to help you, and having concerns addressed can help you relax, which will make the insertion less painful), the first thing you should expect is a bimanual examination, the process where your doctor or nurse inserts two fingers into the vagina and places the other hand on the abdomen to feel internal pelvic organs. This allows your doctor to precisely determine the position, size, and mobility of your uterus and detect any possible complications. After this, you can expect your doctor/nurse to hold the vagina open with a speculum (medical device that resembles a duck beak), and proceed to cleanse the cervix and front and back recesses of the vagina with an antiseptic solution. This is done to prevent the risk of infection. Some doctors will then apply a local anesthesia to minimize discomfort–if you feel like you need this, ask! Next, a tenaculum (slender instrument used to steady the cervix) will be used in order to stabilize/steady the cervix. Then, your doctor will insert an instrument called a sound into the vagina to measure the length and direction of the uterus and cervical canal. By doing this, the risk of a perforated uterus–having the IUD puncture through it–is minimized. Finally, your doctor will remove the sound, prepare the IUD for insertion by removing any packaging and bending its arms, and then insert a tube that contains the IUD into the vagina. The IUD will then be carefully pushed into the correct placement, which was determined by the sound, by a plunger inside of the tube (once completely pushed in, the IUD will assume its “T” shape). Once the instruments are removed, the IUD will be steady in place. IUDs have strings attached to them, which will be left intact. They’re long enough to hang 1-2 inches out of the cervix, but not so long that you’ll physically be able to see them hanging from your vagina. However, the strings can be felt by inserting a finger into a vagina, which is how you can check if your IUD is still intact. Your doctor will show you how to do this. I know this seems complicated as hell, but don’t sweat. The whole procedure only lasts a few minutes.
      6. Does it hurt when it’s inserted? 
Many women do experience some discomfort. A pinching, period-cramp like feeling is what most women who have undergone IUD insertion report, but any pain during the insertion typically lasts no more than a minute. Your doctor will likely instruct you to take Ibuprofen before the procedure, and you may want to keep it handy, along with some pads, because cramp-like feelings and spotting can happen throughout the rest of the procedure day. All in all, don’t psych yourself out. Less than 5 percent of women have experienced moderate to severe pain during IUD insertion. I mean, come on. A minute of pain for potentially over a decade of not having to freak out about birth control? Pssh, we’re women. Ain’t nobody stronger than us.
     7. Will I be able to feel it?
Nope! Neither you nor your partner should be able to feel the actual IUD inside of you (you should, like previously mentioned, be able to feel the strings). If you do, call your doctor–your IUD could be out of place.
    8. I’m a teenager. Can I still get an IUD?
Yes, yes, yes! IUDs are completely safe for healthy teenage girls, and as a long-term birth control method they’re even more ideal for younger people. However, if you’re under 18, be aware that different states have different rules about whether or not you’ll need parental consent. Ask your doctor or local Planned Parenthood clinic for this information. If you’re 18 or older, parental permission is not required.
   9. How much does it cost?
If you and your family have insurance, it’s likely that you won’t have to pay anything out of pocket for your IUD. Without insurance, the cost range for IUDs is typically between $500-$900. If you don’t have insurance but still want an IUD, there are programs in place to help you. If your income meets qualifications, you may be able to get an IUD at a reduced price at a low-income clinic. ParaGard, the brand for copper IUDs, has a system where you’re able to pay for your IUD in increments of 4 or 12 monthly payments. Bayer, the company that produces a selection of hormonal IUDs, has a program in which a number of low-income women can qualify for a completely free IUD. Check here to see if you qualify.
    10. Do IUDs protect against STDs? Does this mean I never have to use condoms again?
No and no. IUDs only prevent pregnancy, meaning that if you have unprotected sex with an IUD you are still 100% able to contract an STD/STI. Unless you know for a fact that your sexual partner has been tested and is clean, you should still use condoms to prevent against STDs/STIs.
If you think long-term birth control might be for you, I highly recommend considering an IUD. There’s a reason they have the highest satisfaction rate out of all reversible birth control options! Whatever you decide, always remember to stay safe, stay educated, and communicate with your partner and doctor when it comes to the world of birth control methods.

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Isami McCowan
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Isami is a teenager from North Carolina. She is an author, aspiring English major, social justice activist, and grilled cheese connoisseur.

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