IUD: Is the Health Risk worth the Benefits?
In good old THK fashion, today we are going to dive straight into the controversial topic of sexual health. With the overwhelming response to my birth control post, I have received an even more staggering amount of questions on what to use as a replacement. While each and every women’s journey is unique, it seems as though the most interest has lied in the IUD, also known as an intrauterine device, because really, do people actually use diaphragms anymore? Therefore, I put on my Nancy Drew shoes and got digging.
The following is an overview of the health risks and benefits of the IUD, so that you as a powerful, kick-ass woman can take control of your health and make the best, and informed, decision for YOU. So let’s get started with the basics…
What is an IUD?
An IUD is a tiny, T-shaped polyethylene device that is wrapped in copper, or contains hormones. It inserted by a doctor directly into the uterus without sedation or anesthesia although some women may feel faint, nauseated or dizzy for a few minutes during, or immediately after, placement. IUDs can be removed either at the end of its life-span or sooner if the patient wishes to discontinue contraception. The cost of an IUD typically ranges from $500 to $1,500.
There are two types of IUDs available for you to choose from:
- ParaGuard: a copper IUD that is effective for 12 years unless removed
- Mirena: a hormonal IUD that releases levonorgestrel a synthetic progestin and is effective for 5 years unless removed
For removal of IUD the doctor applies gentle traction on the threads of IUD extending outside the cervix, in which the arms of the IUD folds upward and the device slides out of uterine cavity.
How does it Work?
Since the copper IUD and hormone IUD work differently, let’s examine each separately.
ParaGuard Copper IUD: it works primarily by preventing the sperm from reaching and fertilizing the egg. If sperm cannot join with an egg, pregnancy cannot happen. This sterile foreign body reacts with the uterus causing biochemical and cellular changes that may be toxic to the sperm. Secondly, copper is released in the uterus, which acts as a spermicidal or cytotoxin (a substance toxic to cells).
Mirena Hormone IUD: it works by releasing small amounts of levonorgestrel, a progestin hormone found in many birth control pills, locally into your uterus at a slow and steady rate. Mirena may stop the release of your egg from your ovary, but this is not the way it works in most cases. In addition, it MAY:
- Thicken cervical mucus to prevent sperm from entering your uterus
- Inhibit sperm from reaching or fertilizing your egg
- Make the lining of your uterus thin; endometrial suppression, decreased thickness and secretions
How effective is it?
The IUD is 99.8% effective against pregnancy, but it does not protect against sexually transmitted diseases. With perfect use (in which the user checks the strings regularly to detect expulsion), the probability of pregnancy in the first year is 0.6%; with typical use, the first-year pregnancy rate is 0.5 to 0.8%. After prolonged continuous use, the cumulative pregnancy rate is 1.6% at seven years, and 2.2% at 8 to 12 years. Overall, the failure rate is substantially less than one per 100 women per year, except in women under age 25 who experience a slightly higher failure rate, most likely because they are more fertile than older women.
What are the Contraindications?
The following is a list of contraindications for the use of an IUD:
- Uterus distortion
- Active pelvic infection
- Known or suspected pregnancy
- Wilson’s disease or copper allergy
- Undiagnosed abnormal uterine bleeding
- Current or previous breast cancer
- Dysmenorrhea or menorrhagia (for copper IUD only)
- Have a bleeding disorder or take blood thinners
- Have had a STD
The Benefits of the IUD
- Provides flexible birth control that you do not have to take everyday
- *May reduce heavy periods
- Extremely effective at preventing pregnancy
- Long term contraception
- May reduce the risk of endometrial cancer
* hormonal IUD
The Health Risks and Side Effects of the IUD
- Pelvic Inflammatory Disease – a bacterial infection (bacteria can be from a STD or from a bacteria naturally occurring in the vagina) that may cause infertility, ectopic pregnancy or constant pelvic pain. In serious cases a hysterectomy is needed.
- May cause ovarian cysts which may go away on their own or may need to be surgically removed.
- Sepsis – in rare cases sepsis, a life-threatening infection may occur.
- Embedment – this is when the IUD attaches to the uterine wall. Surgery may be needed for removal.
- Perforation – the IUD may go through the uterine wall. This may cause scarring, infection or damage to other organs.
- Ectopic pregnancy – this is where the fertilized egg implants on the fallopian tubes when the IUD fails.
- Expulsion – about 10 out of 100 IUDs are pushed out (expelled). This requires frequent checking of the device to ensure its placement and therefore protection from pregnancy.
Mirena Hormonal IUD Specific Risks/Side Effects:
- Irregular bleeding or periods, or absence of period
Vaginal dryness, flushing, headache, nausea and acne
- Weight change, hirsutism (male pattern hair growth), mood changes, skin discoloration and breast tenderness
- Decreased sex drive and ability to orgasm
- Lower back pain
- Arthritic type pain in the legs and joints
- Vaginal odor
- Hair loss
- Chest pain
- Panic attacks
ParaGuard Copper IUD Specific Risks/Side Effects:
- Heavier periods (50% increase in blood loss) – anemia risk
- Increase in menstrual cramps
- Discomfort/pain during intercourse
- Extended PMS
- May cause weight gain, acne and breast tenderness
Copper Toxicity and the ParaGaurd IUD
While this is a very controversial topic, as western medicine claims that the copper exposure from the IUD is innocuous, there has been accounts of copper toxicity from IUD use. The risk is most likely determined by your overall exposure since copper also occurs in copper plumbing, beer, swimming pools, cookware, inorganic mineral supplements, and dental crowns. In addition, copper is naturally found in a variety of foods.
While copper is an essential element need by all tissues of the body, in excess it can result in problems such as bone/joint and connective tissue disturbances, cardiovascular degeneration, abnormal electrocardiogram, accelerated aging, depigmentation and dermititis, anemia and neurologic impairment. Proper balance of copper with zinc is also necessary, since an imbalance influences cardiovascular and immune function. Finally, copper in excess happens to be among the most powerful producers of free radicals, chemically reactive particles that lead to cell death.
Other ways copper interacts in the body:
- lowers iron and zinc
- increases vitamin A
- can aggravate B vitamin metabolism
- copper cause an increase estrogen levels and vice versa
* for more information about copper toxicity, please go HERE.
The Bottom Line
The bottom line seems to be that you have a chance of having a relatively good experience with an IUD, but there is always a risk of side effects. In addition, even small changes in our hormone balance can lead to symptoms, which unfortunately are oftentimes not attributed to the IUD. As for the copper IUD, the leaching of the copper into the body system can cause imbalances that are very hard to link back to the IUD, therefore, setting yourself up for problems that go undetected.
But, hands down the one thing that makes me the MOST weary about the IUD, is that fact that all the research and articles from credible universities and doctors, not to mention the websites for the devices themselves, all state that they are not exactly sure WHY the IUD prevents pregnancy. Like I mentioned before, on the Mirena website under “How does it work?” it states “Mirena may stop the release of your egg from your ovary, but this is not the way it works in most cases. Most likely, these actions work together to prevent pregnancy.” If there is not clear understanding of how the device works, how can they be certain of its safety?
As for my personal choice, after having such a terrible experience with birth control pills, symptoms of which I am still trying to completely iron out, I have no desire to take any risks with either hormones or toxicity. I am at the stage in my health journey of trying to completely eliminate my toxic load while finding the perfect hormones balance, which just does not seem to jive with an IUD. But in the end, everyone has to make a decision that best suits their lifestyle and health goals, whether that is with or without an IUD.
If you have had any experience with an IUD, we would love to hear it. Please share your story below.
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Stanford University: “Teens advised to consider benefits of IUD use for birth control” http://med.stanford.edu/ism/2010/june/iud-0621.html
Textbook of Natural Medicine. Pizzorno and Murray.
Mirena Side Effects: http://www.steadyhealth.com/Mirena_IUD_Side_Effects_t133005.html?page=15
“Not Your Mother’s IUD: Benefits and Risks of Modern IUDs” Women’s Health Activist Newsletter
American College of Obstetricians and Gynecologists http://www.medicalnewstoday.com/releases/106614.php
Women’s Health and Education Center http://www.health.com/health/article/0,,20412230,00.html
World Health Organization Long-term safety and effectiveness of copper-releasing intrauterine devices: a case-study
Centers for Disease Control and Prevention (CDC) Update on intrauterine devices (IUD) and pelvic infection
National Institutes of Health (NIH) Contraception
World contraceptive use 2001. United Nations Population Division, Department of Economic and Social Affairs, New York, 2002