Why IUDs Aren’t as Popular in the U.S. Despite Being 99% Effective

Why IUDs Aren’t as Popular in the U.S. Despite Being 99% Effective

The IUD—Intrauterine Device—as a form of birth control is gaining in popularity among American woman, though still underrepresented among forms of birth control, with less than ten percent of women using one. More effective than the pill, condoms, or a diaphragm, and certainly more effective than the pullout method, the IUD is almost as effective as sterilization at a whopping 99% effectiveness.

Originally, IUDs were meant for married women who no longer wanted to have children. Now, however, doctors are increasingly suggesting them for younger women who want more assurance and control over their contraception.


What’s an IUD?

There are two kinds of IUDs: one uses localized hormones and the other is copper. The three hormonal IUDs are Liletta (lasts three years), Mirena (five years) and Skyla (three years). ParaGuard (10 years) does not use hormones. Off the bat, the longevity of an IUD and not having to worry about taking a pill or staying on top of your contraception are the major benefits to choosing an IUD.

The hormonal IUDs thin uterine lining to create a bad environment for sperm—it has nowhere to land. They work by releasing low dosages of progestin and often cause women’s periods to be lighter or stop altogether. Read: no period. The best part is that no one quite understands why IUDs work: “If you stick a poker-chip-sized bit of plastic in there, the body reacts the way it does to any foreign object, releasing white blood cells to chase after the invader. Once those white blood cells are set free in the uterus, they start killing foreign cells with efficient zeal. And sperm, it turns out, are very, very foreign. White blood cells scavenge them mercilessly, preventing pregnancy.”

The copper IUD, in this case ParaGuard, affects your immune system to ward off pregnancy. It often causes women to experience heavier periods, but it is hormone-free. It can also remain in the body longer.

The price tag shouldn’t be a concern because it is often completely covered by insurance. In fact, most insurance companies will cover the implantation appointment as well as the device because in the long run, an IUD is cheaper all around than various forms of oral contraception. Consider the monthly co-pays for your oral prescription (not to mention the hassle of refilling it and picking it up) compared to no cost for three to 10 years of an IUD.


What Are IUDs Like in Everyday Life?

An IUD is T shaped and is inserted into your uterus. This hurts. But it’s worth it. The

Your partner cannot feel it unless s/he really reaches and knows what to feel for. The string that allows you to self-monitor the placement of the IUD is flexible and feels like stiff floss. It doesn’t cause you or your partner discomfort, and should be checked out if it does.

In the case of any IUD, it does not cause infertility. They can be taken out early if you decide you want to get pregnant, with absolutely no side effects.


Why Are Some Women Cautious of IUDs?

The Guttmacher Institute shows that the USA trails other developed countries in usage of the IUD. The IUD gets a bad rap from older generations because of some pretty nasty incidences that went down in the 1970s.

When first introduced, IUDs were wildly popular, but the Dalkon Shield was not properly vetted and led to pelvic inflammatory disease (PID), infertility, and several deaths. The original IUD made women more vulnerable to infections in their uterus: the makers of Dalkon Shield did not test for safety and effectiveness in the way IUDs are now tested. Many doctors still do not suggest IUDs as contraceptive because of concerns from the 1970s and outdated information about their effectiveness.

Only recently has new information about the safety and effectiveness of today’s IUDs come out. Because of the failure and flawed design of the Dalkon Shield, new IUDs have routinely been questioned, but the conclusion is that hormonal and copper IUDs are safe.


All in all, it is your evaluation of cost, ease, comfort, and side effects that should determine your choice in contraceptives. However, oral pills and condoms are not your only option. IUDs offer long-term, easy, and stealthy control over your body, your menstruation, and your contraception.


Cover image courtesy of Shutterstock.