IUDs: We’ve Come a Long Way, Baby

IUDRemember the Dalkon Shield? Use the phrase “Dalkon Shield” and you conjure up all kinds of horror stories regarding the intrauterine device (IUD). Times have changed, and so has the IUD.

There are two types of IUDs available now, and both are considered very safe to use. Both IUDs are small, T-shaped, flexible plastic devices with threads at the end that are inserted into the uterus through the cervix by a health care professional.

The Mirena IUD is a hormonal device and the Paragard is a copper IUD. The Mirena IUD releases a small amount of progestin, which thickens cervical mucus, on a regular schedule and works by preventing sperm from joining an egg. This device is considered 99.8% effective in preventing pregnancy.

The copper IUD (Paragard) contains no hormones and also works by preventing sperm from joining an egg. Paragard is soft, flexible plastic, with copper wrapped around the ends of the T bar and the base of the T. This device is considered 99.2% effective.

Mirena lasts five years. It is effective and undetectable during sexual intercourse. Progestin may reduce cramps and make periods lighter. After insertion, you may have a few days of mild cramping or a backache. Regular pain relievers can solve this. For the first 3 to 6 months, there may be spotting between periods and/or irregular periods.

Paragard is long-lasting (anywhere from 2 to 10 years), highly effective, and completely undetectable during intercourse. The copper IUD does not affect your natural hormonal levels.

Mirena is recommended for women who have had at least one child, and most of the medical research for FDA approval was conducted on women with at least one child. Paragard has been around approximately 20 years and can be used by women who have not had any children.

You should see your health care provider once in the first 4 to 12 weeks after insertion of either Mirena or Paragard to check the position of the device. After that, see your provider once a year for a regular exam, during which the device can be checked.

For the first 3 to 6 months after Mirena’s insertion, a woman’s period may become irregular. She may have frequent spotting or light bleeding. A few women have heavy bleeding during this time. After the body adjusts, periods may stop altogether. Periods will return when Mirena is removed.

After the insertion of Paragard, a woman may have heavier and longer periods than normal for a few months. Some women have spotting between periods. For most women, this subsides after a few months. Do not use Paragard if you have Wilson’s Disease. This is an inherited disease that blocks the body’s ability to get rid of copper.

Your health care provider should show you how to check the string ends of the device (which should be done once every month).

• Wash your hands and then either sit or squat down.
• Insert your index or middle finger into the vagina until you feel the cervix. The cervix feels firm and rubbery, somewhat like the tip of your nose.
• Feel for the string ends that should be coming through. If they feel longer or shorter than before, or if you feel the hard part of the IUD against the cervix, the IUD has moved. Contact your health care provider to have the device reinserted. Do not try to reinsert the device yourself.

It is very important to pay attention to symptoms after starting the IUD. Tell your health care provider immediately if you:

• find the length of the string ends to be shorter or longer than they were at first when you feel them with your fingers. You should be checking this at least once a month.
• are not able to feel the string ends when you check.
• feel the hard plastic bottom of the T part of the IUD against the cervix when you check.
• think you might be pregnant.
• have periods that are longer or heavier than normal.
• have severe abdominal pain, cramping or tenderness.
• have pain or bleeding during sex.
• have unexplained fever and/or chills.
• have flu-like symptoms, such as muscle aches or tiredness.
• have unusual vaginal discharge.
• have a missed or unusually light period.
• have unexplained vaginal bleeding.

For more information about the IUD, visit Planned Parenthood’s website. If you feel like Paragard is the right choice for you, Planned Parenthood is offering special pricing for Paragard insertion right now. Invest in yourself, and take advantage of the reduced rates.

5 thoughts on “IUDs: We’ve Come a Long Way, Baby

  1. Marianne, you did a good job of comparing the two different types of IUDs. It surprises me how popular the IUD is these days – I know so many women who have one and love it. But it does make a lot of sense – you don’t have to remember to take a pill every day.

  2. Isn’t it Dalkon Shield?

    Also, can you link me to prescribing info that says ParaGard is only good for 2 years? I know that some other types of IUDs (not currently available in the US) have shorter lifespans, but everything I’ve read about the ParaGard says it’s approved for 10 years of use.

  3. Tori, thanks for correcting that typo – we had corrected the spelling while the article was still in draft, but apparently this is just one of those random WordPress flukes.

    I terms of the length of time you can have Paragard, Marianne’s article says 2-10 years. The link at the bottom of the article that references the special pricing has some info about how long you can have the IUD. And on Paragard’s website, they also say 2 years to 10 years – depending on the patient’s preference.

    I hope that helps! 🙂

  4. When I first was fitted by planned parenthood with a dalkon shield in the early 1970’s, I quickly developed chronic painful bleeding and a pelvic infection that eventually led to a hysterectomy. The pelvic infection was ferocious.
    How could planned parenthood give me this horrific device? The experience has made me doubt their stated motives, “to help women.” This thing almost killed me and marred my young marriage forever.

    • Ursula,

      Here is the response we received from Dr. Vanessa Cullins, Planned Parenthood Federation of America’s vice president for external medical affairs, who has expertise as a physician during the brief time the Dalkon Shield was on the market:

      In the 1960s and 1970s testing for safety of IUDs was not as strenuous as it has become since the Dalkon Shield debacle. The Dalkon Shield was a bad IUD, but providers in the private sector and public sector did not know this. Modern IUDs are very safe and effective based upon extensive testing for safety and data from extensive use worldwide. I regret that you underwent such a tragic experience with the Dalkon Shield. Vanessa

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