Vim & Vigor - Summer 2021 - 38

Fact or Fiction

THE TRUTH ABOUT

IUDs ARE HIGHLY EFFECTIVE FOR
BIRTH CONTROL. WE CLARIFY THE
CONTRACEPTION MISCONCEPTIONS
BY SHELLEY FLANNERY
Modern intrauterine
devices (IUDs)-longacting contraceptives
that are placed in the uterus to
prevent pregnancy-have proved
to be safe, effective and convenient.
Reproductive health expert Sophia
Yen, MD, often advises her patients
seeking contraception to use IUDs.
" Generally, I recommend the IUD
with hormone as a first-line birth
control, " she says.
Despite its advantages, only about
8 percent of U.S. women of reproductive age opted for the IUD in
2019, according to United Nations
data, compared with 14 percent of
women who relied on the birth control pill and another 14 percent who
used female sterilization, a permanent surgical procedure. (About 6 in
10 women of reproductive age use
some form of contraception.)
The low use of IUDs might be
because they are subject to popular
misconceptions. Here, we clear
them up.

You can get an IUD only
if you've been pregnant.

FICTION. Most women of childbearing age, regardless of reproductive history, are candidates for

IUD use. Women who have not
previously been pregnant have a
slightly higher risk of IUD expulsion (the IUD coming out) than
women who have given birth, Yen
says. But because the average IUD
expulsion rate is low (2 to 10 percent over three years), Yen says the
possibility shouldn't deter you from
choosing an IUD if you've never
been pregnant.

IUD placement can
be painful.

FACT. Modern IUDs are made
of plastic as thin as a toothpick.
They are inserted into the uterus
through a small catheter (flexible tube). Once the catheter is in
place, your provider releases the
IUD, which causes it to open up
like an umbrella into a T shape.
Because your provider must
open your cervix to access your
uterus, you may experience pain
or discomfort.
But there are steps you can take
to reduce the pain: Schedule your
appointment for day three or four
of your period, when the bleeding
has subsided but your cervix is still
open, Yen says. Take ibuprofen an
hour before IUD placement. Ask

IUDs for Cancer
Treatment, Too

" We use IUDs for birth control,
but we also use them to treat
and even prevent cancer, " says
Kari Ring, MD, a UVA Health
doctor who specializes in gynecologic cancers.
Surgery remains the standard treatment for early-stage
endometrial cancer, which is on
the rise along with the obesity
epidemic. But the intrauterine
device is an option for women
who want to retain their fertility
or are not well enough to safely
undergo surgery.
Dr. Ring places IUDs in women
not just who have precancer or
early-stage cancer of the uterus
but also who have a high risk for
uterine cancer due to obesity,
polycystic ovarian syndrome or
Lynch syndrome.
By confining the released
hormone to the uterus, Dr.
Ring explains, an IUD doesn't
have the negative side effects
of weight gain and higher
risk of blood clots associated
with the pill form of the hormone progesterone.

IUD and Cancer
Research Study

ILLUSTRATION BY GERALDINE SY/GOODILLUSTRATION.COM

Intrauterine
Devices

Kari Ring, MD, is overseeing a
clinical trial to learn if combining a certain type of intrauterine device with a biologic
drug is more effective than
an IUD alone at treating precancer and early-stage cancer
of the uterus. Learn more at
uvahealth.com/iud-trial.

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http://www.uvahealth.com/iud-trial

Vim & Vigor - Summer 2021

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