Healthy Living

Saturday, November 7, 2009

I-U-Don't? I-U-Do!

Hi Dr. Kate!

I can't take hormonal birth control; I've had terrible side effects and I just don't like it! My question is; what is the best non-hormonal option? My doctor will not give me an IUD because I've never been pregnant. How effective is coupling condoms with a diaphragm or the sponge? I've read that The Sponge increases the risk of contracting HIV, but I've been with the same guy my entire life, so I don't think this is too much of a concern for me. Thanks!

No Pills for Me!

Dear No Pills,

My first thought is...find a different doctor! There's no reason that you shouldn't be able to get an IUD before a baby, that's outdated thinking. And a copper IUD will give you 99+% effectiveness for up to 10 years, so it's hands-down the best non-hormonal option. Condoms plus a diaphragm should get you over 90% effectiveness, especially if you use spermicide with the diaphragm (available as creams, suppositories or film). And condoms plus the sponge should be about that good as well.

The sponge - like other spermicides - may increase your HIV risk if you're having intercourse, and using the product, multiple times a day, every day. (The studies that showed us this were conducted in sex workers in Africa.) Since this isn't the sex pattern of most people in the world, spermicides are still a good option, when used in conjunction with a barrier method (condoms, diaphragm) for greater effectiveness.

But my guesstimates on effectiveness are based on PERFECT use - using both products, every time, with no spillage. And that can be tough to do, long-term. I'd still think about seeing another gyno to get the IUD, then going back to your guy for your check-ups, especially if you know you don't want to be pregnant for awhile.

Have you been told you couldn't get an IUD? What was the reason?



[photo credit: Getty Images]
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From the Community…

Comments 1-10 of 29
  • Pyra's Avatar
    Posted by Pyra Mon Jul 6, 2009 10:28am PDT

    My doctor mentioned I could get an IUD after having my first child so there are many doctors that still think that way.

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  • Queen Trixie's Avatar
    Posted by Queen Trixie Mon Jul 6, 2009 11:31am PDT

    I had the same issue as "No pills for me" ... one pill made me crazy, one made me gain weight and I barely had a cycle, the third I had random spotting. I'd used the diaphram but had an alergic reaction to a certain spermicide and from then on was very sensitive to it all together. My doctor and I discussed it and both agreed that the copper IUD was the best choice. I've never had children and that was not a concern for him in the least. I had it inserted 2 months ago and am completely satisfied with my decision. I'd seriously consider changing doctors this case.

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  • mshizzy's Avatar
    Posted by mshizzy Mon Jul 6, 2009 1:15pm PDT

    I can understand why most doctors won't give a woman an IUD before she's had at least one child because there are several women who are rendered sterile from using IUD's. I know personally and have heard of nearly 15 women so far who have never had a child and now cannot because of using the IUD; its about double that for women who have had one or more children. I'm not saying this to paint the IUD in a bad light, are a lot of what we call "IUD Babies" in and around my community as well. Still knowing what I don't from using both personal and professional information and advice I got the copper ParaGard after I had my first child because I can't take hormonal birth control, I don't want more children right now, I'm allergic to most condoms and condoms are unreliable. So as outdated as it may seem for a doctor to not want to risk a woman's fertility with an IUD you have to respect the fact that the doctor is trying to look out for your best interest because sometimes infertility does happen. Better safe than sorry is what I say.

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  • suzette's Avatar
    Posted by suzette Mon Jul 6, 2009 3:15pm PDT

    Ive never had a child and insisted to my Dr that I wanted an IUD inserted instead of an invasive surgical procedure to have my tubes tied. When I say I had to FIGHT for it, that's an understatement. I was 35 years old and married, trying to quit smoking and was still on birth control(which is a toxic mix). After several visits, I finally got what I wanted. Ive had the Mirena IUD for 2 yrs now and couldn't be happier. I will say that the insertion part was no picnic, but 15 minutes of pain vs. 5 yrs of non-pregnancy and no birth control hormones. It's a no-brainer. It's your body and your choice. Good luck!!!!

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  • Dr. Kate's Avatar
    Posted by Dr. Kate Mon Jul 6, 2009 7:08pm PDT

    Mshizzy, it's widely thought that the IUD can cause infertility. But in fact, it's undiagnosed STDs (as well as a variety of other things) that can cause fertility problems. There's nothing in either the copper or progesterone IUD that can take away a woman's ability to have a baby...there's always something else going on.

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  • LuLuBee's Avatar
    Posted by LuLuBee Mon Jul 6, 2009 9:11pm PDT

    I have never heard about IUD use and infertility. I have the Mirena IUD and have had that in place for 2 years now. I have had two children. My uterus has a septum in it, meaning my IUD is shoved up in the right corner of my uterus. The docs gave me the choice to have it removed and just take the pill, but I am like No PIlls, they make me crazy. I don't have the effectiveness that the IUD would give me if it were correctly in place but I have not gotten pregnant while I have had it. I am starting to wonder if now, I am just infertile!

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  • Mysterious Gryphon's Avatar
    Posted by Mysterious Gryphon Tue Jul 7, 2009 6:24am PDT

    I LOVE my copper IUD. Like No Pills, hormonal birth control was miserable for me, so I talked to my gynecologist about a non-hormonal option. She said she wouldn't give me Paraguard - actually, she said there was no such thing as non-hormonal BC, what a lie - but the nurse practitioner at her office was more than happy to pop one in.

    Having it placed is, honestly, pretty awful, especially if you've never had a vaginal delivery to stretch your cervix, but once it's in it's GREAT.

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  • stacey b's Avatar
    Posted by stacey b Tue Jul 7, 2009 6:29am PDT

    I was given an IUD and have never had kids. The only thing I could think of for why they wouldn't want non-mom's to get them is because of the pain!!! Omg THE PAIN!! with my uterus never being stretched out, they had to cram the thing in there. I puked from the pain and am not looking forward to the removal and replacement, but having the IUD was well worth it, having to not take a pill or suffer any side effects :)

    just .... the PAAAIIN of the placement!

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  • Har's Avatar
    Posted by Har Tue Jul 7, 2009 7:13am PDT

    Stacey's post is pretty much my sister's story. She described it as THE most horrible experience(she was a"virgin" down there-2 ceseareans)and she has THE BEST gynocologist in the county. We live in Europe and drs over here are TOTALLY against spirals before childbearing. Too many things can go wrong- and leave you sterile! Please think about it. There are at least 3 new pills on the market. Try them but give them at least 3 cycles. The side-affects DRAMATICALLY diminish after that. I too had a terrible time finding one that didn't bother me. Good luck!

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  • Alicia's Avatar
    Posted by Alicia Tue Jul 7, 2009 8:28am PDT

    I want you ladies to know that getting certain types of UID (like that one they always talk about on TV that you can leave in for 5 years) will not prevent insemination, just implantation. So basically, the eggs are fertilized, just can't take hold in the uterus. You are essentaly having an abortion every month. If you're the kind of person who thinks life starts as soon as that sperm hits the egg, UIDs are murder.

    Yeah, most doctors won't tell you that.

    I have a Ring. I love it. It's great.

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