Healthy Living

Monday, November 30, 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 There's no reason that you shouldn't be able to get an IUD before a baby, that's outdated thinking.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 21-29 of 29
  • Mindy's Avatar
    Posted by Mindy Tue Jul 7, 2009 5:34pm PDT

    I have never had a kid and I've had IUD for close to a year. The reason why most doctors don't advise it is because you aren't stretched from child birth and it does hurt. I had very very bad cramps the first 2 days then they tampered off in intensity day by day and after a week- nothing. I love it! Just find a doctor who is willing to do it.

    I'm been on the pills, patch, shot and now IUD and the IUD has been the best!

    Just my 2 cents :)

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  • Nell's Avatar
    Posted by Nell Tue Jul 7, 2009 7:30pm PDT

    I think you need more info before you make decide on a IUD the are a lot of serious side affects including infertility and death in some cases, I believe every women should be well informed on pros and cons of all methods keep in mind it does not prevent fertilization it prevents the egg from attaching itself to the uterine wall because it tricks the body into thinking there is a baby in place already its kinda cruel if you think about it, with hormonal methods the egg that is released spins too fast for a sperm to fertilize it, there are a lot of options out there talk to your doctor about different pills ones with lower hormone levels

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  • Ani's Avatar
    Posted by Ani Tue Jul 7, 2009 11:17pm PDT

    I've been pregnant and have tried BOTH of the iud's. I hated the copper one. I went from my normal 3-4 day period to a SIX WEEK period. The only reason it ended was because I took that damn thing out! The mirena's placement hurt a lot but the side effects were horrible. I had the mirena for 3 months and gained 30 lbs!! I'm only 5'1'' with a small frame so I looked horrible. I hate IUDs!

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  • Carrie's Avatar
    Posted by Carrie Wed Jul 8, 2009 2:11pm PDT

    Like people have said, the major reasons doctors might be against IUDs for women who haven't had kids yet are that since nothing's come out of the cervix, it's not gonna feel good getting something put in and that younger women are at increased risk for infections that could lead to PID. I haven't had any kids and took a lot of risks when I was younger, but after a frank discussion with my doctor, I had Mirena inserted a little over a year ago. I'm sensitive to a lot of metals and didn't think it'd be a good idea to put some in my sensitive areas so paraguard wasn't an option. The pain for the insertion was horrible and she'd even given me a valium to take an hour before I came in. I thought it was going to do the trick before they really got down to business. I'd been on the pill (various forms) for 10 years and even on monophasic hormones, my emotions were out of control. No amount of psychiatric care and medication was helping...two weeks to 10 days before my period were bad. I also knew I wasn't going to be having a baby any time soon and was sick of the daily routine, the monthly trip to the pharmacy, and the money I was shelling out. I virtually don't have a period any more on the IUD and never needed more than a couple of the pads I bought in anticipation after it was inserted. I have cramps worse than before, but nothing a little ibuprofen doesn't help. I've gained 20 pounds in the last year and worry that Mirena is partly to blame, but this is clearly the best option I have. Do lots of research and good luck with your decision. You'll find lots of websites with horror stories and awful side effects, but clearly it works great for some people!

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  • Brianna's Avatar
    Posted by Brianna Wed Jul 8, 2009 2:14pm PDT

    the comment about having an 'abortion' every month because the fertilized egg didn't implant... you are assuming the woman has sex every month, you are also assuming she always becomes fertilized, it is very hard for some women to get pregnant, it can take months of having sex daily with no result, if these women were previously on the pill or had an IUD, do you really think they became fertilized every month and just didn't implant... probably not... a weak argument to try and make people who are trying to be responsible out to be monsters... sad

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  • Shadow's Avatar
    Posted by Shadow Wed Jul 8, 2009 2:40pm PDT

    I had an IUD put in in 2001. I had it taken out and replaced with Assure (Permanent sterilization) in November 2008. Getting the Assure was far more painful than having the IUD put in. I've also never had kids and obviously never intend to. The one thing that surprised me, though I wasn't completely unprepared for the possibility, was that my uterus was shredded. They have to scope when they put in Assure, and you get to see exactly what's there. It wasn't pretty.

    All that having been said, I loved my IUD and wouldn't change anything, but it's quite unlikely I ever would have carried to term after it. Now, since they don't scope to put an IUD in, I have no pre-IUD image to compare it to.

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  • Katie B's Avatar
    Posted by Katie B Thu Jul 9, 2009 7:41am PDT

    The reason I haven't used it and the reason that I have heard as why Dr. don't want to insert it in women that haven't had a child yet is because it could collapse your cervix when taken out. Fortunately the patch works well enough for me though.

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  • valerie's Avatar
    Posted by valerie Thu Jul 9, 2009 8:38am PDT

    I had my Paraguard IUD placed right after the birth of my first child (an oops baby - pills obviously didn't work for me). My husband and I LOVED it. I had it in for 4 years, had no weight gain, no mood swings, and I didn't even know it was in there. I had it removed in November of 2008 so that we could have another child, we got pregnant right away, and that child is due in the next few weeks. Even though my insurance doesn't cover birth control, we WILL be scraping up the cash for another Paraguard IUD. It's not for all women, but it's definitely the best birth control option for my husband and I.

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  • Duckandcover's Avatar
    Posted by Duckandcover Thu Jul 9, 2009 10:46am PDT

    After my second child, I requested and received a copper IUD. I had minor discomfort during the procedure and for, oh, an hour or two afterwards (more a sense of being able to feel the presence of the foreign object). I loved it for 3 years, after which I started having a lot of spotting. My OB/GYN removed it, thinking the IUD was the likely cause of the spotting, apparently this is one of the most common reasons for early removal of an IUD.

    I'd never been on hormonal birth control because of a family history of blood clots. My OB/GYN put me on NuvaRing, which was fine for convenience but produced side effects I wasn't willing to live with (don't want to be the Wicked Witch of the West). A progestin-only pill did the same.

    My insurance covered all but $80 of the IUD cost. It's certainly worth investigating. I couldn't have been on the pill for three years that cheaply.

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