IUDs
A Sexual Panacea?

By Betsy Boutelle

Many Americans may be surprised by the news that the world’s most popular method of long-term birth control is virtually unheard of in the U.S. But then again, most are not aware that intrauterine devices, known as IUDs, are used worldwide by over 100 million women to prevent pregnancy. Widespread discomfort and an ominous reputation have made IUD use exceptionally rare in the U.S., despite the device’s remarkable effectiveness, often touted by the international medical community.

“IUDs can claim 99.99 percent effectiveness, do not depend on user memory or compliance, are cost effective, [and] do not interrupt the act as condoms do,” says Dr. Susan Richman, a practicing physician and assistant professor at the Yale School of Medicine who specializes in gynecology and family planning.

IUDs are small T-shaped devices made of flexible plastic that are placed in the uterus by a medical clinician. Once inserted, an IUD may be left in place for years at a time, requiring no maintenance other than a routine gynecological check-up. Many IUD users see this as a key advantage of the method—it requires neither repeated installation before intercourse nor a regimen of pills to be taken on a rigid schedule. For this reason, IUDs allow a woman a degree of spontaneity that could arguably improve her sex life.

The devices are also relatively inexpensive compared to other long-term methods of birth control. Each IUD costs US $350, in addition to charges for the initial exam, insertion, and follow-up. Two types of IUDs are available to women in the U.S. ParaGard IUDs include copper structures surrounding the base of the “T” and can be left in the uterus for twelve years. There is no definitive explanation of how this type of IUD functions to prevent pregnancy, but experts speculate that the device disrupts the uterine lining and affects sperm motility. Mirena IUDs, which can remain in place for five years, release small amounts of the hormone progesterone over time. This hormone increases the effectiveness of the IUD by causing the cervical mucus to thicken, creating a barrier that can prevent sperm from entering the uterus.

In an age when sexually-active and monogamous women are waiting longer than ever to have children, the many advantages of IUDs should make them a popular product. But while in countries as diverse as China, Egypt, Finland, and Norway, IUDs are the most popular form of female birth control, American women have largely shied away from them. Instead, according to a survey conducted by the Centers for Disease Control and Prevention (CDC), oral contraceptives (i.e., the Pill) and tubal ligation are the most common forms of female birth control in the U.S. How can we explain American women’s resistance to IUD use, despite the fact that it is as effective as the Pill, less invasive than surgery, and more easily reversible than either? Continued
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