Getting an IUD Before Jan 20th?

Most women know that when it comes to birth control, it’s not one size fits all. Fortunately, there are many different modes of contraceptives currently available, from oral contraceptives, to depo shots, to IUDs. And over the last six years, the Affordable Care Act has made access to most of these methods easy and, well affordable, ensuring that all plans must cover low cost or free options for almost every type of contraceptive.

The most popular method by far among women is the oral contraceptive, or pill, which requires a monthly prescription. With the Affordable Care Act in danger of getting overturned this January, many women on oral contraceptives are worried about the availability of those pills going forward — that they will become expensive, or that providers will no longer cover them at all. This is why so many women are looking to the IUD, or intrauterine device, which is a highly effective and long-term form of birth control. So, if you are a woman thinking about running out to get an IUD before January 20th, here are some things to know about choosing the best options for you.

The IUD is a small T-shaped apparatus that is inserted into the uterus via a quick, 5–10 minute outpatient procedure. Depending on the brand you choose, the IUD can stay in the uterus safely for 3–10 years, and can be removed at any time with a similarly quick procedure. There are two types of IUDs: Copper or hormonal.

Copper (ParaGard): The copper IUD, brand name ParaGard, is the longest lasting IUD option on the market. As of now it has been approved for 10 years, but research is underway with the FDA to extend approval to 12 years. There are no hormones in this option, rather the copper releases ions that essentially make the uterus a toxic environment for sperm, preventing them from fertilizing an egg. But as soon as the copper is removed, your body is ready and able for pregnancy, with no long term effects.

• Pros: It is the longest lasting options and it’s hormone free, which is good for women who do not react well to hormones. Also, most women are able to get pregnant upon removal.
• Cons: Because there is no regulatory hormones, many women experience heavy periods and painful menstrual cramps. This can be especially bad in the first 6–12 months after insertion.

Hormonal (Mirena, Skyla): The two hormonal options on the market are Mirena and Skyla. Mirena is approved for 5 years (awaiting approval on 7 years to come), while Skyla is approved for 3 years. Both hormonal IUDs work by omitting a low-dosage of the hormone progestin into the uterus, which affects ovulation and thins the uterine lining to avoid fertilization. The hormone also thickens the cervical mucus, making it hard for the sperm to enter the uterus.

• Pros: Many providers recommend Mirena for women who experience heavy periods or painful PMS symptoms, as the low, centralized dose of hormones helps to regulate menstruation. Many women see lighter periods, or will stop bleeding during menstruation altogether.
• Cons: Because the insertion procedure can be painful (quick, but painful), many younger women prefer the longer lasting options. Some women also aren’t comfortable with the change in their periods, like spotting in between periods, or no bleeding at all.

Like any form of birth control, there are risks to both types of IUDs. These mostly include infection, which usually only occurs within the first 20 days after insertion, at a rate of about 0.97%; migration or expulsion of the IUD from its proper placement in the uterus, which is also rare, occurring in 0.1% of cases. Both cases are highly treatable with immediate medical attention.

Overall, IUDs are an excellent option for women looking for long-term but reversible birth control. It has one of the highest efficacy rates for preventing pregnancy — 99% effective, and also allows women to get pregnant immediately after removal (this of course is dependent on each woman’s own body and fertility, some women can get pregnant right away, while others take more time). The most important thing is to find the best method for you, so talk to your healthcare provider about your options, but also don’t be afraid to open up the dialogue to friends and loved ones who’ve used these methods.