The Best Birth Control You're Not Using

Relegated to the pregnancy-prevention D-list for years, the IUD has recently been racking up endorsements from the country's top doctors for its safety and 99 percent (!) effectiveness rate. So why do so few of us use them?
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Finding the Right Birth Control

You may have found your perfect romantic match, but when it comes to ID'ing your ideal birth control, well...that's a challenge. While you hate to complain about having an abundance of options, weighing them gets complicated. Will you remember to take a pill, slap on a patch, insert a ring? What kind of side effects could you be in for: semi-tolerable stuff like breast tenderness or something potentially deadly like blood clots? What tends to be overlooked or ignored altogether in the analysis is one of the safest, most effective and low-maintenance forms of reversible contraception there is: the IUD.

If you don't know much about the IUD (intrauterine device), here's your crash course. It's a small, T-shaped piece of plastic implanted in the uterus that prevents sperm from entering the fallopian tubes, where eggs are fertilized. There are two types to choose from: Mirena, which contains progestin, and the hormone-free ParaGard. During an office visit, your ob-gyn (or a nurse-practitioner) inserts the IUD into your uterus through your cervix and presto -- you've got nearly instant protection that can last for up to 10 years. Want to have another baby? Your doc can take it out anytime -- using the removal strings that hang down into the vagina -- with zero effect on your fertility.

With your birth control literally out of your hands, there's no way you (or your partner) can screw it up. And that's a key reason why less than 1 percent of women with an IUD get pregnant. Of all the unplanned pregnancies in the United States, 43 percent occur among couples who were using contraception inconsistently or incorrectly -- a missed pill here or a slipped condom there. Think that that's mainly an issue for teenage girls? Research shows nearly a quarter of surprise pregnancies occur in women ages 30 to 44.

Given all the advantages of IUDs, why do only about 6 percent of women use them? The devices were actually pretty popular when they first hit the market in the 1960s. That changed when a poorly designed version called the Dalkon Shield debuted in 1971. Back then, medical devices didn't have to undergo testing by the FDA. The Shield's flaws, which included finlike appendages and removal strings that wicked vaginal bacteria into the uterus, led to severe pelvic infections (and subsequent infertility), uterine perforations, and at least 18 deaths. The manufacturer pulled the Shield from the market in 1974 and later paid out nearly $3 billion to hundreds of thousands of women injured by it. Even though other versions of the IUD were safe, the scandal effectively destroyed the device's reputation.

Four decades later, fears and misconceptions surrounding the IUD persist. That's why we decided to round up the most commonly repeated myths about IUDs and quiz top experts to get the straight truth on what could be a good birth-control choice for you.

Continued on page 2:  Myths and Realities


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