The IUD: The Best Form of Birth Control is the One No One is Using
time.com
time.com
IUD may be verify effective but as a male, I have to trust my partner that she is using IUD. Of course, this is not important when couple already trusts each other and are committed. [Similar logic applies for vasectomy]
I might be an outlier and I've also got the benefit of free health care and sexual health clinics being in the UK, but it seems like sensible practice to not stop using condoms until you've both had an STD screen - which takes all of ten minutes plus a week to get results - just to be safe. Especially since it's possible to have an STD while also being unaware of it.
But I agree, it's a good idea to use them until you've both had a screen.
http://en.wikipedia.org/wiki/Comparison_of_birth_control_met...
It lists both the perfect use failure rate and the typical use failure rate. When I first saw this I was surprised at how often condoms fail! I'm also a little puzzled by the infographic in the article that claims that natural family planning is less effective than condoms. While the rhythm method is less effective than condoms, symptoms-based fertility awareness is as effective as the copper IUD in the perfect use case, and its typical use case is still far better than the pill, patch, and ring.
It's easy (in principle) to solve the problem of avoiding pregnancy: "just" avoid all sexual activity. The problem contraceptives were invented to address wasn't the problem of avoiding pregnancy but the problem of having sex without getting pregnant.
"Natural family planning" is -- when done optimally -- very effective at the "without getting pregnant" part of that, but not so good on the "having sex" part, since somewhere around half the time it's equivalent to abstinence.
Redefining the problem isn't always a bad thing, but it's as well to be aware of when it's being done.
When I was in high school, university and in my 20's almost all the women I knew were on the pill and I didn't hear once about an unplanned pregnancy or abortion.
Infact all the women I know joked about how they were surprised when they went off the pill how easy it was for them to get pregnant given that the pill had never failed them when they were younger.
Most studies show that a user can miss quite a few, such as 4 days in a row[1], and not ovulate.
[1] http://journals.lww.com/greenjournal/Abstract/1992/06000/Eff...
http://www.contraceptionjournal.org/article/S0010-7824(04)00...
A girl I know got pregnant after taking the pill with antibiotics, or stopping it because of antibiotics and forgetting to mention that? Something like that.
Add to that that the people you know might be atypical in their use patterns. The "perfect use" failure rate for the pill is ~0.3%, which I take to mean that most of the pregnancies that occur on the pill are because someone forgot to take pills, that sort of thing.
You GP might have a decent grounding, if you're lucky. However the NHS prints a range of excellent leaflets with the 4 main approaches compares side by side.
In the US you have to run the gambit of worrying if you doctor has recently been taken on a golf trip by a pharma rep.
Of course, in Europe and Asia, there is also a much broader range of options to choose from, which helps women select one that has fewer risks for their particular needs. In the US we have problems with regulatory agencies holding up approval of birth control for really dumb political reasons.
1) "A lot of women have painful allergic reactions to the copper ones" -- No. Copper allergies are rare and occur in less than 1% of the population, according to the FDA. If you suspect you have a copper allergy or are sensitive, you can do a simple patch-test on your arm before considering a copper IUD to check for copper reaction.
2) [IUDs] "have a bad history of getting lodged in the wrong places and having to be surgically removed" -- Also wrong. The most common occurrence of perforation is during insertion, and even then perforations during insertion happen in less than 0.001% of cases. I would not consider this a "bad history" or common occurrence.
SOURCE: http://en.wikipedia.org/wiki/IUD_with_copper & I have a hormonal IUD currently and have had copper before.
Your information about IUDs is over 50 years old, and is based on the copper "coil" IUD which hasn't been in use for decades. Current IUDs (both hormonal and copper) are extremely safe, effective, and perhaps the most error-proof and reliable form of birth control out there. The largest risk with an IUD is rejection, where your device falls out -- the solution is simple, it's just reinserted. The largest barrier to getting IUDs is the belief in the US that you need to have had children first, to have a cervix wide enough to tolerate insertion. This is also untrue. You can have an IUD at any time in your life, insertion is just much more painful if you haven't had children.
Additionally, you don't need to scan a woman's womb before having sex to confirm she has an IUD. You can usually feel the strings from the IUD (there for easy removal) at the top of the cervix, with your fingertips. And if you're a man worth half his salt, you'll have had the opportunity to... check that out before having sex with her ;)
For males, a better form of birth control would be a reversible vasectomy (like RISUG/Vasalgel) because it would be in place for 100% of his sexual partners. I think there is a version of RISUG that will be available in the US soon. If I'm not mistaken, some other countries already have it on the market.
Also IUDs are solely for BC, and require (out patient) procedures that fall under the 'religious' exemptions. So you don't get coverage for that either.
Note: I say ish, because if people were responsible at all, we'd not have unplanned pregnancies. None 2: I'm a dude and I think it's horribly pathetic that men always expect women to 'deal' with this.
That being said, I'll be meeting Citizen Snips right after child #2 is born, whenever that happens.
That being said, I'm sure that the implant use is still pitifully low compared to less effective methods like the condom.
Why can't IUDs be spheres or at least something a lot less pointy? Something spherical or much more rounded and with more surface contact with the uterus could have perforations in the surface and lots of copper inside to maximize surface area.
The next problem is getting it through the cervix, but existing IUDs have to get the t-bar through the uterus. Is it so different? Couldn't there be a design that allows a IUD ball or blob to expand once inside the uterus, in a way that can be reversed to extract it, all while not presenting any remotely pointy surfaces to the uterus?
I can understand why most investment overseas (mostly for poverty-stricken areas) is focused on barrier methods like condoms (limit the spread of disease), but something like this seems worthwhile. Since the mechanism of copper IUDs is believed to be the presence of copper ions in cervical mucus [1], I'd imagine that the shape of the device isn't quite as important as its composition (correct me if I'm wrong--I haven't seen a study that the shape is important for anything more than holding it in place). If it were of a "safer" design, a woman could be more confident that the device will function without damaging her innards. As an anecdote, I know I wouldn't be comfortable with something like that in me--and I know for a fact my girlfriend isn't. (Aside: It appears they were also invented by men.)
Of note, it appears that IUDs are the most common form of birth control in China, but I seem to remember reading they were fairly common elsewhere and can't find the resource. Maybe someone else can chime in.
Edit: xxxargs (below) [2] provides some interesting information that may alleviate some of these concerns.
Also, random anecdatum, best to disregard: I personally know one woman who became pregnant while on Mirena. She was told that it is very unusual, though.
Makes me think I am getting value for money from the NHS. Other half has used three in the last decade and the doctors send a reminder letter when its coming due for renewal.
Biggest thing that amazes me is that they can create a medicine that has a known decay rate of 3 years inside the human body.
A:"Mineral water"
Q:"Before or after?"
A:"Instead"
Then again, I'm not sure I would trust a young twenty something I just met if she said she has an IUD. When an attractive, gainfully employed thirty-year-old who clearly doesn't want kids says she has an IUD it's much easier to believe.