I didn't notice if any of the articles mentioned, but next-gen IUDs like Mirena release progesterone IIRC, and can help regulate menstruation.

There are also male implantible contraceptives that are availible outside of the USA. Once they're here in the US, I intend to get the procedure done.

Still, given the disease prevention angle, condoms should be heavily promoted. I intend to keep using them.

hells no. i understand that perhaps its safer than i thought, but there is something seriously off-putting about having something foreign in my body all the time. i think that's why i decided to go off the pill recently, having so many hormones in my body for so long couldn't be a good thing. i agre with josh, i'm all about condoms.

I have a copper IUD (the copper inflames the uterine lining and acts as a spermicide) and I LOVE it. I came off hormonal contraception (I've tried the pill, depo, ortho evra and the mini pill) because it was making my depression worse. Insertion hurt (though having my uterus sounded was the only really painful bit, the actual insertion was just a bit crampy) and my periods were all over the place for the next two months, but now that everything's settled I adore it. It lasts five years and I can get a new one put in when I have this one removed. I love the freedom it gives me. The only downside is that my periods are slightly more painful, but the good far outweighs the bad :)

I have a Mirena IUD--I had it inserted when I was 20 (3 years ago). So I suppose you are right to think IUDs aren't so scary to younger women.

My OB-GYN encouraged me to get the IUD inserted while I still qualified for Medicaid, right after my kid was born. I am somewhat suspicious it was so I couldn't burden the taxpayers with another pregnancy for at least five years. :(

I'm a lot more put off by the idea of having to use condoms than I would be by having something stuck in my body. But I've got a piercing in my nose, and the biochemist in me thinks hormonal birth control is real cool. It's nice to have choices.

I think part of the problem in the U.S. may be circular: they're unpopular, so physicians don't do them very often, and it's understandably scary to contemplate being the first person a doctor has performed an IUD insertion on in ten years, if ever. Plus, uterine perforations are a lot more scary sounding than hormonal imbalances, even if they're a lot less likely to happen.

My partner and I have used condoms for the last half decade, and we both hate them. Next on the list to try is the NuvaRing, once she has proper health care coverage again. I personally find hormonal adjustment to be much scarier than IUDs (which I have suggested in the past), but it's not my uterus, and with the NuvaRing the amount of hormone shift has reputedly gone down enough to stop most of the side effects.

Since Ann mentioned how common the IUD is elsewhere in the world -- does anyone know about the quality of IUDs in other countries? New England Journal of Medicine had an article about the one-child policy in China recently. The article said that 87% of Chinese women use contraception (a huge proportion for a developing country) and more than 90% of those women use either an IUD or have been sterilized -- but 25% of Chinese women have had at least one abortion, and the most commonly cited reason was contraceptive failure. Unless other reasons for abortion (like #2, fear that the government will forcibly abort an "unapproved pregnancy") are being way underreported, this means that a large number of women with IUDs are getting pregnant anyway.

Moreover, Vietnam has the highest abortion rate in the world, and an Alan Guttmacher study cited reliance on IUDs "with a relatively high failure rate" for the rate there as well as in other countries with high abortion rates (Cuba and a number of Eastern European nations).

Having lived in South America, I know many women who have used the IUD and love it. The pill is easily accessible too, but a long-term, non-hormonal option is very attractive (and hate to say it, but especially for smokers).

I know I could just find this information by searching the internet, so please don't lecture me, but.... can someone please explain to me what an IUD is and how it works.

I'm 27 and have honestly never heard much more about it, except that it's a form of birth control and that I shouldnt' get one.

I love my Mirena. I don't know why so many people don't want to use it, but I've been able to persuade a few friends :). My gyn was also very enthusiastic about it. Modern IUDs are as effective as a pill in preventing pregnancies. I'm not sure where you got information about ectopic pregnancies though - from what I've read they actually increase it, but the overall risk is still very very small. If you're in a committed relationship (that is, no risk of STDs), then IUD is the best thing since sliced bread.

Leyan- if 90% of Chinese women have been sterilized or use an IUD, but at least 25% have had an abortion, it doesn't neccessarily mean that there is a high rate of IUD failure. One abortion means a single unplanned pregnancy. If a woman has one abortion in her lifetime, that means that out of all the times she had sex, she might have only gotten pregnant once. There is a good chance that many of the women who have been sterilized had abortions prior to their surgery, so it's possible that the number of pregnancies resulting from IUD failure is really low.

But maybe not.

Stormcloud- How IUDs Work

Both kinds of IUDs work by preventing sperm from joining with an egg by affecting the way they move. The hormone in Mirena increases effectiveness. It thickens cervical mucus, which provides a barrier that prevents sperm from entering the uterus. It also prevents some women's ovaries from releasing eggs (ovulation).

IUDs also alter the lining of the uterus. In theory, this may prevent pregnancy by preventing the implantation of a fertilized egg — but this has not been scientifically proven.

IUDs have a string attached that hangs down through the cervix into the vagina. A woman can make sure the IUD is in place by feeling for the string in her vagina. A clinician uses the string to remove the IUD.

more info here
-----------------------------------------------

I was told that the hormone released by an IUD is progesterone, which is also in Plan B/emergency contraception. You can also get birth control pills containing progesterone instead of estrogen, but I've heard that you have to take it at the exact same time daily, and that even an hour or two deviation can result in pregnancy. I suppose the IUD provides a more consistent release if inserted properly.

Ann- you can tell your 55year old coworker that diaphragms are now on the outs because they must be used with spermacidal jelly or cream, which we now now irritates the delicate lining of the vagina and increases the risk of contracting STI's as a result.

Random- The bit about IUDs reducing the risk of ectopic pregnancy was from the Philly Inquirer article:

"Now, companies specializing in women's health care are reviving the method, but many women and doctors mistakenly believe all IUDs increase pelvic infections, miscarriages, infertility and ectopic pregnancies."

FrenchKiss- My coworker and I didn't really get into the merits of the diaphragm vs. the pill. It was really more a conversation about what seems to be popular among women of our respective generations.

"It's nice to have a choice." American women have some, actually not so many, choices. Our lack of control and knowledge about birth control is further proof that women need to be the decision-makers about birth control.

Mother Jones magazine writes about US double standards regarding birth control safety here: "Unsafe IUDs, dangerous high-estrogen birth control pills and, most recently, Depo-Provera -- an injectable contraceptive not approved for American use -- are bought up wholesale by the U.S. government for mass consumption in the Third World." http://www.motherjones.com/news/feature/1979/11/ehrenreich.html This was prior to Depo being legalized in the US, to disastrous effects. Over 75% of women who get Depo for FREE get off it in a year's time. 'Cause it has nasty, nasty side effects. Ask a few women you know. I hear the copper T is nice, but that they only make it WITH hormones now, so that's not much of a choice if you don't want the extra hormones, like myself.

If you think that modern medicine is more scientific, you must read "For Her Own Good," recently released, by Barbara Erhenreight. Skip to the end and read about how the national institute of health JUST realized that Hormone Replacement Therapy, which had been prescribed to women for decades, actually increased risk of stroke & blood clots. They stopped the study because the effects were so bad. This is a drug that's been prescribed for menopause for many many years. I will never put hormones in my body again, after the worst experience with Depo several years ago. If I had spoken with other women earlier, I would never have tried it. Talk to women you know, in person, before trying new medical treatments. It is the best way to find out what it's REALLY like. hope and resistance,
~ Kate

along with the generational differences in birth control options, also consider generational differences in trying to use them. my roommate asked her doctor (in his 60s) for an IUD and not only did he make her take a psychological exam to test her fitness (whatever that meant) he made her wait a year to 'make sure' she really didn't want to get pregnant; she was so tired of the run around she dropped her doctor and found a younger one who fitted her for one right away.

but she loves hers. (even better than the Ring!)

This is cool, you have to try it. I guessed 22541, and this game guessed it! See it here - http://www.funbrain.com/guess/

@Random: I think maybe what you're thinking of is that while IUDs lower risk of ectopic pregnancy, they increase the risk of miscarriage when a woman does get pregnant.

I just ordered a Mirena IUD and I'm really excited. I've got several years until I clinch my PhD and I don't want an Oops between now and then. :)