#1: So you decided not to get pregnant

the IUD edition

Welcome to our first blog, designed to guide patients through common medical problems. Thanks for reading! This is our first on a series on birth control (male and female). We hope to release a few over the following days while our podcast is MIA.

So you decided that you need some birth control and you are heading to see your healthcare provider and thinking about what kind of options might be open to you. If you have the female bits, I have some good news and bad news: the good news is you have a lot of options for on your needs; the bad news, you have to choose. If you have the male bits, well the choices are few and far between (for now). Here is a short list of things you should think about in order to help us, help you:

• What are your goals?
• Is pregnancy your only worry?
• Are you an athlete or do something that might need you to miss a period every now and then?
• Do you care about getting a period?
• Do you get bad cramps?
• Are you a smoker? (if yes you should quit right now)
• Do you want to take something everyday, once a week, or every 3-5 years?
• Have you used anything before?
• And what forms of birth control have you heard about, do you have friends using something?
• And don't forget to think about STDs (or STIs or STIBBs - it’s all the same to me)

Intrauterine device (IUD)

Why?

• Let's be real, these are all the rage right now, likely you know someone who has one and loves it

• You don't have to take something everyday, literally you set it and forget it (for 3,5,6 or 12 years)
• If you aren’t big on a period many women who have an IUD (hormonal) over 3-6 months have light spotting and then their period will slowly disappear. Now you might say to me, isn’t that a bad thing? The answer is no and maybe we can get into why in a later blog
• When you decide you want to get up the duff (preggers), we simply take it out and you are good to go
• Reduces your risk of endometrial cancer (ya!!)

Why not?

• You’re going to have pain for a few days after insertion and maybe need a little more TLC (but some people get groceries that day and don’t have any problems)
• The main risk during insertion is poking a hole in your uterus, but it is incredibly rare
• Also a risk of infection and of it coming out (about 2-10%)
• Can cause ovarian cysts (hormonal) - but these usually go away on their own
• Some people report some hair loss (but it has not been proven in studies)

How?

• If you are not 100% you aren’t pregnant, a quick pregnancy test will be done
• Many healthcare provider will also do a quick gonorrhea and chlamydia swab
• Takes a few minutes to insert a small t-shaped implant into your uterus, we leave a string out of your cervix to help removed it (you can feel them to make sure its still in)
• It may be uncomfortable and you should probably have ibuprofen, a hot water bottle, and lots of love ready for you when you leave

Types?

• Hormonal - prevents fertilization by releasing levonorgestrel (a progestin) slowly, this causes mucus to build up in the cervix making it hard for sperm to penetrate (it also inhibits ovulation in some women)
• Copper - basically turns your uterus into an inhospitable hellhole where sperm cannot get anything done (does not inhibit ovulation)

Who cannot get it?

• If you are pregnant
• If you have had an STI or pelvic inflammatory disease in the past 3 months
• Cervical, endometrial or breast cancer
• If you have unexplained vaginal bleeding
• And a few other special populations

Myths

• I haven’t had a baby so I can’t get it. MYTH (even teenagers are getting in on it)
• I might get an ectopic pregnancy (pregnancy not in the uterus). MYTH (you are at a lower risk)
• I won’t get pregnant once it is out. MYTH (you’ll be normal once its out)
• I’m going to get a big infection. MYTH (your risk is the same as everyone else)
• It’s not as good. MYTH (99%)​

What are your questions and concerns? Let us know!
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We hope we have answered some of your questions! If you have anymore send us a message. Remember this is for education and entertainment only!