From basic facts to food for thought, here are all your contraceptive questions answered. Photo / Getty Images
From basic facts to food for thought, here are all your contraceptive questions answered. Photo / Getty Images
When it comes to women’s sexual health, there seems to be a large amount of taboo and awkward sighs surrounding the subject, making it inaccessible to the average person and pretty tricky to navigate.
And with the term IUD being thrown into various conversations, a lot of you might be asking: is it a type of tax or a DUI offence for driving backwards?
For those swimming against the tide in the murky waters of contraceptive information, the Herald spoke to fertility specialist and gynaecologist Dr Devashana Gupta about the truth behind IUDs and everything you need to know in order to enter the sex conversation well-informed.
From basic facts to food for thought, here are all your contraceptive questions pondered and answered.
Gupta explains that we have two groups of IUDs in New Zealand: hormonal IUDs and non-hormonal IUDs or copper IUDs.
Types of copper IUDs include: The Copper T (a five-year device) and the copper multiload (five years for short and ten years for long)
Types of hormonal IUDs are the Mirena® (a five-year device) and Jaydess® (a three-year device) which is smaller and better for adolescents.
How do IUDs work?
According to Planned Parenthood, the copper IUD slowly releases copper into the uterus which prevents the sperm from fertilizing an egg,
Hormonal IUDs thicken the mucus on your cervix. This mucus blocks sperm so it can’t get to an egg.
Which contraceptive is best?
Your choice of contraceptive is always personalised and tailored to your preference. Photo / Getty Images
When it comes to sexual health, the choice is always yours and needs to be tailored to your preferences, so it’s best to speak with your GP.
Gupta agrees, stating, “I think that’s going to be quite a personal question.
“So, IUDs fall into the group of what we call LARCs or long-acting reversible contraceptives. LARCs are something gynaecologists, GPs and family planning practitioners do try to promote because they are much better for various reasons.”
When researching the LARCs umbrella, the term includes both IUDs and the contraceptive implant called the Jadelle, which is a five-year device and releases a hormone called progestogen.
“So what do I think is better?” Gupta asks. " I think LARCs are better, whichever one you use, compared to using the contraceptive pill, injection, condoms, natural methods, et cetera.”
Which IUD is best?
IUDs are are small devices inserted inside your uterus and provide contraception. Photo / Getty Images
Again, when considering your contraceptive options, staying true to your personal preferences and needs is crucial. But from a gynecologist’s point of view, there are a few that take the lead.
“This is a personal opinion, but my preference is the Hormonal: the Mirena® or the Jaydess®,” shares Gupta. “And that’s because we know that the copper IUD can cause heavier and more painful periods, which usually subsides within the first three months. But, personally, I have seen that it can persist for some.
“We know the Mirena® was largely developed as a device to manage heavy periods, painful periods. So it’s a go-to as a gynaecologist. Someone who’s coming to us with abnormal bleeding, painful periods, maybe endometriosis, maybe not endometriosis: we would manage that with a Mirena® and would recommend using a Mirena® as a first port of call.
“So, it gives you sort of a double-edged sword that you’re getting both contraceptive and you are also getting the benefits of the improvement in your cycle. So, that’s my preference.”
However, contraception is never a “one size fits all” matter.
“The levonorgestrel, which is a progesterone in the IUD, is contraindicated in some situations that I have mentioned”, says Gupta. “And in that context, the copper IUD is best because it has no hormones in it.”
What misconceptions are there about IUDs?
Misinformation is a huge factor that reduces the accessibility of LARCs. Photo / Getty Images
While IUDs have earned most gynaecologists’ stamp of approval, it’s still not the number one form of birth control in New Zealand, with the pill reigning supreme, according to Bpac NZ.
However, the birth control pill is susceptible to human error. It can be forgotten and thus decrease efficiency, whereas IUDS are 1 per cent off from being a failsafe, boasting a 99 per cent effectiveness as opposed to the pill’s 92 per cent success rate, according toFamily Planning.
“Interestingly, I was reading some articles a couple of months ago, and it seems to be largely Australia and New Zealand that are lagging behind in the use of LARCs,” reveals Gupta.
“A lot of other countries have really moved on to using IUDs or implants. This article was suggesting it’s due to education and also maybe the misinformation that’s present in society.
“The misinformation could be that IUDs should not be used by someone who’s a teenager or someone who has never given birth. Go back 20 years, maybe that was the case, but not anymore. We routinely put IUDs in teenagers who have never given birth.
“There’s also a misnomer that IUDs can affect the cycle and can affect fertility later as well.
“I think all of that misinformation might be reducing the accessibility.”
What’s more, Gupta says, people actually want to know more about them.
“This article in Australia also published recently said that more patients would be keen to know about LARCs and use LARCs if they were given that information and if they were given that option to them.”
New Zealand recommendations
Healthline suggests you sit down and ponder some of your options before choosing a birth control method. It is recommended to do a little self-reflection and answer these questions:
How reliable do you need your birth control to be? What level of pregnancy risk are you comfortable with?
Do you want your birth control to reduce sexually transmitted infection (STI) transmission risk, too?
What budget are you working with?
Do you want children in the future? How about the near future?
Are you trying to manage other symptoms too?
Can you realistically use something on a schedule?
How do you feel about receiving a pelvic exam?
If you’re feeling anxious or nervous, it’s a great idea to make an appointment with a healthcare professional to talk through these questions. Then, they can help address any worries you might have.
There are no bad options when choosing a birth control method. It just comes down to your personality, lifestyle, objectives, priorities, and concerns.
