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Birth Control Series: Part 1 - IUDs
This series of posts on birth control methods will not cover condoms and other barriers to be used during sex. For information on condoms and barriers, see this post. None of the birth control methods discussed during this series are effective at preventing the transmission of STDs and STIs.
An intrauterine device, also known as an IUD, is a small (no thicker than a tampon string), T-shaped object inserted into the uterus to mess with the way sperm moves and intercept it from fertilizing an egg. There are two main types of IUD, Mirena and Paragard. The Mirena IUD is hormone-based, and the Paragard IUD is copper. Once inserted, an IUD lasts for several years (up to 12, depending on the kind) before it will need to be removed and/or replaced.
An IUD is one of the most effective forms of birth control, right up there with sterilization. Less than 1 out of every 100 people using the IUD method of birth control will become pregnant when an IUD has been placed properly. It is also easy to use and maintain. The insertion process takes about 60 seconds and you are protected from pregnancy immediately after insertion. After insertion, assuming that there are not complications, you do not have to worry about the IUD until the point where it needs to be replaced or removed. It is discreet and private, many people who use an IUD say that their partner(s) cannot even tell that it is there. Occasionally, the string that hangs down from the cervix (for removal at a later point) can be felt during intercourse, but this can be trimmed if needed.
The Mirena IUD is hormone based. It works by secreting a small amount of progesterone each day. It contains no estrogen, so there are fewer side effects than other hormone-based forms of birth control, but there are still some hormone-related side effects for certain users of the IUD. The Mirena IUD lasts for 5 years as stated by the manufacturer, but in Europe it is approved for use for up to 7 years. Side effects at first include unpredictable and irregular bleeding, but it is usually only spotting. After the first 6 months, most people’s periods stop altogether, or are much lighter and shorter.
The Paragard IUD contains copper and is hormone free. It is the ONLY super-effective hormone-free form of birth control available, other than sterilization. It lasts for 10 years as stated by the manufacturer, but many studies have shown evidence that it is effective for up to 12 years, and many establishments that provide Paragard insertion services (Planned Parenthood being one of them) agree that it is effective for 12 years. Most users of the Paragard IUD experience heavier, crampier periods for the first few months, but most people’s menstrual cycles return to normal after 6 months.
In a healthy person, regardless of age and whether or not one has given birth or had an abortion, IUDs are a viable option. IUDs, however, are not right for every person. An IUD could be wrong for you if you have any of several health conditions. You should not use an IUD if you: have had a pelvic infection following a birth or abortion in the past 3 months, have or might have an STI, have or might have a pelvic infection, are pregnant, or may be pregnant, have untreated cervical cancer, have cancer of the uterus, have unexplained vaginal bleeding, have pelvic tuberculosis, or have a uterine perforation during an IUD insertion.
The Mirena IUD in particular is not for people who have severe liver disease, or who have, or might have, breast cancer.
The Paragard IUD in particular is not for people who have, or might have, an allergy to copper, or who have Wilson’s disease, an inherited disease that blocks the body’s ability to get rid of copper.
If you are interested in using an IUD as a method of birth control, see your doctor - either a OB/GYN or your general practitioner should be equipped to discuss it with you.
Condoms and barriers for safe sex.
With any sexual activity that involves genital contact, barriers are important, and unless you and your partner have decided to be fluid-bound to each other, or unless you are sure that all parties are STD free and pregnancy is not a worry, it is advised that you use them any time you have contact with a partner’s genitals, whether with hand, mouth, or your own genitals. It is also recommended to use a barrier with any sex toy that is used by, or has the potential to be used by, multiple people.
Condoms, especially external condoms, are the most common and widely talked about and used form of barrier.
The external condom, as mentioned above, is the most widely discussed form of barrier. In many cases, it is the only one mentioned. It covers the penis during intercourse and catches the semen upon ejaculation. They are often made of latex, but polyurethane, polyisoprene, and lambskin condoms are available to those with latex allergies. (It is worth noting that lambskin condoms can prevent pregnancy, but are not highly effective at preventing the transmission of STDs and STIs.) External condoms are easily accessible, as they can be found at almost any store that sells cosmetics and health products (drug stores, Walmart, gas stations, etc) and there is a wide variety available, such as condoms with spermicide or without, flavored condoms, textured condoms, condoms with different kinds of lube to “enhance” the sexual experience, even glitter and glow in the dark condoms!
An external condom is effective at preventing pregnancy as well as most, if not all, STDs and STIs. The transmission of genital herpes (HSV 1 and 2) cannot be completely prevented using a condom, however, there is a lower risk of transmission while using a condom. (Effectiveness with perfect use: 98%. With typical use, 82%.)
The internal condom is fitted inside the vagina prior to intercourse and come in various sizes. They are most often made of nitrile, but polyurethane is relatively common as well. They are more expensive than external condoms and harder to find for purchase, but many say they prefer them to external condoms, especially in cases where external condoms, even larger sized ones, have been reported to be uncomfortable or too tight around the penis. There is also less variety with internal condoms than there is with external ones.
Internal condoms are slightly less effective at preventing pregnancy and STD/STI transmission, but are still highly effective with perfect use every time. Some say that transmission of HSV is less likely when using an internal condom rather than an external one, because of the larger area covered, however, there is no official research on the subject. (Effectiveness with perfect use: 95%. With typical use: 79%.)
- Dental Dams
Dental dams can be placed over the vulva or the anus before cunnilingus or anilingus to protect against oral transmission of STDs. It may seem like an obvious piece of advice, but only one side of the dental dam should come in contact with your mouth. Flipping the dental dam over exposes you to the bacteria that you were likely trying to avoid to begin with. You can use lube with a dental dam to make it more comfortable for your partner, or to make it taste a little better. If you are using a latex dam, though, be sure to use a water-based lube, because oil-based lubes can weaken the latex.
Dental dams are often made of latex, but for those with latex allergies, dental dams made of silicone are available.
If you don’t have a dental dam, you can make one out of a condom (internal or external, both work) by cutting the end/s off and cutting down the side so that you have a rectangular piece, which can then be used exactly as a dental dam. You can also use non-microwaveable Saran wrap, but be sure that it is non-microwaveable, as microwaveable Saran wrap has pores which allow it to be microwaved, but are larger, and can allow some pathogens through.
There has been debate over whether or not using medical gloves (made of latex, vinyl, nitrile, or perhaps other materials) while fingering someone, vaginally or anally, is necessary in all cases. However, it is strongly advised that one wear a glove while performing manual sex if they have any cuts or hangnails on their fingers or hand, to prevent infections and the transmission of harmful bacteria.
It is possible, however, that invisible cuts may be present on the hand and could allow pathogens to enter the bloodstream, so especially if you are unsure if your sexual partner has any blood-transmittable STD or STI, use a glove when performing manual sex at all times possible.
I love the use of the words “internal condoms” and “external condoms” the only thing I have to add is you can also make dental dams out of gloves by cutting off the fingers and down one side.