The intra-uterine device, or IUD, is extremely effective (more than 99%), and lasts for a very long time. There are 2 IUDs currently on the market: the
Paragard (or 'copper T') and the
Mirena. I had the Mirena placed about 3 years ago, and I heart it.
Both types look very similar - a small plastic 'T' that rests
inside the uterus. The Paragard contains a small amount copper which inhibits sperm motility, while the Mirena contains a tiny amount of the hormone progestin, which prevents ovulation and thickens cervical mucus so the sperm can't swim well. The devices themselves create a physical obstacle, as well. The Paragard remains effective for 12 years, the Mirena for 5 years.
Both are placed by a health care professional. The placement procedure takes about 20 - 30 minutes, costs between $175 and $650, and is covered by most insurance. Now, I can't lie...the placement hurts like hell. It's supposed to be easier for women who've given vaginal birth, but even then, it's not fun. Don't fear, though...local anesthesia is available and is WORTH EVERY PENNY. It's called a 'cervical block', and it is your friend.
Side effects are few, but include spotting between periods, especially in the first several months. The Paraguard can make monthly periods heavier, which can lead to anemia, and can also make cramps worse. Mirena can stop periods completely - I only have 3-4 super light periods per year, which is win.
One rare side effect (that I experienced, unfortunately) is a temporary, but marked, decrease in sex drive. For me, it lasted about 5 months. Everything got 100% back to normal, but it definitely put a kink into my relationship for a while there, and not in the fun way.
If someone is ready to get busy right away, Paragard is effective immediately. Mirena is effective immediately if placed within 7 days of a woman's last period. If it's placed at any other time during her cycle, a backup method is needed for 1 week.
IUDs are best suited to women in monogamous sexual relationships, as the strings used for retrieval pass through the cervix into the vagina, creating a veritable superhighway for bacteria (chlamydia, gonorrhea, even normal
flora) to enter into the uterus. Bacteria + uterus =
OW. I have known a few health care professionals that insist women with more than one partner
can safely use IUDs, but most recommend against it.
Less than 1 in 100 women will get pregnant while using and IUD. Unfortunately, if a woman does get pregnant while using one, there is an increased risk for ectopic or tubal pregnancy. A woman can get pregnant within a month or two of having the IUD removed, so if "No Babies!" turns into "Babies, Please!", you're solid. They're also both safe to use while breastfeeding!
An IUD gives the protection and forget-about-it-ness of permanent birth control without having to commit to the permanent part. It's the most effective non-permanent method (some say it's most effective, full stop) and also the most cost-effective. That equals 2 thumbs up 'round these parts!