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A Gentleman’s Guide to IUDs

A Gentleman’s Guide to IUDs

An IUD is to birth control what the 1993 Porsche 911 is to cars. Anything that good deserves not just your respect, but your deep understanding, too

Since many men insist on putting their dicks in things, and many women enjoy receiving those dicks, it would serve us all well to understand what method best stops a baby from happening as a result.

So far, on this earth, as far as we’ve been able to devise, that method is the IUD.

Of all the kinds of birth control apart from not actually fucking, IUDs are considered best in class when it comes to preventing pregnancy; they are the gold standard. Think of whatever thing you really like, and then think of the best version of it — that’s an IUD. It’s the 1993 Porsche 911. It’s the Japanese denim. It’s the Iranian beluga caviar.

Anything that good deserves to be not just respected and cared for, but understood. And yet, a man on the internet’s recent insistence that an IUD literally plugs your vag “so semen can’t enter your reproductive system” makes clear that we are in desperate need of some education. Let us clear up the myths and answer your most burning T-shaped questions, so you don’t sound like this guy:

What is an IUD?

The IUD, short for intrauterine device, is a T-shaped device that is about as big as a paperclip, with a few strings hanging out. At a peripheral glance to the untrained eye, it could be mistaken for a futuristic tiny boomerang or fancy fishing bait or lure — something that belongs in a tackle box.

There are two kinds of IUDs: hormonal and non-hormonal. Both are inserted into the opening in her cervix.

So if it doesn’t ‘plug it up,’ what does it do?

It creates an inhospitable, hostile environment for sperm to survive. Some people call it a force field. Like campus security in a freshman dorm, it will kill your sperm’s drunken reckless buzz in an instant.

But how does it do that?

Each does its own thwarting of your seed.

The hormonal IUD, typically referred to by the brand name of one kind, the Mirena, releases a hormone called progestin, which inhibits the endometrial lining and can prevent ovulation. It prevents pregnancy for up to five years (some experts say six), after which point it must be removed and replaced.

The non-hormonal IUD, often referred to as its main brand, Paragard, has copper filament wrapped around it. The copper prevents pregnancy by releasing copper ions that nuke the sperm. Paragard lasts up to 10 years (some experts say 12).

After removal (and it could expel itself, though it’s a low risk), women become fertile again within a day.

Do IUDs do anything else other than prevent pregnancy?

The Mirena can also lighten a woman’s period or make it go away altogether. The Paragard can make her period heavier in the short term, but possibly lighter after six months. It can also be used as emergency contraception if its implanted three to five days after unprotected sex.

Other benefits include the peace of mind of knowing highly effective birth control is in place, and not worrying about unplanned pregnancy can lead to better sex.

Is it going to be pricey?

It depends. Planned Parenthood puts the price range at somewhere between $0 and $1,300. It depends on whether it’s covered by health insurance, and women should ask their gynecologists about the real up-front costs before booking that appointment.

Does it hurt going in?

All pain is relative, but the answer is: like a motherfucker.

Doctors recommend taking some kind of pain reliever a half hour or hour before the insertion and they may numb the cervix before the procedure. And while it’s possible you could poll the next 100 women with an IUD and get wildly different answers about how precisely shitty that pain is — and there will always be that one woman somewhere who said she felt nothing — it’s generally somewhere between a pinch or bad period cramp to upwards of feeling like your cervix has been tasered, and/or the worst pain a woman has ever experienced. Some say it is so painful they almost passed out, and even guides on getting an IUD include that you might feel like fainting.

If personal anecdotes matter, here’s mine: I’ve had an IUD and also a baby. Labor, particularly back labor, felt like someone repeatedly shattering my pelvic bones with a hammer, but the IUD was a specific unique pain in its own awful way. It felt like someone piercing the innermost hole inside my body with a crochet needle. Granted, it’s going inside a hole inside the cervix, so it’s not a “piercing” so much as an insertion. Also, the width of the IUD going inside is really more like a tampon string so it’s not as big as it feels (er, that’s what she said). But that insertion feels sharp and specific. It’s brief, but unforgettable. Even years later I can easily conjure the wincing of the experience.

But then what?

If all goes well, after the insertion, there might be more light bleeding and cramping. Mirena typically leads to lighter periods or no periods over the next few months. Paragard can cause heavier bleeding for a few months before tapering off.

How do women pick one kind or the other?

It’s complicated, but generally depends on how well she does with hormones vs. no hormones, and how long she wants a no-baby shield in place. I chose Mirena because I already have heavy periods and didn’t want to release the bloodgates of hell with Paragard. But Mirena gave me wicked cystic acne. That’s only a side effect in some 15 percent of women who use it, particularly those already predisposed to acne. You can stick it out and see if it clears up after a few months.

Paragard, in addition to heavy bleeding, may cause cramps or severe menstrual pain.

How soon does an IUD really work?

As mentioned before, the Paragard is immediately effective after insertion and can also be used as emergency contraception.

The Mirena, because it’s hormonal, is effective immediately if inserted within a week of the first day of her period. If not, then wait seven days before boning without a backup method.

How effective is it really?

It’s more than 99 percent effective, and a lot of that is because she can’t fuck it up by forgetting to put it in. It’s already in! Women have told me that even after telling a sexual partner that they have an IUD, that before sex the guy will ask “Hey, so did you put that thing in there?” Unless either you or your lady is an amazingly skilled gynecologist/contortionist, you will never put an IUD in for her and she will never put it in herself.

So I don’t have to wear a condom anymore?!

Sorry. Remember that condoms aren’t just for baby prevention. The IUD is not remotely effective at preventing sexually transmitted infections. Unless you have a clean bill of health for STIs and have discussed this with your partner, you’ll still have to put a rubber on it.

Ok, but I’m going to feel those strings tickling my dick, right?

You shouldn’t. Your partner could reach inside herself and feel the ends of the strings. A gyno will use those strings to remove the IUD later. A friend of mine who is a women’s health nurse practitioner actually tells her female patients to not even mention the string thing to dudes, because then dudes always think they can feel the strings, even though that’s highly unlikely.

She told me it’s theoretically possible a dude could feel them, but that’s only if the strings are cut too short and then it can “feel a little pokey.” But usually, she said, “The string is soft and wrapped around the cervix and very difficult to feel.” They are typically only an inch or two long, and longer on purpose so they can be tucked away around the cervix. Plus, they soften over time.

But this hasn’t stopped men from insisting they can feel them. Of note: They tend to only say they can feel it after being told about the strings, though.

But will it make rough sex too painful?

It shouldn’t. Most women shouldn’t feel anything different, though there have been reports of doggy style being affected.

That’s not because it was dislodged by your dick, Casanova. It would be because it moved out of place for some other reason, in which case, have a little respect. Support your partner in going back in for a checkup to make sure it’s properly situated. Just because it’s the best birth control there is doesn’t mean you don’t have to take care of it.