IUD vs. the Pill
One of the main things to remember when you are deciding on the best form of birth control for your particular age, health and lifestyle, is that most of today's birth control choices, while parading under the same names, are radically different from those of your mother's generation. The birth control pills today have from 20-35 micrograms of estrogen, while the original pill--which made its debut in the 1960's--had a whopping 150 micrograms of estrogen. Additionally, the birth control pills of today can be combination pills which contain estrogen and progestin or you can choose the mini-pill which has only progestin. The much-lower dosages of hormones in today's pill not only bring a lower risk of negative health issues, such as certain forms of cancer, but also lessen the moodiness, bloating and nausea that accompanied the higher-dosage pills.
Should I Choose the Pill?
Although the pill has significantly lowered the hormone dosages, it still pretty much works the same as ever. Using daily doses of estrogen and progestin, the pill prevents ovulation by overriding your monthly hormonal fluctuations. The birth control pill is also responsible for making sure sperm don't stand a chance of making their way to the egg by thickening up cervical mucus. If you've seen the commercial where the swimmers attempt to swim in a pool of caramel, then you get the idea. The pill's goal is to make the uterus an inhospitable place both for the egg and the sperm. The problem with the pill is the same as it's always been-it's only effective if you remember to take it. If a woman takes the pill in the most perfect way possible, then she has a 97% protection rate against unwanted pregnancy. The pill also offers lighter periods, less acne, defense against certain types of cancer, and fewer cramps. On the negative side, however, the pill is probably not a good choice if you are over 35, smoke, or have migraine headaches, as it could substantially raise your risk of a stroke or heart attack.
How About the Intrauterine Device, or IUD?
The modern IUD began to take shape in the United States in the 1950's, however the first marketed IUD was not effective due to its large size. 1962 brought a much smaller, plastic IUD, and toward the end of the 60's, a plastic-cased, copper-based IUD came along which was even smaller. Finally, the second generation of plastic/copper IUD's came out in the 1970's, and it is a design which remains essentially the same today, other than the small amounts of hormones which are built into the Mirena IUD. The Mirena IUD and the Paragard IUD prevent the fertilized egg from implanting in the uterus by significantly thinning the uterine wall. Like the pill, the IUD also creates thicker cervical mucus, making it much less likely sperm will ever enter the uterus. While the IUD is the number one contraceptive device in the rest of the world, less than one percent of American women who use birth control choose an IUD. There are certain fertility risks when using the IUD, as well as accidental expulsion and worsened periods.
If money is an issue, you should probably choose the pill since it doesn't require a huge up-front investment, and, overall is much cheaper than the IUD. While the pill can be started or stopped without a great deal of thought, decision-making or notice, the IUD requires a doctor's visit to put it in-and take it out-as well as an initial investment of around $750.00. You will want to consider whether you plan to have children soon, as well as whether you are anemic when making your choice. The IUD has a higher success rate for preventing pregnancy, plus you are not required to remember to take a pill each day, which is the main reason for unintended pregnancy while taking the pill. IUD's go to work right away to prevent pregnancy, while the pill may take up to a few weeks to start and stop working reliably. IUD's can work from 5-10 years, depending on whether you choose Paragard or Mirena. Both the pill and the IUD can cause cramping, spotting and breast tenderness at first, and some birth control pills can cause weight gain-- although some of the newer low dose pills can actually contribute to weight loss, clear skin, improved moods and lighter periods. Take a careful look at your lifestyle and risk factors, then discuss your options with your doctor to choose the best method of birth control.