Dear Lucy: I have a boyfriend (finally!), which means that I’m sexually active now. Our method of contraception (no babies plz!) has been just using a condom. However, me and my partner would like to try to have sex without it to experience a different sensation. The problem is that I don’t trust myself in taking oral contraceptives, because I fear that I will forget. I have been exploring other options, and I found the IUD and that MIT is able to give me one for free!
But I have three main concerns:
Who should I contact? Can I do this during IAP?
What type will be the best for me?
I suffer from PCOS (polycystic ovary syndrome); can I still get an IUD? What are the pros and cons?
Thank you so much! —Soon-NOT-To-Be Mom
Dear Mom-NOT-To-Be: What a great question! Or, rather, questions. Plural. With IAP approaching, Lucy wanted to answer this letter as quickly as possible, and she knew just where to turn—Medical Director and Gynecologist Cecilia Stuopis.
Stuopis tells Lucy that she considers IUDs to be “first-line contraception” for most women of reproductive age. “IUDs are classified as ‘long-acting reversible contraceptives,’” she continues. “They provide excellent contraception—they’re more than 99 percent effective—with low risk and few side effects, while being completely reversible and having no effect on long-term fertility.” And women with PCOS are fine candidates for an IUD, she adds. “Just don’t expect it to help with some of the common, non-gynecological symptoms of PCOS, such as acne.”
MIT Medical offers three types of IUDs: Mirena and Kyleena, which are both progesterone-containing IUD that last five years, and Paragard, a copper IUD lasting 10 years. While all provide excellent contraception, there are some differences, Stuopis notes.
“With the Mirena, women tend to have lighter, less painful periods, and many will have no period at all—something many women consider a bonus,” she says. “Women with the Kyleena are more likely to have periods, but because this IUD is slightly smaller in size, insertion may be easier for women who haven’t had children. The Paragard copper IUD is attractive to women who can’t use hormones or prefer to avoid them. But periods can be heavier and more painful, at least initially.”
Insertion of the IUD is a simple office procedure, Stuopis explains. “It involves a speculum exam, placing a clamp on the cervix, measuring the length of the uterus, and then inserting the IUD. Some women don’t find this procedure particularly unpleasant, but others can have pain and cramping that is significant. There’s no way to know what an individual woman’s experience will be until we get started.”
Still have questions? Stuopis recommends taking a look at bedsider.org, which she calls “a great reference for all things contraception.”
You should be able to schedule the procedure during IAP. Make an appointment with our OB/Gyn Service (no referral required) or with one of the primary care clinicians who perform this procedure (Marie Caggiano or Allison Daly).
In closing, Lucy would like to make the point that IUDs aren’t “free,” even though students who get one will have no out-of-pocket cost. Rather, at the beginning of the last academic year, MIT Medical made the decision not to charge students for IUDs. Before that, IUDs were covered only under the Extended Plan or, for students who had waived that coverage, their home insurance. Because the latter group sometimes experienced situations where parents were informed of the procedure by their insurance company, MIT Medical decided to pick up the cost for all students. Three cheers for patient privacy!
Thank you for giving Lucy the opportunity to answer this question about an important topic. You’re definitely not the only one with these questions, and Lucy is happy to have the chance to share this information with other women as well. —Lucy