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Speaker 1: Brought to you by the reinvented two thousand twelve camera.

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Speaker 1: It's ready. Are you welcome to Stuff Mom Never told you?

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Speaker 1: From House top works dot com. Hey, Aaron, welcome to

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Speaker 1: the podcast. This is Kristen and this is Molly, So

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Speaker 1: Molly on the podcast. We've had a couple of discussions

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Speaker 1: about birth control, and in response to that, we've gotten

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Speaker 1: some listener mail from a number of women who made

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Speaker 1: talked about how birth control does not work for every woman,

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Speaker 1: especially with the hormones UM. A lot of times they

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Speaker 1: would try different especially oral contraceptives, and the hormones would

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Speaker 1: just kind of throw their body out of whack and

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Speaker 1: it was a really frustrating process for them. And along

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Speaker 1: those same lines, uh, some of those same listeners brought

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Speaker 1: up the i U D, which is a form of

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Speaker 1: birth control that we're hearing about a little bit more

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Speaker 1: um in the media US. But this is truly, and

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Speaker 1: I'm stealing this for me because you mentioned this earlier.

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Speaker 1: This is truly something that our mom's probably never told us,

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Speaker 1: because I U D as a storied passed. Oh yes,

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Speaker 1: I'm sure they're women of a certain age listening to

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Speaker 1: this podcast and hearing that we're gonna start talking about

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Speaker 1: i U D s, a k intributer, and devices, and

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Speaker 1: they're probably shocked. They think we're about to advocate death

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Speaker 1: an awful fertility, infertility, awful things for for women out there.

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Speaker 1: But I needed to use really experiencing sort of a

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Speaker 1: resurgence in the United States. But the question we want

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Speaker 1: to talk about today is why is it even having

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Speaker 1: a resurgence? Why is it so unpopular to begin with?

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Speaker 1: Because when we start listening to positives, it's great, nine

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Speaker 1: percent effective as a birth control method. Uh, there's a

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Speaker 1: huge upfront cost, a few hundred bucks to insert it.

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Speaker 1: But then uh, you know, there's that's it. You don't

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Speaker 1: have the monthly cost of something like birth control. But

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Speaker 1: only two percent of women in the United States use it.

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Speaker 1: Two percent of women who are on birth control. Why So,

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Speaker 1: before we answer that question, Molly, I think that we

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Speaker 1: should just briefly say what exactly the I U D is.

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Speaker 1: Let's let's it's different from the pill. You don't you

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Speaker 1: don't eat it, you don't you don't shoot it. I

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Speaker 1: guess the closest thing you could you could compare it

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Speaker 1: to would be the ring. Because it's a it's just

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Speaker 1: about an inch long, and it's T shaped and a

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Speaker 1: gynecologist inserts it into the uterus work days and then

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Speaker 1: there are a pair of strings that hang down from it.

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Speaker 1: And in the United States there are two main brands

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Speaker 1: of it. One of them has hormones that will shoot

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Speaker 1: out some protestigen into your uterus every so often, and

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Speaker 1: then the other one is made of copper, and it

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Speaker 1: doesn't have that hormone shot, which is why it's such

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Speaker 1: a good option for women who can't take oral contraceptives

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Speaker 1: for one reason or another. It's just there's none of

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Speaker 1: that hormone jumping around, right. And basically what the i

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Speaker 1: U D does is it blocks interaction between the sperm

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Speaker 1: and the eggs. The sperm can never fertilize the egg

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Speaker 1: and never make a baby n percent effective. And what

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Speaker 1: happens is you install it and then you forget about it.

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Speaker 1: You know, some breath control methods, like the pill, you

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Speaker 1: have to take something every day at the same time,

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Speaker 1: whereas with these you can just put them up there

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Speaker 1: and leave them for five to twelve years. Right, The

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Speaker 1: hormonial one last five years, and then the copper option

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Speaker 1: last up to like you said, twelve years. But we'll

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Speaker 1: get back to our current options in a minute. But

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Speaker 1: first let's go back to the nineteen seventies. The I

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Speaker 1: guess the word would be heyday for the iu D

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Speaker 1: in the United States, about ten percent of women used

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Speaker 1: them then. Right, This was developed around the same time

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Speaker 1: as the pill um, and a lot of women started

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Speaker 1: using the iu D. But then in nineteen seventy three

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Speaker 1: it all came crashing down when there was a series

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Speaker 1: of congressional hearings about a specific i u D called

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Speaker 1: the dal Con shield that was linked to a lot

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Speaker 1: of deaths from septic miscarriages, and it was also linked

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Speaker 1: to publvic inflammatory disease and then infertility caused by that. Right,

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Speaker 1: so doctors would only want to prescribe them for women

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Speaker 1: who had already had families because there was such a

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Speaker 1: huge link in people's heads with infertility that they didn't

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Speaker 1: want to take the chance on a young fertile woman

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Speaker 1: having her life ruined by this birth control method. Um.

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Speaker 1: But you know, part of the problem was is that

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Speaker 1: at that time they weren't doing a lot of testing

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Speaker 1: for STDs, and so a bigger marker of how you

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Speaker 1: become infertile is an untreated case of gnarrhea or syphilist

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Speaker 1: or the like, and these women had these STDs that

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Speaker 1: went unnoticed and sort of you know, there's just unfortunate

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Speaker 1: linkage between the i u D and the infertility. Right

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Speaker 1: the way those strings were designed, that that hanged down

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Speaker 1: from the i u D, it actually um kind of

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Speaker 1: drew the bat attracted the bacteria further up into a

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Speaker 1: woman's cervix and uterus, just making it even the infection

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Speaker 1: even worse. Yeah, there was a lot of public inflammatory disease.

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Speaker 1: Christen before this podcast described this unfortunately designed object as

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Speaker 1: a bacterial straw because basically the strings that they use

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Speaker 1: now on io D s are much different than that

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Speaker 1: original design, which really did just sort of suck up

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Speaker 1: all the bacteria and leave it there. But at the

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Speaker 1: same time, this this bad press did not seep over

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Speaker 1: to European and Asian women as much at all. Right,

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Speaker 1: when the U S pharmaceutical industry just basically stopped researching

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Speaker 1: this and making this, that effect wasn't felt elsewhere. Yeah,

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Speaker 1: And the interesting is today China is one of the

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Speaker 1: leaders in i u D development. Is a very popular

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Speaker 1: birth control option in Asia and in France. I think

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Speaker 1: twenty three percent of women who are on birth control

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Speaker 1: use the i u D, as opposed to like you said,

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Speaker 1: two percent of women in the United States. Yeah, in China,

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Speaker 1: like you said, they're the big leaders in this forty

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Speaker 1: percent of married women using i u D. It's pretty

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Speaker 1: pretty staggering. Yeah. So now we're kind of seeing the resurgence,

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Speaker 1: the return of the i u D as a safe

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Speaker 1: and reliable form of birth control in the US. I

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Speaker 1: think particularly because of these two products that you mentioned,

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Speaker 1: the Marina and the Paraguard, that have been tested and

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Speaker 1: deemed very safe to use. Right. Uh. Marina is the

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Speaker 1: one that we've been talking about that releases the steady

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Speaker 1: amount of hormone directly into the uterus, and even if

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Speaker 1: you are sort of susceptible to the hormonal shifts of

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Speaker 1: an oral contraceptive, there's some evidence that if it goes

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Speaker 1: directly into the uterus, you might feel less of an effect. UM.

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Speaker 1: But that's the one that's good for five years, and

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Speaker 1: the bonus is that it may actually make your period

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Speaker 1: lighter or non existent um. One possible benefit. There may

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Speaker 1: be some spotting, but that's one possible benefit to this. Right.

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Speaker 1: And on the flip side of that the Paraguard brand

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Speaker 1: iu D, which is the one that's made out of

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Speaker 1: copper um, has been shown to increase bleeding your You

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Speaker 1: will probably have a much heavier flow for the first

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Speaker 1: few weeks after it's inserted, but kynecologists um say that

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Speaker 1: that will taper off. Now, one effect of this sort

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Speaker 1: of generational gap about knowledge of the i U D

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Speaker 1: is you may not be able to easily find a

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Speaker 1: doctor who can insert the i U D. Uh. They

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Speaker 1: did some study where, you know, people in medical school

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Speaker 1: very rarely learned in lectures how to insert one. You know,

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Speaker 1: if they happen to see one when they were out

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Speaker 1: on rounds or observing another doctor, that might be how

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Speaker 1: they learned. But now we have a lot of doctors

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Speaker 1: who don't necessarily know how to insert the device and

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Speaker 1: may not recommend it to their patients because they're still

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Speaker 1: in that old research mindset. Right, and being able to

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Speaker 1: correctly insert the device is a huge part of whether

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Speaker 1: or not it's going to to work for a woman,

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Speaker 1: because there is a chance that after it's inserted, if

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Speaker 1: it's inserted improperly, it could slip or shift, and uh,

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Speaker 1: it's not going to a either work effectively or um.

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Speaker 1: It could actually cause pelvic perforation UM, which can heal back,

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Speaker 1: but you know, it still be cause of some discom

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Speaker 1: It's pretty rare, but interestingly, it seems to happen most

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Speaker 1: to young women who haven't had children. We mentioned earlier

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Speaker 1: that doctors tended to recommend this form of birth control

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Speaker 1: for women who had had their families, but it's still

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Speaker 1: a perfectly legitimate birth control for women who haven't had

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Speaker 1: babies yet. It just might be harder to insert, and

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Speaker 1: there might be more of a chance that it would

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Speaker 1: sort of dislodge itself in the first team months. So

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Speaker 1: it's very important that women who choose this method UH

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Speaker 1: do self examinations regularly to make sure that the string

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Speaker 1: from the i D is still about where it was

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Speaker 1: before the length of the string hasn't you know, it

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Speaker 1: hasn't disappeared, it hasn't gotten longer to indicate its coming out.

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Speaker 1: You do have to check that pretty regularly, right, and

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Speaker 1: as far as availability of an iu D goes, you

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Speaker 1: might have to do some searching around UM. For instance,

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Speaker 1: an article published in Slate magazine found that only fifty

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Speaker 1: percent of family planning clinics in the US even offer

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Speaker 1: the i U D. And even though the offer it

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Speaker 1: may not be as willing to give it to these

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Speaker 1: young women who haven't had children because of that old research,

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Speaker 1: but also because it's important to remember that like oral contraceptives, UH,

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Speaker 1: iu D does not protect against sexually transmitted diseases. So

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Speaker 1: be preferable to have a woman who's in a long

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Speaker 1: term monogamous relationship, you know, get this method of birth control. Yeah.

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Speaker 1: And if you are a woman who's thinking about UM

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Speaker 1: possibly getting an I E D inserted UM, the American

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Speaker 1: Family Physician UH has some characteristics of good candidates for

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Speaker 1: iu D use, and among those are women who UH

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Speaker 1: have a problem remembering to take their oral birth control

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Speaker 1: UM at the same time every day UM, women who

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Speaker 1: are breastfeeding, women who are at low risk for sexually

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Speaker 1: transmitted diseases UM, women who are finished having children. Because

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Speaker 1: there have also been studies to show that UH the

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Speaker 1: iu D can be even more effective than tubal ligation

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Speaker 1: and cheaper and cheaper over the long run. And UH finally,

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Speaker 1: women who want a reversible, long term and cost effective

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Speaker 1: birth control method. I think those three factors, right, they're

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Speaker 1: pretty huge selling points. Yeah, and let's talk about the

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Speaker 1: reversibile thing real quick, and a lot of other countries

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Speaker 1: they get i U d s instead of having a

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Speaker 1: tubal ligation just because you can change your mind. You know,

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Speaker 1: sometimes women do you make that decision that they're done

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Speaker 1: having children, but for whatever reason, then later they regret it.

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Speaker 1: And so the chance of regret can be lower if

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Speaker 1: we have this reversible method, because as soon as you

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Speaker 1: take it out, maybe factor is righty to go, I'm

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Speaker 1: ready to go. And on the on the flip side

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Speaker 1: of that, it takes effect once it's inserted pretty quickly

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Speaker 1: quickly as well, I think even faster than oral contraceptives,

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Speaker 1: that is true. But always remember that the io D

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Speaker 1: does not prevent against STD, so condoms in that case

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Speaker 1: are necessary. Good job christens By Public Health announcement like

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Speaker 1: it of the week. So that's a little bit of

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Speaker 1: information on this non hormonal method of birth control. Um,

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Speaker 1: you know, definitely ask your doctor if you're interested in

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Speaker 1: it's going to have to be a discussion between you

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Speaker 1: and the doctor. Everybody's body is different, that's true. And

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Speaker 1: if you want to do some research on the i

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Speaker 1: E D before you head over to your doctor, there's

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Speaker 1: a lot of research out there, especially on Planned Parenthood's

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Speaker 1: website and American Family Physician if you want to learn

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Speaker 1: some more about that. Yeah, and I'll give a quick

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Speaker 1: shout out to Kate Klinic at Slate who did write

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Speaker 1: the article that Kristen mentioned earlier that served as a

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Speaker 1: lot of our Uh. That provided a lot of the

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Speaker 1: research that we used in this podcast. Yes, thank you.

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Speaker 1: So just like every woman's body is different, every person's

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Speaker 1: reading list is different. Nice transition, Molly to a listener mail,

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Speaker 1: So listen your mail. Let's do someone's reading list. Today's

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Speaker 1: reading list comes from Zoe who was thirteen and listen

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Speaker 1: Tescaloos to Alabama. Uh. Joey has a very impressive reading

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Speaker 1: list that that makes me feel a little bit of

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Speaker 1: shamed about how short mind is, because not only did

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Speaker 1: she send us thirty two books that she's read this summer,

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Speaker 1: she's read most of twice, so she is a reader.

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Speaker 1: Some of the books include Peter Pan by J. M. Barry,

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Speaker 1: The Sorceress by Michael Scott, The Princess and the Bear

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Speaker 1: by mett Ivy Harrison, Rose Bride by Nancy Holder, Snow

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Speaker 1: by Tracy Lynn and Sherlock Holmes Volume one, and two

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Speaker 1: by Sir Arthur Conan Doyle, as well as many Luisa

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Speaker 1: may alcop books, which is nice to see girls reading

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Speaker 1: Little Women being one of my favorite books. I was

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Speaker 1: a big fan that myself. Molly see, even though we're

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Speaker 1: all different, we can find common ground. And if you

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Speaker 1: would like to learn more about what Molly and I

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Speaker 1: are doing day to day here at how stuff Works,

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Speaker 1: she should head over to our blog. It's called how

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Speaker 1: to stuff and you can find our blog and other

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Speaker 1: articles about uh I, E d S, birth control, and

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Speaker 1: reproduction over at how stuff works dot com for more

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Speaker 1: on this and thousands of other topics. Because it how

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Speaker 1: stuff works dot com. Want more house staff works, check

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Speaker 1: out our blogs on the house stuff works dot com

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Speaker 1: home page. Brought to you by the reinvented two thousand

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Speaker 1: twelve Camray. It's ready, are you