Talking to your kids about sex can be daunting, no matter how close you are. But discussing issues like abstinence, sexually transmitted diseases (STDs), and birth control can help lower teens' risk of an unintended pregnancy or contracting an STD.
The American Academy of Pediatrics (AAP) supports sex education that includes information about both abstinence and birth control. Research has shown that this information doesn't increase kids' level of sexual activity, but actually promotes and increases the proper use of birth control methods among sexually active teens.
How and when you discuss sex and birth control is up to you. Providing the facts is vital, but it's also wise to tell your kids where you stand. Remember, by approaching these issues like any other health topics, not as something dirty or embarrassing, you increase the odds that your kids will feel comfortable coming to you with any questions and problems. As awkward as it might feel, answer questions honestly. And if you don't know the answers, it's OK to say so, then find out and report back.
If you have questions about how to talk with your son or daughter about sex, consider consulting your child's doctor. Lots of parents find this tough to tackle, and a doctor may offer some helpful perspective.
What Is an Intrauterine Device (IUD)?
The intrauterine device (IUD) is a piece of T-shaped plastic, about the size of a quarter, that is placed inside the uterus to prevent pregnancy. Two types of IUDs are available: one is covered with copper, the other releases the hormone progesterone.
How Does an IUD Work?
The copper-coated IUD primarily prevents pregnancy by not allowing the sperm to fertilize the egg. It may also make it harder for a fertilized egg to implant in the uterus. When an IUD is coated with progesterone, it works in a similar way, but may also thicken the cervical mucus, which prevents sperm from entering the uterus, and possibly prevent ovulation (the release of an egg during the monthly cycle).
How Well Does an IUD Work?
Over the course of a year, fewer than 1 out of 100 typical couples using an IUD will have an accidental pregnancy. In fact, studies indicate that the IUD is one of the most effective and safe methods of birth control. However, it can come out of place and, therefore, should be checked regularly to be sure it is in place.
In general, how well any type of birth control method works depends on many different factors. These include whether a woman has any health conditions or is taking any medications or herbal supplements that might interfere with its use. The copper IUD allows some flexibility for females who cannot use a hormonal method of birth control (such as the Pill, ring, or patch). The IUD also provides a long-lasting term form of birth control.
Protection Against STDs
The IUD does not protect against STDs. Couples having sex must always use condoms along with the IUD to protect against STDs.
One of the concerns with the IUD is that girls who have multiple partners and do not use condoms can be at greater risk for STDs, and there's the possibility that these diseases could develop into a pelvic infection. This is true, though, for all methods of birth control.
Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.
Possible Side Effects
The most common side effects of the IUD include:
- spotting between menstrual periods
- heavier periods with more cramps with the copper IUD
- irregular or loss of periods with use of the hormonal IUD
- expulsion or loss of the IUD — for some IUD users (particularly teens), the IUD can fall out or become displaced and not work properly
- acne, breast tenderness, headaches, and nausea with the hormonal IUD
Rare side effects include:
- perforation of the uterus — there's a very minimal risk of the device perforating the wall during its insertion
- an infection from bacteria getting into the uterus during insertion
One early type of IUD increased the risk of pelvic inflammatory disease (or PID, an infection in the upper part of a woman's reproductive system). But it has been taken off the market and testing of the current IUDs shows that the risk of infection is very small. Some doctors recommend testing for STDs before having an IUD inserted in order to help avoid a pelvic infection. And in order to help prevent future infections, condoms should always be used with IUDs.
The other concern that people have with IUDs is the possibility of ectopic pregnancy, which is when a fertilized egg implants somewhere other than in the uterus. However, researchers have found a decreased chance of ectopic pregnancy among women who use an IUD compared with those who do not use any birth control.
Who Uses an IUD?
In the past, IUDs were not typically recommended for younger women, especially those who had not had a baby. Up to 10 out of 100 IUDs come out in the first year after insertion, and this is more common in young females who haven't given birth. An IUD can come out — leaving a woman unprotected — without her realizing it. This is why it is important to check the IUD regularly. IUDs sometimes need to be removed if a woman gets an STD. So IUDs may not be right for females who have multiple sexual partners or who have sex with someone who has multiple partners, especially if condoms are not always used.
However, for many teens, IUDs are a safe and effective birth control option.
Where Are IUDs Available?
An IUD must be inserted into the uterus by a doctor. It is often easiest to insert during a menstrual period. Copper IUDs need to be replaced by a doctor about every 10 years. IUDs with hormones must be replaced more frequently — up to every 5 years.
How Much Do IUDs Cost?
An IUD costs about $200 to $400 plus the cost of having a doctor insert and remove it, as well as follow-up visits. Many health insurance plans cover these costs, and family planning clinics (such as Planned Parenthood) charge much less, and the IUD is effective for several years.
Reviewed by: Larissa Hirsch, MD
Date reviewed: November 2009