Dr. Alexandra Hall is a family physician who has been specializing in college health for the past 10 years, initially at Cornell University and now at the University of Wisconsin Stout, where she also serves as adjunct faculty. She is a regular speaker at regional and national conferences on all topics of medicine but especially women's health and sexual health. She recently published an article in the Journal of Family Planning and Reproductive Health Care about the use of IUDs (intrauterine devices) for birth control in college-aged women. An IUD is a small, t-shaped piece of plastic, each arm about the size of a matchstick, that is placed inside a women's uterus by her physician or nurse practitioner as a form of birth control.
IUDs are the most effective forms of reversible birth control that are offered to women today. They are more than 99 percent effective, and, being such, recommended as first-line options for all women.
Recently, a study found that young women who use an IUD for long-term contraception are generally happy with this form of birth control.
What did the researchers find?
About 83 percent of women said they were happy or very happy with the method at an average of one year, and 87 percent said that they would recommend it to a friend.
One of the benefits women love about an IUD is not having to remember to take a pill every day at the same time and knowing that their birth control is highly effective.
Also, women who used the Mirena, or hormone-containing IUD, had lighter periods with less cramping, which they felt was a huge benefit.
Researchers also found that problems were rare with an IUD. A few women, three percent, did have a spontaneous expulsion, and some women (five percent) had some cramping or discomfort, upon which they chose to have the IUD removed.
However, 89 percent of women continued use at one year, which is also far higher than the continuation rates seen for other methods. Finally, despite what many women hear about IUDs, there were no cases of serious pelvic infections.
What should women take away from this study?
Dr. Alexandra Hall shares the recent findings on why young women are satisfied with their IUDs, as well as why it can be a great option for women's contraception.
Young Women Say They're Happy with IUDs
Guest
: Alexandra Hall, MD
From the Show: HER
Summary: What is an IUD, and how does it work to prevent pregnancy?
Air Date: 6/11/15
Duration: 10
Host: Michelle King Robson and Pam Peeke, MD
Transcription:
RadioMD Presents:HER Radio | Original Air Date: June 11, 2015
Host: Michelle King Robson and Pam Peeke, MD
Dr. Pam Peeke, New York Times best-selling author and founder of the Peeke Performance Center and Michelle King Robson, leading women's advocate, entrepreneur and founder of EmpowHER.com host the show everyone's talking about. It's time for HER Radio.
PAM: Hey, Michelle when you and I were going to college (you're a little smarty pants, aren't you?) do you remember IUD's were a big deal for birth control in addition to the diaphragm and the pill? A lot of women, a lot of my classmates had them. I think they kind of disappeared a little bit. Now, it appears that there's a bit of resurgence. I was looking at that piece with you. Fox News did a little something on young women say they are happy with IUD's, what's going on with that? We have Dr. Alexandra Hall. She's a family physician who specializes in college health. She's been doing this for the last 10 years.
She started out at Cornell and is now at the University of Wisconsin. Dr. Hall and I were just laughing about the fact that the University of Wisconsin is at Stout, which is about an hour north of Minneapolis. There you have it. She is an expert in understanding what the real story is presently with IUD's.
So, Dr. Hall, Michelle and I welcome you to HER Radio and why don't we start right on in? Tell us what an IUD is and how does it work to prevent pregnancy?
DR. HALL: Absolutely. An IUD is a small, plastic device-shaped like a seed (the ones available in the United States) and each arm is about the size of a matchstick. It gets placed up inside the uterus--hence the name intrauterine device--during a visit to your healthcare provider. It provides lasting contraception from anywhere from 3 to 10 years depending on the model that you are using. What we now understand about how they prevent pregnancy is one of two ways – usually by thickening the mucous in the cervix so that sperm cannot get up into the reproductive tract and then also potentially by making it not possible...for the sperm to not do their job if they do get through.
MICHELLE: Is the IUD, Dr. Hall, the most common form of birth control that we are seeing today?
DR. HALL.: That's a great question. It's not at all. At least not in this country. Only about 7% of women in the United States use an IUD currently. But the CDC, the American College of Obstetricians and Gynecologists and lots of other organizations are working to try to change that and increase rates of IUD use because they are so effective at preventing pregnancy. This is super important because right now about 50% of all pregnancies that occur in the United States are unintentional pregnancies.
MICHELLE: Really? How much? About 50%?
DR. HALL: About 50%.
MICHELLE: Do we know why?
DR. HALL: That's a good question. So, of those unintentional pregnancies, again, it's about a 50/50 split. Half of those women aren't using any form of birth control at the time they conceive and the other half are using a form of birth control but not using it perfectly. So, they are on pills but they maybe forgot to take the pills with them for the weekend, the condom broke, or something else happens.
PAM: So, you have been studying this, right? This whole phenomenon of IUD? Tell us about what you found in your studies that you are really looking at – the stories behind IUD's presently.
DR. HALL: IUD's fell out of favor in the 1970's when there was a type of IUD that caused some serious infections in young women. So, they really lost favor. We no longer use that IUD. The IUD's that we have now are very safe and yet we are still finding a lot of reluctance among practitioners and patients to use those devices.
So, what we did is we followed college students from Cornell University who chose to use the IUD and said, "How did they do? Did they like it? Did they not like it?" What we found is that 83% of women at one year were either happy or very happy with their IUD as a form of birth control, which is beyond the charts for birth control. Usually, when you are looking at happy or satisfied customers, it's usually only about 50%. In fact, pill users 60% will go off of the pill within a year just because they are unhappy with it.
MICHELLE: Right. They don't feel good on it. Which I know. We see it all the time on EmpowHER. They don't feel good on it and/or they are changing pills with their girlfriends because they are gaining weight. There's this whole thing going on with birth control--it's just so fascinating. Obviously, with an IUD, you don't have a lot of those same situations that they are faced with when they are taking the birth control pill. What implications do these findings have for healthcare of women, particularly our young women?
DR. HALL: What we've found is not only are women happy with this form of birth control and not only is it the most effective form of birth control we can offer – so 99% effective in terms of preventing pregnancy but we also have found that, by and large it's very, very safe. What we've found when we followed women and looked at other studies is that for many years there has been concern that young women, women who had multiple sexual partners who hadn't previously been pregnant, teenagers, there used to be a lot of concern that they would be at a higher risk for side effects from IUD's.
What we've found again and again in the literature as in the [inaudible 6:02] is that is simply not true. The rate of side effects or problems or serious complications from IUD's is actually very low among all women. Because it's so effective and so popular with the women who use it, we are trying to educate people that this can be a really good option for a lot of women out there.
PAM: When you are out there at the University of Wisconsin and you see all of these young women coming through the student health center, what kind of conversations are you having with them about birth control options? Do you find that they are asking sort of the same kinds of questions? Is there a fear? Is there anxiety about the IUD?
DR. HALL: It's a good question. What we find is that there's a lot of confusion and there's a lot of lack of knowledge out there. Usually a visit for birth control, when we do it right--which hopefully we do most of the time-- if they are not very educated when they come, that visit can easily take 30-60 minutes because there are so many options out there.
Each one of them has its unique benefits/advantages as well as risks and there's stylistic differences. You have to figure out what's the right fit for the woman in terms of does she want to take a pill every day, does she want to use a ring, does she want to have an implant, does she want to have an IUD. So, there are so many different options to choose from that there's a lot to know when trying to choose a birth control method.
MICHELLE: How do you handle that like when they are coming in and they need like 30 to 45 to 60 minutes with you?
PAM: Good luck.
DR. HALL: So, thankfully there are some good resources out there. Planned Parenthood has some good resources. There's a website that's called bedsider.org. There's a lot of online information. Of course, we give them a lot of handouts. Sometimes we give them a whole bunch of pamphlets and say if they are not yet sexually active and they don't urgently need contraceptive I'll say, "Go home, read through these things and come back with your questions and we will talk about it then."
PAM: It's tough. I think that certainly Michelle and I are in the business of educating women. Young women are so swayed by what they read in the media. They are looking at fitness magazines, health magazines and back and forth. Michelle wouldn't you agree that they are just sitting around half the time just confused and what do I do?
MICHELLE ROBOSN: Completely. To Dr. Hall's point, they don't know, so we have to educate them. That's what we do on EmpowHER. That's why we are doing HER Radio and it's really all about education. The more education we can give the patient the better off we are going to be and they are going to be.
PAM: What we want to do is thank you so much, Dr. Alexandra Hall, for being on HER Radio to help us understand why young women say they are happy with IUD's. You did such a great study and you've really done a huge favor for all of the young women out there. We so appreciate that. Now we understand that it's all about knowing and learning.
I'm Dr. Pam Peeke with Michelle King Robson.
MICHELLE: I'm a big fan, Dr. Hall. You can go to Dr. Hall's website at www.uwstout.edu/healthandsafety.com. You're listening to HER Radio. Like us on Facebook, follow us on Twitter. Stay well.
RadioMD Presents:HER Radio | Original Air Date: June 11, 2015
Host: Michelle King Robson and Pam Peeke, MD
Dr. Pam Peeke, New York Times best-selling author and founder of the Peeke Performance Center and Michelle King Robson, leading women's advocate, entrepreneur and founder of EmpowHER.com host the show everyone's talking about. It's time for HER Radio.
PAM: Hey, Michelle when you and I were going to college (you're a little smarty pants, aren't you?) do you remember IUD's were a big deal for birth control in addition to the diaphragm and the pill? A lot of women, a lot of my classmates had them. I think they kind of disappeared a little bit. Now, it appears that there's a bit of resurgence. I was looking at that piece with you. Fox News did a little something on young women say they are happy with IUD's, what's going on with that? We have Dr. Alexandra Hall. She's a family physician who specializes in college health. She's been doing this for the last 10 years.
She started out at Cornell and is now at the University of Wisconsin. Dr. Hall and I were just laughing about the fact that the University of Wisconsin is at Stout, which is about an hour north of Minneapolis. There you have it. She is an expert in understanding what the real story is presently with IUD's.
So, Dr. Hall, Michelle and I welcome you to HER Radio and why don't we start right on in? Tell us what an IUD is and how does it work to prevent pregnancy?
DR. HALL: Absolutely. An IUD is a small, plastic device-shaped like a seed (the ones available in the United States) and each arm is about the size of a matchstick. It gets placed up inside the uterus--hence the name intrauterine device--during a visit to your healthcare provider. It provides lasting contraception from anywhere from 3 to 10 years depending on the model that you are using. What we now understand about how they prevent pregnancy is one of two ways – usually by thickening the mucous in the cervix so that sperm cannot get up into the reproductive tract and then also potentially by making it not possible...for the sperm to not do their job if they do get through.
MICHELLE: Is the IUD, Dr. Hall, the most common form of birth control that we are seeing today?
DR. HALL.: That's a great question. It's not at all. At least not in this country. Only about 7% of women in the United States use an IUD currently. But the CDC, the American College of Obstetricians and Gynecologists and lots of other organizations are working to try to change that and increase rates of IUD use because they are so effective at preventing pregnancy. This is super important because right now about 50% of all pregnancies that occur in the United States are unintentional pregnancies.
MICHELLE: Really? How much? About 50%?
DR. HALL: About 50%.
MICHELLE: Do we know why?
DR. HALL: That's a good question. So, of those unintentional pregnancies, again, it's about a 50/50 split. Half of those women aren't using any form of birth control at the time they conceive and the other half are using a form of birth control but not using it perfectly. So, they are on pills but they maybe forgot to take the pills with them for the weekend, the condom broke, or something else happens.
PAM: So, you have been studying this, right? This whole phenomenon of IUD? Tell us about what you found in your studies that you are really looking at – the stories behind IUD's presently.
DR. HALL: IUD's fell out of favor in the 1970's when there was a type of IUD that caused some serious infections in young women. So, they really lost favor. We no longer use that IUD. The IUD's that we have now are very safe and yet we are still finding a lot of reluctance among practitioners and patients to use those devices.
So, what we did is we followed college students from Cornell University who chose to use the IUD and said, "How did they do? Did they like it? Did they not like it?" What we found is that 83% of women at one year were either happy or very happy with their IUD as a form of birth control, which is beyond the charts for birth control. Usually, when you are looking at happy or satisfied customers, it's usually only about 50%. In fact, pill users 60% will go off of the pill within a year just because they are unhappy with it.
MICHELLE: Right. They don't feel good on it. Which I know. We see it all the time on EmpowHER. They don't feel good on it and/or they are changing pills with their girlfriends because they are gaining weight. There's this whole thing going on with birth control--it's just so fascinating. Obviously, with an IUD, you don't have a lot of those same situations that they are faced with when they are taking the birth control pill. What implications do these findings have for healthcare of women, particularly our young women?
DR. HALL: What we've found is not only are women happy with this form of birth control and not only is it the most effective form of birth control we can offer – so 99% effective in terms of preventing pregnancy but we also have found that, by and large it's very, very safe. What we've found when we followed women and looked at other studies is that for many years there has been concern that young women, women who had multiple sexual partners who hadn't previously been pregnant, teenagers, there used to be a lot of concern that they would be at a higher risk for side effects from IUD's.
What we've found again and again in the literature as in the [inaudible 6:02] is that is simply not true. The rate of side effects or problems or serious complications from IUD's is actually very low among all women. Because it's so effective and so popular with the women who use it, we are trying to educate people that this can be a really good option for a lot of women out there.
PAM: When you are out there at the University of Wisconsin and you see all of these young women coming through the student health center, what kind of conversations are you having with them about birth control options? Do you find that they are asking sort of the same kinds of questions? Is there a fear? Is there anxiety about the IUD?
DR. HALL: It's a good question. What we find is that there's a lot of confusion and there's a lot of lack of knowledge out there. Usually a visit for birth control, when we do it right--which hopefully we do most of the time-- if they are not very educated when they come, that visit can easily take 30-60 minutes because there are so many options out there.
Each one of them has its unique benefits/advantages as well as risks and there's stylistic differences. You have to figure out what's the right fit for the woman in terms of does she want to take a pill every day, does she want to use a ring, does she want to have an implant, does she want to have an IUD. So, there are so many different options to choose from that there's a lot to know when trying to choose a birth control method.
MICHELLE: How do you handle that like when they are coming in and they need like 30 to 45 to 60 minutes with you?
PAM: Good luck.
DR. HALL: So, thankfully there are some good resources out there. Planned Parenthood has some good resources. There's a website that's called bedsider.org. There's a lot of online information. Of course, we give them a lot of handouts. Sometimes we give them a whole bunch of pamphlets and say if they are not yet sexually active and they don't urgently need contraceptive I'll say, "Go home, read through these things and come back with your questions and we will talk about it then."
PAM: It's tough. I think that certainly Michelle and I are in the business of educating women. Young women are so swayed by what they read in the media. They are looking at fitness magazines, health magazines and back and forth. Michelle wouldn't you agree that they are just sitting around half the time just confused and what do I do?
MICHELLE ROBOSN: Completely. To Dr. Hall's point, they don't know, so we have to educate them. That's what we do on EmpowHER. That's why we are doing HER Radio and it's really all about education. The more education we can give the patient the better off we are going to be and they are going to be.
PAM: What we want to do is thank you so much, Dr. Alexandra Hall, for being on HER Radio to help us understand why young women say they are happy with IUD's. You did such a great study and you've really done a huge favor for all of the young women out there. We so appreciate that. Now we understand that it's all about knowing and learning.
I'm Dr. Pam Peeke with Michelle King Robson.
MICHELLE: I'm a big fan, Dr. Hall. You can go to Dr. Hall's website at www.uwstout.edu/healthandsafety.com. You're listening to HER Radio. Like us on Facebook, follow us on Twitter. Stay well.
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