VIDEO TRANSCRIPT: THIS TRANSCRIPT WAS GENERATED USING AN AUTOMATED SERVICE SO WE APOLOGIZE FOR ANY TYPOS AND SPELLING ERRORS.

IUD Tawk

[00:00:00] Hello. We're gonna talk about IUDs. This is an iud. This is actually a pin that's an iud, but we're gonna talk about IUDs. As promised, my eyes look freaky cuz I decided I'm gonna be upstairs using my ring light today. I haven't used this in. A long time. I think I used it once, so i u D stands for intrauterine device. 

It is a contraceptive product. Is it better than anything else? The answer is like anything else. There are pros and cons to the I U D. You might love being on the pill or the patch or the ring or using condoms or being comfortable with withdrawal. A method. If you're okay with a certain level of failure and ability to get pregnant, you might be okay with natural family planning if you're really compulsive with it, but, Pros and cons to all those. 

So an I U D is a great alternative, especially for those people who feel like they might not take the pill every day, especially for those women who don't want to have systemic side effects from the hormones of the pill, the patch, the ring. So let's talk about IUDs in general. entry uterine device means it literally [00:01:00] sits inside your uterus. 

And I'm gonna show you a couple different models of things so we can try to visualize it. I need you guys to understand this. It sounds simplistic, but an i U D does not sit in the vagina. It goes up into the uterus. This is an example of your vagina that is your cervix. This is the. Opening. This is actually the canal of the cervix. 

And then this is where the I U D would sit inside the uterus. This is where the tubes are, and the ovaries would be sitting here. So when you're having intercourse, this is where the penis would be. Okay? So the i u D is up in there. This is the i u D. The string starts here and comes out. So nobody's gonna feel it or poke it or harm you by doing anything. 

I need you guys to understand that, cuz I think conceptually it's really hard to get, so hopefully this lasting image, i u d in that space, not in the cervical canal, not in the vagina. This is where a tampon would sit. Okay. Just to give you the background. In general, there's two general types of IUDs, [00:02:00] right? 

There is copper. There is one that has hormones in it. Let's first talk about the side effects of an I U D, meaning all IUDs. Are 99.7% effective. We say that means three out of a thousand women will get pregnant, and if they do get pregnant, the concern is that now that there's something sitting here, when the egg and the sperm meet and create the embryo, they don't necessarily have an easy place to implant because the i u d, the intruder device is stopping their ability to implant so they can stay inside the tube. 

And that can be what's called an ectopic. So if there's pregnancy outside of the pre, outside of the uterus, in the tube or anywhere, , it's an ectopic. So first and foremost, you should know that like any form of birth control, it's not a hundred percent 99.7. Pretty good odds, especially because it doesn't require you to do anything. 

You don't have to remember the pill. You don't have to remember the patch. You don't have to remember to put on the condoms, although we're gonna talk about condoms because that's still important with an I U D. So for pregnancy alone, [00:03:00] 99.7%. That's first. Second, putting in an I U D can be crampy. We're gonna go through how to put it in in a second. 

I have my speculum to show you. It's crampy and uncomfortable as you can imagine, because the opening of the cervix, by the way, is rarely that open. Even if you've had babies, it's not that open. This is a very faulty model in that way. So it can be crampy and uncomfortable, but typically taking ibuprofen or one of the NSAIDs ahead of. 

will make it much more tolerable and you can ask most patients who have gone through, gone through it, it really sucks for that couple of minutes, but then it's done and it typically takes one to three minutes and that is it. Is it harder to put it in in a young woman who has not had a baby? probably because her cervix will not be as dilated, but that's not always true. 

Even women who have had babies, sometimes their cervix is small and, and, and closed shut. And even women who haven't had babies sometimes have a more dilated cervix. So it's not across the board. But those are the things you have to consider. And you have to remember that when you have an i u D in, [00:04:00] there are strings coming out and there's a foreign body in your uterus. 

That means that the risk of chlamydia or gonorrhea sticking to the strings and causing a very bad pelvic infection is higher. Nobody wants gonorrhea or chlamydia, but you especially do not want it if you have an. . So I tell patients all the time, having the i u D does not mean that you don't need to use condoms. 

It means that if you are at all in a non-monogamous relationship, you have to use condoms. Okay, so between copper and the hormone, i u d, let's first talk about the copper i u d. So this is all a little model. You see that little, that's a piece of plastic that's wrapped in copper. The benefits of the copper i u d, no hormones. 

It's actually really the only thing outside of condoms or natural family planning where you go by your calendar mucus, things like that. It's the only thing we have that doesn't have any hormones in it. So the beauty of this is that women who have had breast cancer, for example, or women who for whatever reason just do not wanna have a trace of hormone in their [00:05:00] system, this is what they could. 

The downside is, the way this works is it causes a little bit of healthy, non-toxic, non-infectious inflammation that makes the cervical mucus less likely to allow the sperm to get in there, and a little bit of inflammation in the lining of the uterus. And that means, unfortunately, that you might get heavier crampier periods. 

So if you come to us with a history of heavy crampy, irregular periods, the likelihood is we're gonna say, this is not gonna be the one for. Anyone else, it's fine. And if you said, I have heavy crampy periods, but I don't mind it and I'd really rather do this than anything else, then you can have it and it lasts for 10 years, so that's another huge benefit. 

You don't need to worry or think about it for 10 years, but again, you can see the string comes out. So if you get exposed to chlamydia or gonorrhea, that is not good. Please use condoms if you are at all considering being with more than one partner or if you think your partner is with someone else.[00:06:00]  

That's the copper i u d. 10 years zero. Hormones may be crampier, period. The next one is, , the I U D that has hormone in it. The most common one was originally called Marina. Now there's a generic of Marina called Liletta, and there are a couple other offshoots, meaning Marina and Liletta can last for six years. 

The newer offshoots Ky um, Skyla are variations of it as far as how long they last and whether or not you may get more of a period. So we're gonna primarily talk about Marina and Liletta, marina and Lile. . I'm gonna show you this example. Do you see this? See, the difference is it's just all plastic. So that little plastic is impregnated, no pun intended, with progesterone. 

Hormone. Just progesterone, no estrogen. I'll tell you why in a second. The beauty of this, Is that it makes your period thinner and lighter, and we'll talk about why. And it can stay in, we used to say for five years, but now the newest data says six years. So that [00:07:00] means that a woman can put this in and not have to worry for six years. 

Who is this a great candidate for? Well, I have heavy crampy periods. I just don't want my period. I have polycystic ovary syndrome where I never get my period, and I don't know when it's gonna come, and I have to be mindful that I need my uterine lining to be thin. Those are all great people. In other words, anyone except for women who either shouldn't have hormones, for example, if you have had breast cancer, your oncologist would likely tell you they would rather you not use this and they'd rather you use the the copper i u d. 

But if you. I actually just don't want systemic hormones, meaning when you take the pill, the hormone gets into your system suppresses ovulation, and that's how you stop yourself from getting pregnant. This is not systemic. This is only in your uterus. This hormone shouldn't get into your system at all. 

The company in the package insert really says that they've done studies and that it does not get into your system. I would say anecdotal. A couple of percentage of [00:08:00] patients per year in our practice will say that they feel side effects that seem systemic. Breast tenderness, nausea, acne, mood changes, weight changes, and those could be progesterone side effects. 

Now, when we take out the I U D, they seem to feel better. Is it from the I U D? Is it placebo? We don't know. It doesn't matter if they feel better. This is not for them, but they wouldn't know unless they try. And again, I would say in my practice anecdotally, that is a small percentage, like 95% of the women who have this i u d will love this i u d because. 

They get very little period or no period at all, which is excellent and safe. And again, we're gonna talk about the hormones and why that's safe in a second. As far as, um, other side effects, really it's the insertion for both IUDs. There's a small risk of perforation through your uterus and it's crampy to put it in. 

99.7% effective. Yes, you have to worry about an ectopic if you do get pregnant. So if you ever worry that you are pregnant, meaning your breasts feel different, you're nauseated, you're bleeding [00:09:00] differently, you weren't getting your period with the I U D that has the hormones and all of a sudden you do get it. 

Anything different. Do a pregnancy test and please use condoms. Okay, now let's just talk quickly about hormones and why this is okay. In a typical cycle, your estrogen hormone will prime up the lining of the uterus and thicken it up, and then once you ovulate, that's the signal to your uterus. To release your lining and shed it out. 

Right? So we're supposed to thicken it and then shed and thicken and shed, and ideally that happens at about monthly cycles. Unfortunately, there are some women, for example, if you have P C O S, polycystic ovary syndrome, where your estrogen levels are thickening the lining, but they're never getting the signal to ovulate and shed it out. 

This is a great idea because this will stay inside and constantly thin it out. And for the rest of women who are getting, let's say, a regular, normal cycle, the estrogen will still be there. Your cycle will still ovulate at least 70% of the time. They say maybe 30% of the time this might locally suppress the hormones that cause ovulation, but the rest of [00:10:00] the time you're gonna ovulate, your lining's gonna thick. 

In theory because the estrogen is working. But in reality, because the progesterone is constantly antagonizing, that estrogen's ability to thicken the lining, it never thickens up. So your lining stays thin. So the notion that you have to shed that lining and that it's bad for it to stay in is not true when this is keeping it constantly thin. 

And that's an important thing to know, cuz many women will say, is it bad? Is it unnatural? Is it unhealthy? Well, if it were bad, unnatural, unhealthy, we probably wouldn't let you do it, but. Unnatural. Yes, cuz we're putting in something into your uterus. But we've accepted that is unnatural in a way that is not unhealthy and in fact can decrease the risk of uterine cancer because one of the mechanisms for uterine cancer is that thickening and need to shed this does not allow it to thicken. 

But let me repeat your hormones. Your systemic hormones are still working, so your body should still feel the same, but without a period. Okay? So I just wanna show [00:11:00] quickly how we put it in and yes, it's crampy. I gotta be honest, I can't lie. Okay? This is a speculum. Who knows what this is? Show and tell speculum. 

You guys call this. That is not true. It's not a clamp because it's not clamping down on anything. It's actually going inside the vagina and then opening up so that we can see what's in there. So this is not made to go with this model, but we're gonna show you anyway. All right. So we would put in the speculum into your vagina, right in here. 

Then we would open it up and we would see your cervix. And then once we see your cervix, we have. Our I U D and these, that little thing pulls back. Mine is malfunctioning, so I'm gonna use my other one. I love these show and tells, okay, so this pulls back into the little mechanism. We put that up inside, we pull back, and then [00:12:00] the little. 

Stays out, we pull it out, we cut the strings, and then this is in your uterus again, non hormone. I u d. Copper can stay in 10 years. Hormone i u d six years, unless you have one of the other brands, which would be three to five years. Talk to your doctor about those other ones. I tend to use these ones the most, the six year one, because once you have it in who wants to take it out and the six year one doesn't have to stay in for six years, it can come out sooner. 

what are some other things that you should be mindful of? Let's say you suddenly have changes in your bleeding. We've talked about, please make sure that you check a pregnancy. But you should go see your doctor because there is that chance that your uterus decides to contract and push the I U D either out or move it down enough that it might not be effective. 

Let's say somebody has their hand in there. You need to be mindful and let your boyfriend or girlfriend know not to pull on those strings. That sounds crazy, but we have seen that before. Many gynecologists will tell you that they have heard a patient come in and say, my [00:13:00] partner didn't know, and she pulled it out, or he pulled it out. 

So please make sure of that. Other things to just make sure of are, it's good for you to go to your doctor yearly so they can tell you when you got this put in. But put a little notation in your phone. Everyone has a phone. Remind yourself when you had it put in so that you know when to get it taken. 

Okay, so again, the IUD is great. Is it the best form? There is no best form. All forms of birth control have pros and cons. Just like everything in our world has pros and cons. This is one form that can be amazing, especially if it's troublesome to remember the pill, the ring, the patch. But you cannot forego condoms if you're not sure you're in a monogamous relationship. 

Okay, I hope that helps. Bye.