Gordon: Better than birth control

You should probably take two Tylenol beforehand,” my gynecologist advised me.

“What about codeine?” I asked.

“Well, codeine won’t make you feel less pain,” she said. “It’ll just make you not care about the pain.”

Two hours before the appointment I gulped down three tablespoons of liquid codeine. Ultimately, I still cared about the pain. An intrauterine device insertion is mildly painful for approximately five seconds and extremely painful for a lucky 5 percent. With my feet in stirrups and the speculum in place, I screamed mightily, one hand bashing the wall and the other crushing a midwife’s fingers. It felt sort of like giving birth. Except instead of producing life, I was eliminating my ability to produce life for five to seven years.

For those unfamiliar, an intrauterine device is one of the oldest forms of Federal Drug Administration approved contraception. There are two kinds — progesterone and copper — the former preferred by young women, the latter by married moms. Both are a 1-inch plastic “T” that is placed in the uterus through the cervix.

In France, 23 percent of women on birth control use an IUD, as do almost half the married women in China. The IUD is the second most common contraceptive in the world, behind female sterilization.

Yet in America, less than 2 percent of women on birth control do. Americans, and especially American co-eds, are not fans of the IUD. Many have no idea what it is. High school sex-educators tend to place the IUD in the same quirky vintage birth control category as diaphragms and cervical caps.

In our mothers’ generation, the IUD came to mean deformed children, inflamed pelvises and bitter lawsuits. In the 1970s, the Dalkon Shield, a now-defunct brand of IUD, damaged hundreds of thousands of uteri and led to the largest tort liability case since asbestos. Although both types of IUD on the market are now perfectly safe, there are few parents, teachers and doctors in America who enthusiastically recommend either.

So women today choose instead a sexier and less stigmatized form of birth control. Thirty-eight percent of American undergrads currently pop a pill every day to keep their uteri sperm-unfriendly. But if women can get over the idea of a foreign body in their uterus, the IUD has much to recommend it over oral contraceptives.

Unlike the pill, the IUD is a one-time insertion. The intense but very brief pain involved is a bargain for half a decade of pregnancy-scare-less intercourse. If sometime in that window you become interested in impregnation, the IUD is conveniently reversible.

I tried the pill the beginning of my freshman year. It was a problem. For starters, the pill has to be taken at the same time every day for optimal effectiveness. My first semester freshman year, there was not a moment every day that I was consistently awake.

Take it first thing in the morning, my doctor suggested. Um … the first thing of what morning? The morning I wake up at 6 a.m. to do my maximally procrastinated problem set? The morning I wake up at 2 p.m., since it’s Sunday? The morning that I have no idea what time of day it is, because I’ve been upstairs in G-Heav writing a paper for 24 hours?

The price of a missed dosage is the dreaded, but scenic, Hillhouse shame walk. Of course a girl from your section is also in line at the YUHS pharmacy, picking up malaria pills for her internship in Uganda. You tell her you’re “getting antibiotics” for a “skin thing.”

The pill also made me crazy. A lot of people first semester freshman year feel occasionally overwhelmed, numb and nauseous, spontaneously burst into tears, gain weight and radically swing between manic and depressed. Maybe it wasn’t the pill. At the time, however, it seemed those little white pills contained 50 mg of mental meltdown.

These are all common complaints about the pill. Loss of libido, vaginal dryness and acne are other reported side effects, as well as an increased risk of heart attack, stroke and possibly breast cancer. Sexual liberation isn’t all that useful with a palpitating heart, zero sex drive and a dry vagina.

There’s also the cost factor. Most Yale students’ birth control regimens are heavily subsidized by insurance, but some prescriptions are still over $50 a month. Changing to a cheaper brand is tricky, when the product in question is a particular bundle of hormones.

The IUD, in contrast, is a single expenditure. On the Yale Health Plan, if you haven’t yet paid the $100 deductible, it’s a one-time installment of $180. I’m baby free for less than a dime a day — half the cost of the cheapest, best insured pill.

You’ll also save a lot of money on Tampax. For some women, the pill can cause heavier and screwier periods that reappear mid-cycle or last for weeks. An IUD, however, can make them magically vanish.

The progesterone IUD makes many women’s periods shorter, lighter and ultimately nonexistent. If, like me, your period is not a monthly reminder of your earthly fertile womanhood, but a scourge on your life, than the IUD is a one-inch miracle. Yes, the insertion procedure can involve intense pain. But menstrual cramps are also painful, as is calling your roommate a “demon bitch” because of hormonal madness.

No amount of liquid codeine can anesthetize those hurt feelings.

Claire Gordon is a senior in Saybrook College.


  • Umm…

    1. I take issue with the title. What’s better than birth control? The only answer to that question is not having sex. This article is about a supposedly better FORM of birth control.

    2. Gordon claims that an IUD with progesterone is somehow the blessing menstruating women have been waiting for, but a pill with progesterone is going to turn us into bleeding, shrieking, fat, acne ridden banshees. Well, I don’t buy it. All the good side-effects of the IUD that she mentions are also potential side effects of BCPs, and all the bad side-effects of BCPs are potential side-effects of an IUD. It’s the active ingredient that does these things, not the method of delivery.

    Ms. Gordon, your articles are normally so good. But this one is crap.

  • this is awful

    I don’t understand why this was published. There is no “opinion” truly established here other than that one person prefers one method of birth control over another. What do we care? The YDN is not a health forum or a place for columns that advertise a product. Try to stick to opinion pieces that express opinions on pertinent issues. This does not read like an opinion. It’s also very poorly written.

  • YLS Student

    I really liked this piece. Though I do not plan on going out to get an IUD (and will stick to my pills), I very much appreciated the author’s openness in talking about this issue, which is rarely aired so honestly.
    It is true that the headline captures only one point of the article, as the piece also reveals very much about being a female at Yale College. As an undergraduate, I went through many similarly awkward and frenzied moments. It can be difficult and overwhelming for an intelligent woman with many other things on her plate to struggle with birth control on an everyday basis.

    Thank you for your honesty and openness, Claire.

  • ’10

    It’s great to talk about different kinds of birth control, but I think you shouldn’t present IUD’s and contraceptive pills as the only two options. Honestly, I have no idea why so many women rely on pills when there are so many other (and in my opinion, better) options that (unlike IUD’s) don’t involve excruciating pain. You can get Depo-Provera shots every three months, use a weekly patch, or the once-monthly NuvaRing. Why stick a piece of metal in your uterus?

  • yalie

    First, I would say that the side effects you list for the pill, including but not limited to those above, ARE NOT UNIVERSAL. You are completely within your right to describe your body’s reaction to the pill, but presenting these side effects as common is deceptive and just plain incorrect. Many women on the pill actually experience lighter periods, more regular periods, and acne improvement (in fact, the pill is often prescribed to treat problems in these areas, even when patients are not sexually active).

    Furthermore, it is irresponsible to say that the pill leads to increased risk of cancer. Studies have not shown a positive or negative correlation between the pill and breast cancer. Moreover, according to the informational pamphlet I was given at DUH, pills reduce the risk of ovarian cancer: three years reduced the risk of ovarian cancer by 40%; ten years reduces the risk by 80% and pills reduce the risk for endometrial (uterine lining) cancer. And, the rate of serious side effects like blood clot and heart attack is very, very low. Your article is deceptive making these seem common.

    As a previous commenter pointed out, there are few differences on the macro level between the pill and an IUD in terms of side effects. Individuals may prefer one to the other, based on their lifestyles and comfort. Your decision to get an IUD is a personal one, a totally fine one, one that YOU made for YOUR body and YOUR life, but you should not use scare tactics to get other women to switch to an IUD if the pill is working for them.

  • P.A.

    Thanks, Claire, for this honest, informative, and funny piece about a little-discussed form of contraception.

  • young yale alum

    As a female alum, I’m kind of confused about why a female Yale student would want to publish articles describing a “dry vagina” and other very personal aspects of her gynecological and mental health. This kind of thing would only be held against a woman trying to make it in the “real world”, unless she’s planning to become a sex advice columnist. I’m concerned for the careers of the Yale students who are suddenly writing so much, non-anonymously, about the most private area of their life (sex and sexual health). It’s great for the other students, who get to learn from their peers, but the people who are writing may find that these articles haunt them.

  • Y11

    I think this article has some flaws, but it makes a good point. I never understood why so many women who have trouble taking the pill regularly are on it in the first place. Options like the Nuva Ring, the Patch, and the Shot are much better suited for the lifestyle of college students than the traditional pill.

    The hormonal affects of some birth control is very real for some users, and the non-hormonal IUD is the most affective non-hormonal choice, so those who don’t like hormones should be informed about it.

    The IUD is definitely under represented when it comes to discussing birth control methods.

  • Y10

    Great article! I was on the fence about IUDs, but I’m now reassured and convinced that I should get one for myself! It’s nice to know that women my age are starting to explore alternate forms.
    And actually, in response to previous comments, depending on the type of IUD you get, the side effects are not at ALL the same as with birth control. Yes, there can be some spotting the first month, just like with the pill. Yes, there might be some hormonal side effects. However, nowhere in the pamphlets for the IUDs I’ve been researching do they list heart attack, blood clots, stroke, gallbladder disease. The worst side effect of an IUD is probably pelvic inflammatory disease, which comes not from the hormones released, but from the device itself. I’d take that over a blood clot or stroke any day.
    This was a well articulated article that advocated for a very nice/safe alternate to the pill and merely explored an option most people might not think about.

  • ….

    If you represent Yale, then I must say Yale is a disgusting place.

    Do you get paid to write these articles, or are you just a natural ?

  • BtL’10

    Thanks for another informative article Claire. And some of the comments were interesting too – but not the stupid hater ones like #10. Yo 10, go [insert “disgusting” word here] yourself. Why are you on the YDN website anyway if you think Yale is so disgusting?

  • Hiring Mgr

    Right. On. The. Button (as they say).

  • Anon.

    Something tells me that Claire doesn’t really want to work at the place where youre a “Hiring Mgr”, #12. Jeez, how about being supportive of an incredibly smart and savvy young woman whose stylish and provocative writing will surely get her far? Ok, maybe not at Goldman Sachs. But anyone who has met Claire Gordon can assure you that her future success in the “real world” is not in question.

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