Unless you’ve been living under a rock lately (which is totally possible, it is midterm season), you’ve heard about all of the controversy surrounding birth control. From Congress to the presidential debates to Twitter to Facebook, everybody is talking about birth control, who should have access to it, and how they should get that access.

That conversation mostly focuses on the birth control pill. Sometimes Nuva Ring and Depo Provera, the monthly shot, are also mentioned. But there’s another form of long-term birth control that’s gaining popularity in the U.S. And when considering your birth control options, it might be worth a look.

The intrauterine device, or IUD, is the most popular form of contraception worldwide. But not in the U.S., where oral contraceptives are the most commonly used form of birth control. Why? In the 70s and 80s, lots of poorly conducted research incorrectly linked IUDs to serious infections. It was also thought that IUDs might affect future fertility, so they were only recommended for women who had already had children and wanted to prevent future pregnancies. But better research has disproved all of these fears, and now IUDs are becoming more popular among young, unmarried, childless women. And they’re blogging about it, too, on sites like IUD Diva.

Since 2002, the number of women using IUDs in the U.S. has more than tripled. IUDs now account for 10.4% of contraceptives issued by doctors in the U.S. That’s still low compared to many other countries, but it’s a big increase.

IUDs are more than 99% effective at preventing pregnancy. The Association of Reproductive Health Professionals reports that the number of women who become pregnant while using an IUD is about 1 in 100. Compare that to 8 in 100 women on the pill, and 15 per 100 among condom users.

IUDs last for 5 or more years, depending on the type. Once implanted, they don’t require any maintenance beyond usual checkups. So no pill to take, ring to insert, or shot to get. They’re helpful for women who have heavy periods, as they can reduce or even stop menstrual bleeding. Plus, they’ve been shown to reduce the risk of developing endometrial cancer, and they may help protect against cervical cancer as well. Sounds pretty great, right?

So how does an IUD work? Unlike the pill, IUDs don’t prevent you from ovulating. Instead they interfere with the fertilization and implantation of eggs.

There are two types of IUD available in the U.S. The first, ParaGuard, is a non-hormonal IUD that can stay in place for 10-12 years. It contains copper, which stimulates the production of natural sperm-killing fluid in the reproductive tract. If an egg becomes fertilized, the copper causes changes in the uterus that prevent the egg from being implanted.

The second, Mirena, is a hormonal IUD that lasts for 5 years. It thickens the cervical mucus, making it difficult for sperm to reach the fallopian tubes. It also prevents changes in the uterine lining that are necessary for the implantation of a fertilized egg.

IUDs have to be implanted by a doctor, and taken out by a doctor as well. They’re not appropriate for some women with certain preexisting medical conditions. And they don’t protect against STDs, so unless you’re with a trusted and tested partner, condoms are still needed. Another issue is cost – implantation can cost between $300 and $1,000. But it’s covered under many insurance plans, and it’s also a one-time cost for a device that lasts for years.

I’m a longtime user of the pill, but all this new information about IUDs has me thinking. It’s definitely something I might look into.

What do YOU think? Do you use an IUD? Would you consider using one?

Garnet is a student at Columbia University in New York City. She is “that person” who starts dancing at a party when everyone else is standing around, and if there were a Facebook stalking Olympics, she would be a gold medalist. She also loves cheesy 90s music, and almost died of happiness when Vanilla Ice retweeted her. Once. Follow her on Twitter @garnethenderson.

Most random celebrity couples

Facebook vs. Twitter: which one is better?

7 adorable and comfy flats

Now you can find knock off versions of Kate and Pippa’s wedding looks

10 reasons you should be banned from the internet

What you need to know about the IUD

4 Hottest nail polish trends for 2011

Do you ever fake it?

Tom Hanks’ rapper son has a music video…oh dear

Pippa Middleton covers Tatler magazine

Maria Shriver finally files for divorce

]]> http://collegecandy.com/2011/07/06/candy-dish-guess-who-he-hooked-up-with/feed/ 0 ccandystaff conan_o_brien http://collegecandy.com/2011/06/21/sex-in-the-news-better-than-the-pill/ http://collegecandy.com/2011/06/21/sex-in-the-news-better-than-the-pill/#comments Tue, 21 Jun 2011 20:30:12 +0000 Ashley - University of Michigan http://collegecandy.com/?p=107719 ]]>

As college girls, we have a lot of on our minds. From balancing work and class, yoga and fast food, our boyfriends and Half-Off Ladies Night, there is a lot to keep track of! So maybe you can relate with me when I say that the last thing on my mind is remembering to take the biggest pain in my ass, The Pill. Ladies, I am going to be honest with you. I hate the pill. I truly despise it. I leave it everywhere, sleep through my ‘You Don’t Want a Kid” alarm, and often go days without even thinking about it. So let me tell you, when I heard that there was another alternative – that doesn’t involve shots or wearing a patch – I was intrigued. When I read that it was the safest and most effective alternative to taking the pill, I called my doctor.

American College of Obstetricians and Gynecologists just released a report this Monday stating that the reversible contraceptives (like the IUD) are the safest and most effective contraceptive for all reproductive aged women. According to the study, most women who have had an unplanned pregnancy were using contraception, but were inconsistent. With a 0.05 pregnancy rate, these devices are inserted into the uterus by a doctor and then can be forgotten about until they’re removed. There are no alarms or daily reminders.  IUDs and the alike, release hormones that prevent pregnancy for up to five years.

They are also reversible, which means that if you want to get pregnant later, all you have to do is have a doctor remove it. To avoid sounding like a commercial on Lifetime, let me just quickly tell you that of course, like all contraceptives, there are risks. These include increased menstrual bleeding, cramps, and infection.

For more information, check out the article on Women’s Health or see your doctor. The IUD isn’t for everyone, but if you are anything like me, it might be the perfect no-baby solution for you!

Hey Girls, let me know. Have you tried the IUD? What form of birth control do you recommend? Help a sister out!

Gettin' some doesn't come cheap.

With the latest events surrounding Planned Parenthood, I’ve been thinking a lot about how much it costs to be responsibly sexually active. Birth control, condoms, PAP smears, STI tests, and Plan B — it adds up fast!

In Canada, the cost of medical tests are usually covered under our provincial health care. As far as birth control goes, my school’s health insurance plan covers the vast majority of the cost every month, leaving me to pay a tab that usually ends up anywhere between $3 and $5.

But for Americans without access to insurance or an institution like Planned Parenthood, the cost of having a healthy active sex life can be huge. Prices tend to vary from place to place, but according to the Planned Parenthood website, here are some ball-park figures of how expensive it is to get sexy:

Standard medical exam (needed in order to receive a BC prescription): $35-$250

The Pill: $15 – $50 per month

NuvaRing: $15 – $70 per month

Depo-Provera: $35 – $75 per injection (4 injections per year)

Ortho Evra (the patch): $15 – $70 per month

Birth Control Implant: $400 – $800, effective for up to 3 years

IUD — $500-$1000, implanted once and effective for up to 12 years

Condoms: Though you can often receive condoms for free from sexual health clinics, a 12-pack of condoms can cost anywhere from $5 to $15

Pregnancy Test: Up to $20

Plan-B (morning after pill): $10 – $70

PAP smears and STI Tests: Sliding scale depending on income and state

The bottom line is, this sh*t can get expensive, and having a place like Planned Parenthood or other sexual health clinics that take into consideration that we all might not have $50 a month to spend on birth control is very important.

And honestly, as expensive as it is to be responsibly sexual — even with places like PP giving a helping hand — it’s even more expensive to raise a child or treat an STI. (Just ask CC writer Donyae, a college student and mother.) So maybe you should put off buying those fancy shoes and instead invest in your sexual health. It’s worth it.

Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

We thought we’d help and every Thursday our friend Dr. Lissa Rankin will be answering your questions. The ones you couldn’t ask your doctor in person and didn’t really trust the Yahoo community to answer for you. Just leave your questions in the comments, or send em over to us. (We’ll keep it all anonymous for you.) Dr. Lissa will answer anything – really, anything – about sex and other lady things. Don’t be shy; she’s waiting for ya!

Q: I’ve been on the pill (normal combination pill) for 3 years. I am very happy with it. I never miss a pill, but I take it at very different times during the morning. Does this decrease the effectiveness?

A: It’s always better if you can take your pill as close to the same time as possible, but if you normally take it at 8am and the next day, it’s not until 11am, that shouldn’t make much difference. The one exception is very low dose pills like Yaz and Mircette (pills with 20 micrograms of estrogen). In this case, it’s more important to try to remember to take your pill at the same time.

Q: I was also wondering, is it possible to use the pill with the Mirena IUD? Would you recommend it?

I hear you, sister. I’m assuming you DO NOT want to get pregnant! While I appreciate the sentiment, I would not recommend using a Mirena IUD with a birth control pill. Both contain hormones that act differently. And since both the Mirena IUD and oral contraceptives are highly effective, I don’t see the reason to assume the risks of both. If you’re particularly worried about pregnancy and want to use double protection, consider condoms plus the Pill or condoms plus an IUD. But adding two hormonal methods together can really mess up your system.  

Q: And finally, when I’m having sex with my boyfriend we sometimes start without condoms and then later he’ll pull out and put a condom on and continue. How effective is this in preventing pregnancy when used in combination with the pill? We’re in a monogamous relationship & have been tested, so I’m not worrying about STDs.

A: If you’re religious about taking the pill, and you’re using the withdrawal method and you’re sort of using condoms, chances are good that you will be protected from pregnancy. But mostly, that’s because of the Pill, which in and of itself is highly effective. In general, withdrawing before ejaculation is not an effective method of birth control because sperm are present in the pre-ejaculate released before orgasm.  So if you want to do everything possible to protect yourself, put the condom on before you start fooling around and leave it on until you’re done and can safely remove it.

It’s all about assessing your own personal risk tolerance. No birth control is 100%, which means that sex can always result in pregnancy. That said, it sounds like you’re being very conscientious to try to avoid an unwanted pregnancy, and I commend you for that.

Is your partner opposed to wearing a condom during sex? My gut tells me that maybe you would be feel a bit more comfortable if he did. If so, maybe it’s worth having a chat with him about this. Remember, it’s your body, and if anybody gets pregnant, it will be you. Listen to your heart, and honor your body.

Get to know more about Dr. Lissa on her website, www.owningpink.com

Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

We thought we’d help and every Thursday our friend Dr. Lissa Rankin will be answering your questions. The ones you couldn’t ask your doctor in person and didn’t really trust the Yahoo community to answer for you. Just leave your questions in the comments, or send em over to us. (We’ll keep it all anonymous for you.) Dr. Lissa will answer anything – really, anything – about sex and other lady things. Don’t be shy; she’s waiting for ya!

Q: I am weighing my birth control options with my boyfriend. There are so many different choices now, so which is the least likely to fail? Any help would be appreciated!

A: In my opinion, the two reversible birth control options that are the most reliable are the Mirena IUD and Depo-Provera. Other hormonal contraceptives are also highly effective if used correctly.  Barrier methods, such as condoms and the diaphragm, are the least effective for pregnancy prevention.  To help you, I’ll go through each birth control method, one by one.

Barrier Methods
I’ve listed the barrier method options below, along with how effective they are. As you can see, in typical use, the failure rate is very high, but they’re cheap, safe, and non-hormonal. The downside, apart from the relatively high failure rate (and resulting unintended pregnancies) is that they’re messy, sometimes difficult to use, and a real pain in the rear. But because condoms are the only way to reduce your STD risk (note that I said REDUCE, not eliminate), it’s important to keep them on your radar.

Hormonal Methods
Oral contraceptive pills (OCPs) fall into this category, as does Ortho-Evra (the patch), Nuva-ring (the vaginal ring), and injectable contraceptives like Depo-Provera.  OCPs, Ortho-Evra and Nuva-ring are all just different delivery methods of basically the same hormones, which work by shutting off your own system and replacing your body with the hormones your own body would otherwise make in a way that inhibits ovulation (in addition to other mechanisms of action that I won’t get into here).  How are they different?  Ortho-Evra is a slightly higher dose and is available as a patch you can attach to your skin, which must be changed weekly. Nuva-ring is a vaginal ring you insert into the vagina (it’s easy to get in). Nuva-ring can stay in for 3 weeks, then you remove it to get a period. Nuva-ring seems to have fewer estrogen side effects than Ortho-Evra, in my experience.  Birth control pills come in all kinds of dosages and are easier to customize to the individual woman’s needs, but you must remember to take them every day.

Depo-Provera and Implanon are a bit of a different beast. While the others all contain a combination of low dose estrogen and progesterone, Depo-Provera and Implanon contain a very high dose of progesterone. Depo-Provera is an injection you get every three months, and because there is no estrogen, it can be used in women who cannot use other methods.  The down side is that it has a lot of side effects (irregular bleeding and weight gain are the biggest).  Frankly, I think Depo-Provera is great for teens who just can’t remember to use other methods correctly, but I’d never use it myself.  But that’s just me.  Some of my patients absolutely swear by it.

Implanon is an implantable form of birth control which is similar to Depo-Provera in its action and in the same family as the old Nor-Plant (but supposedly with fewer side effects). Since I have no personal experience with this contraceptive, I can’t comment on it further.

The advantage of these hormonal methods is they are all highly effective if you use them right.

IUD’s
IUD’s come in two types – the hormonal IUD (Mirena) and the non-hormonal Copper-T. I’ve been using Mirena for three years, and I LOVE it. Your gynecologist puts it in, and you’re good to go for 5 years (10 for the Copper-T).  The Mirena may have some breakthrough bleeding in the beginning, although because I put mine in when I was breast-feeding, I didn’t even have that. So I haven’t had a period in three years, which, frankly, is fine by me.

With the Copper T, you do continue to have menses, and they can be heavier and crampier because of the IUD. But some women love it because the Copper T contains absolutely no hormones.  Mirena does contain progesterone, which is released gradually and mostly acts locally on the uterine lining.  The advantage of the Mirena is that, over time, most women get very light or no menses, since the progesterone shrinks the uterine lining.  Both the Copper T and Mirena have an efficacy rate of >99%, making it a great alternative to tubal ligation.

Some gynecologists are reluctant to insert an IUD in a woman unless she is in a long-term monogamous relationship, because if a woman is at risk of STDs, the IUD may pose problems.  But if you’re interested, ask your gynecologist to help you assess whether you would be a good candidate.

Hope that helps!

It’s been almost six months since I wrote to you all about my blood clot experience, and, let me tell you, has it been rough. I’ve gone through a lot of snags that I didn’t expect, but then again I didn’t expect to get a clot either.

I’ve spent the first half of 2009 looking like a heroin addict from all the blood tests I’ve gotten and a pill-poppin’ animal (thanks, Lil Wayne) from all the medications I’m taking. I can’t even count how many times I’ve told the story of what happened and answered countless questions. I particularly love the, “Aren’t you young?” question.

Yes, I’m young.
Does it mean I’m invincible? No.

The first few months were very difficult for me because I was still adjusting to the medication and trying to process the fact that I almost died. Coumadin, or Warfarin, is a blood thinner. I quickly found out that being on blood thinners makes you cold. Almost all the time. So walking to class was hard because I was freezing my little butt off. And don’t even try me on going to parties at night. Since my clot was bigger, it took a long time for it to disappear, which made it hard for me to breathe a lot of the time. Long walks across campus got me winded, and I couldn’t exercise. Pretty much, my whole love for being fit and athletic went out the window.

Along with my lack of exercise, my love for healthy foods like salad, broccoli, asparagus, basically anything green (yeah, kiwi too), was gone. Since foods that are green are rich in vitamin K, a blood thickening agent, I couldn’t eat them unless I did it consistently. I decided it was better not to eat them at all because my blood level was so hard to regulate in the first place.

While on Coumadin, they test your INR (international normalized ratio), which is a fancy way of telling how thick or thin your blood is. The margin is very small, and because I’m so young it made it much harder to get my blood to fall in the range and stay there. While the “average” person with a blood clot takes a few weeks to regulate, it took me about 4 months. I was getting blood tests two or three times a WEEK instead of once a month.

I’ve encountered several issues during this whole ordeal. I can’t be on the Pill ever again, which means I have to be extra careful (and, thankfully, my boyfriend has been great about that).  I’m currently debating my other birth control options. The Depo-Provera shot doesn’t have estrogen in it, but it still carries a slight risk for blood clots. I’m too young for an IUD, so I’m pretty much stuck with the shot or using a diaphragm or condoms.

Another issue is that I get sick… a lot. I’m prone to frequent bladder infections, colds and flu-type illnesses, and I tend to get migraines and headaches frequently.  Unfortunately, because meds affect the blood thinners, I can’t take anything. Think about trying to endure the flu without meds.  Welcome to my clotted life.

In thirteen days I will be of Coumadin and I am excited to celebrate with a salad and margaritas. Finally, I’ll be able to get back to some sort of normal life with vegetables and alcohol!  Not to mention I’ll have the tolerance of a five year old, and that is awesome.  I’m looking forward to not getting goosebumps when it’s 60 degrees outside and being able to walk around without feelings like I ran up ten flights of stairs.  I can’t wait to run into stuff and not immediately bruise, and for my veins to stop looking like I’ve been shooting up in some back alley on campus.

I can joke about the situation now having lived it, but I seriously want every single reader to know how serious a situation this is.  It can happen to anyone on birth control, especially you girls who like to light up. Whether you smoke like a chimney or you “socially” smoke (“I’m so drunk I need a cigarette”), it increases your risk for a clot.  I was lucky; had I not gone to the hospital or if I had been an hour late, I’d be dead.

Birth control has serious side effects like blood clots, strokes, and heart attacks.  Take the risks seriously and pay attention to your body!

Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

After so many of you wrote in to ask Dr. Lissa Rankin questions during CollegeCandy’s STD Awareness Day, we thought we’d bring her back more regularly. So, every Thursday she will be answering your questions. The ones you couldn’t ask your doctor in person and didn’t really trust the Yahoo community to answer for you. Just leave your questions in the comments, or send em over to us. (We’ll keep it all anonymous for you.) Dr. Lissa will answer anything – really, anything – about sex and other lady things. Don’t be shy; she’s waiting for ya!

Q: I am on the birth control pill and I want to stop using condoms with my boyfriend. I know he is clean, so I am not worried about STDs, but I am worried about pregnancy. Is the birth control pill enough to keep me from getting pregnant? Am I safe without condoms? I’m sorta freaking out, so any answers you can give me would be greatly appreciated.

A: Well, you know what they say- the only perfect birth control is abstinence (with one famous exception- and even that is highly contested!).  But the birth control pill, when taken daily – without fail – is extremely effective. Are you the type that forgets your pill from time to time?  Lower dose pills (ones that have 20 micrograms of estrogen, like Yaz or Lo-Estrin 1/20) are pickier pills, meaning that it’s more important that you take them at the same time every day.  But if you’re good about taking your pill every day, around the same time, you’re pretty darn close to protected (>99%).

If you’re not one of those “perfect users” of the Pill, you might want to consider something like Nuvaring, which is a vaginal ring you only have to think about once a month.  Or the Mirena IUD, which lasts for 5 years and is more effective than tying your tubes.

I’m guessing that, since you’re so freaked out about pregnancy, you’re going to be very responsible about birth control, and I’m high-fiving your right now for that. You go girl!  But if using condoms with your pills eases your anxiety, why not keep doing it?  If your boyfriend doesn’t mind and it gives you both peace of mind, there’s something to be said for being careful.

But if you’re taking your pills religiously and you’re willing to take the <1% risk of pregnancy, let your freak flag fly, girlfriend!

Props to B. Palin for that brilliant realization (and for basically admitting being a mom sucks), but since, as she said herself just weeks ago, “abstinence is unrealistic,” why don’t we figure out a more-um-successful way to stay child-free, while still satisfying our libidos.

Enter: Birth Control!!

Crazy, right? This stuff comes in all sorts of forms: patches, IUDs, condoms, looking at teen mothers trying to care for their kids and realizing how much less fun life would be with a child… Oh, and the pill, which, when taken correctly (not a difficult feat to accomplish if you can swallow a pill), is 99.9% effective. Certainly more effective than preaching abstinence…and then having unprotected sex with your hockey playing boyfriend in the middle of the Alaskan wilderness. And most of the pills now come in pretty packaging! (Yaz has a tidy blue suede case with fun stickers that help you stay on track and turn birth control into a fun craft project).

Of course, we all (should) know that hormonal contraception doesn’t prevent against narsty STDs, so, unless you and your sex-bud have been tested and are exclusively hookin’ up, please use condoms too! I can tell you from looking at some pretty graphic books that Syphilis ain’t pretty. Neither is abandoning your education to raise a child on welfare and food stamps. So instead of shooting moose, go get yourself some nooky. Because, like Ms. Bristol once said, not getting any is just “unrealistic.”

Just remember to pop that very important pill first.

We talk a lot about birth control around here (a natural progression from our daily musings about sex). We think its ability to stop babies is pretty badass, but many of us aren’t sure if that is worth all the crappy side effects: headaches, bloat, moodiness, debilitating cramps….We seriously thought we had it pretty bad until we found out that all of our suffering was nothing compared to those unlucky ladies who opted for the birth control patch.

While it was marketed as every woman’s dream birth control option (“Lower estrogen! Lasts all month! No need to remember those pesky daily pills!”), it has recently become every woman’s worst nightmare.

“The patch actually delivered much higher doses of estrogen than the pill; Johnson & Johnson failed to reveal this to the public for six years. At least fifty deaths have been attributed to the patch because of this, with thousands more women reporting alarming symptoms.”

The people behind the patch have been dealing with major lawsuits from patch users who experienced blood clots, strokes and heart attacks!

We love our ability to enjoy sex without the worry of havin’ a baby (and getting those awful stretch marks), but really? Stroke? Death? Does Johnson & Johnson really think women are willing to risk their lives for a little no-strings-attached booty?

If you are on the patch, get off of it NOW. There are plenty of other options for you: the pill, the Nuva Ring, an IUD, condoms, or, the tastiest option, Diet Coke? Just tear that thing off and call your doc. Fo realz.