Dear Audrey, I’m thinking about getting an IUD, and it scares the shit out of me. I know it’s an extremely effective method of birth control, but I’m also perfectly content with condoms. Thing is, my boyfriend of two years is not. We’ve had tussles in the past over the way in which he brings up the IUD option, and it’s become this “thing” in our relationship—a kind of subtle pressure to get ‘er done. That said, I know he loves me and wants me to be happy (and most of all, he knows it’s my own goddamn body), but I’m wondering if you have any tips for communicating/moving forward with uncertainty and mortal fear of a freak accident happening in my cervix. I’m genuinely curious about exploring the IUD possibility, but sometimes when my bf asks me about it, I just get pissy and sad that it’s often on his mind.
Here’s the thing about IUDs: everyone acts like they’re so far and away the best birth control option that only a total ding dong would ever question getting one. They are immensely safe and effective. Which is great! Good for you, IUD! What a little copper miracle you are! May all IUD users have sex 1,000 times and never conceive.
But there are a lot of minor side effects ranging from the merely annoying to the actually painful that aren’t represented by the 99 percent effective, 99 percent major-side-effect-free statistics. I have friends who’ve had less-than-perfect IUD experiences, including long-term spotting, awful periods, and early removal due to infection. All small stuff, but not the fuckin’ babyless utopia that IUD life is made out to be by some people, either.
I guess my point is that you seem to be working from the assumption that your fear of an IUD is silly and unreasonable, and I don’t think that’s fair. Yes, the chances of something going horribly, irreversibly wrong are very small. But the chances of something going annoyingly, minorly wrong—or even just unpleasantly different from how your body usually operates—are non-trivial. And the chance of feeling pain and soreness during insertion is very high. There’s a gradient of risk that, when compared with other contraceptive methods, looks pretty great. But you are the one assuming all the risks, and you have to live with the side effects, so you get to make the call. I know I’m a hard-liner on the “if it’s not your body, you don’t get a vote” front, but making you feel pressured about this is a dick move. You say you’re genuinely curious about exploring the possibility, so, great, explore—talk to people that have them, talk to your doctor, unpack your worries. But it seems to me that you pretty clearly understand the potential risks and rewards, and yet your gut is saying no. Don’t insert something into your uterus that your gut says no about.
I think you need to tell your boyfriend that it’s off the table for now and to quit nagging you. Obviously this is important to him, so do honestly think it through. You might decide it’s worth a try—after all, it is reversible, so if you hate it, you can get it removed. But he has to be at peace with the fact that you might not change your mind, and that you get the final say. If he thinks that’s unfair, well, try being a lady some time, dude.