I'm going to tell you a story about my body. If you're uncomfortable thinking about me as a sexual being, I suggest you not read this post.

Over a year ago, I decided that an IUD was the thing for me. IUD is short for "intrauterine device," and it's a type of birth control. An IUD is a little T-shaped thing that goes in a uterus. They haven't quite figured out how IUDs work, just that they're 99.9% effective at preventing pregnancy. I thought, "Wow! 99.9% effective! No pills! No cyclic hormones! Nothing for me to remember to take or put on! Good for 5+ years!" I decided that this sounded like a great idea, and I began my pursuit.

A couple decades ago, IUDs were terrible things. They poked holes in uteruses (uteri?). They caused infections (PID, or pelvic inflammatory disease) that resulted in pain, infertility, and death. They got a bad rap.

Now, IUDs are very safe. The biggest risks are incurred during the insertion. Something could go wrong and the clinician could poke a hole. Something could go wrong with the sterile techniques and the woman could get an infection. But once it's in, it's very safe.

A lot of doctors are still wary of IUDs because of their history. Specifically, they don't like to give them to women who are at any risk for contracting an STI. There is research that suggests that a woman who contracts an STI while she has an IUD is at a higher risk for complications (PID) from that STI. But, as with all science, this is constantly open to questioning and further research. Here's what the "FHI Briefs: Intrauterine Devices: Safe, Effective, and Under-used" from the USAID IUD Toolkit has to say:

Historically, the most important adverse effect associated with the IUD was PID, which can cause infertility. However, recent studies have found the causal relation-ship suspect. A study in 1,895 women (Hubacher, et al., 2001) found tubal infertility was not associated with prior IUD use, regardless of the duration. Furthermore, the study found that tubal infertility was not associated with the reason for IUD removal, or the presence or absence of gynecological problems related to IUD use. However, past exposure to chlamydia was strongly associated with infertility.

Well, neat. PID is, perhaps, not as closely tied to IUDs as was previously believed. Some clinicians are also wary of giving IUDs to women who have never had children, because the risk of expulsion (basically, having the IUD fall out) is about 10% greater.

In the USA, there are two types of IUDs available: Mirena and Paraguard.

Paraguard is a T wrapped in copper. It's good for ten years or so. It doesn't have any hormones, just copper. It also makes periods 50-75% heavier. My periods are already pretty heavy, and I'm not tempted to flirt with anemia. Also, women are advised to be very careful with menstrual cups when they have IUDs. It's easy to accidentally create suction with a cup, and if things go just wrong you can pull your IUD out. If I was having 50-75% heavier periods and couldn't use my DivaCup for up to ten years I would be miserable. Paraguard also has a nickel core, and I've had issues with nickel in the past.

Mirena is a plastic T that releases low levels of progestin, a hormone that affects ovulation. It's good for up to five years. A common side effect is that periods become lighter and less frequent, with some women even experiencing amenorrhea (not getting a period at all). Don't get me wrong-- I don't mind my period at all. I welcome it as a sign of continued fertility and non-pregnancy. I don't love it, but I don't hate it. We exist together quite well. But if I'm choosing between having ungodly heavy periods and having light periods/no periods at all... well, I'll go with the latter.

Having informed myself, I grabbed my dependent ID and headed to my local military clinic. "Ah, free health care," I thought. "What a marvelous thing."

While free health care can indeed be a marvelous thing, I was consistently frustrated by the military medical system in my quest for temporary infertility. I was told "no" many times. I was prescribed the pill twice without my consent. For one of those prescriptions, I was subjected to an unwanted breast exam to make sure I didn't have breast cancer for the pill to worsen. I was referred to other doctors, other clinics, other hospitals. I hauled myself to clinics and hospitals again and again merely to hear "no" once more.

No, you're not married. No, you're at risk for contracting an STI. No, you've never had kids. No, this might make you infertile. No, you're too young.

I felt very disempowered. I didn't feel that my voice was being heard. I stared at my prescribed birth control pills in defeat. I opened a box of them and looked at the four tidy rows of seven pills. Could I resign myself to twenty eight, twenty eight, twenty eight for the next several years? A pill every day at the same time, teaching my body that it didn't have to worry about regulating itself; the pills could do that instead.

I called Planned Parenthood. I asked to schedule an appointment for an IUD consultation. The deep voice on the phone asked, "what does your schedule look like tomorrow?"

I arrived at the clinic and passed my ID card through the slit under the thick, protective plexi-glass. A bored-looking receptionist buzzed me into the waiting room. I filled out the consent forms and read the information sheets. Eventually, I talked with a pleasant nurse who told me about the procedure, gave me a pill to dilate my cervix, and sternly told me not to have sex between the consultation and the insertion. I peed in a cup, paid the consultation fee, and made an appointment for the next week.

The night before my appointment, I slipped a pill into my vagina next to my cervix. Grumpily, it began to dilate and I went to bed with some serious cramps.

Yesterday morning, I woke up, had a bagel and four ibuprofen, and went to Planned Parenthood once more. A friend accompanied me in case I couldn't drive myself back afterwards. Again, I slipped my ID under the plexi-glass and signed consent forms. I spoke with the same pleasant nurse. At the end of our conversation, she asked me to undress from the waist down and sit under a paper sheet on the table/bed/chair thing with the stirrups. I asked to keep on my socks, which she agreed to with a laugh. The stirrups had potholder mittens on them to make them a little less cold and hard, which I appreciated.

The procedure itself was a little uncomfortable physically, but mostly it was just sort of funny. From her nose down, my view of the nurse was blocked by the paper sheet. She had a light to see inside me, and the glow lit her face from beneath. She apologized for the speculum being so cold-- it needed to be sterile, so she couldn't warm it up. There was another woman in the room to wake me up if I passed out (I had told the nurse I had a history of passing out after shots) who seemed very interested in my cervix. She moved around behind the nurse to get a better view. I felt a little shy about it at first, but then I realized I would probably be doing the same thing if I were her.

On "1, 2, 3, cough," I coughed and the nurse grabbed my cervix with metal tongs. I'm not sure whether she was opening it or just holding it in place. I couldn't exactly see what was going on inside me. It felt pretty weird. A pinch? A pull? I don't know how to describe it. She measured my uterus to make sure it was big enough for the IUD, and that was probably the worst part. I felt a dull poke, and then there was just a wave of cramps. She turned her back on me for a moment to fiddle with things on her low table, then turned to me again with another proddy thing. "You might feel some cramping," she warned me. Were they measuring me again? If they were, the cramps weren't nearly as bad this time.

"And now you have an IUD!"

"Really?" It was that simple.

I wasn't turned away for being young, unmarried, and childless. It hadn't hurt that much. I laid there amazed as she cleaned me up a bit and took out the tongs and the speculum. She was more worried about my being able to sit up without feeling dizzy than she was about my risk of contracting an STI.

I thanked her, paid my bill, and listened to Jenny Lewis on the drive home.

I took an ibuprofen when I got home because I figured a muscle relaxant was probably a good idea, but I wasn't even experiencing that much cramping. I slept well last night and woke up feeling great.

I'm not going to have children for the next five years, assuming my uterus doesn't expel this thing. Cool. Medical professionals heard my voice and respected my needs. Cool.

(For more information on IUDs, I would suggest checking out the Planned Parenthood site, the Wikipedia page, and the USAID Toolkit.)