Thursday, May 13, 2010
Contraceptive Confections—IUDs, you are so sweet
Disclaimer: These cookies do not prevent pregnancy.
In my last post I celebrated the birth of oral contraceptives. Today I will salute another favorite form of birth control, the intrauterine device, or IUD. IUDs have an interesting history of their own. They have a very bad reputation among many of the lay population, but in fact, they are an extremely effective and safe form of birth control. I would say that IUDs are a great form of contraception because they are very popular for OB/GYN docs . If that doesn’t speak for itself!
The bad reputation of the IUD comes from a previous form of the IUD called the Dalkon Shield released in the 1970s. The Dalkon shield caused a lot of controversy because it was blamed for causing an increased rate of pelvic inflammatory disease and infertility. A 1981 study showed that woman were 5 times more likely to have pelvic inflammatory disease from the Dalkon Shield than from other IUDs [2,3]. The Dalkon Shield is banned, but won’t be forgotten because it’s also a band. Although, not a very good band.
In the US currently, there are two FDA approved IUDs--the Mirena and the Paragaurd. The Mirena is impregnated with progesterone and is effective for five years, and the Paraguard, the more traditional device wound with copper wire, is effective for ten years. The Mirena works by secreting progesterone into the uterine cavity and makes the uterus inhospitable to implantation as well as thickening cervical mucus (yeah I know, cervical mucus…kind of gross to some). The copper in the Paraguard reacts with the uterine cavity to inhibit implantation.
The IUD is an highly effective form of contraception, more effective than birth control pills, with a pregnancy rate of <0.5% over 5 years . The side effect profile is low; women are at a minimally increased risk of PID if they have an STD at the time of insertion [5,6]. Women can experience cramping, abnormal bleeding, and expulsion. The IUD does not affect fertility, and fertility returns once the device is removed .
Along with the birth control cake for my contraceptive confections series, I made IUD cookies. What could be more delicious than a simple sugar cookie decorated to look like a plastic device inserted into the uterus? Nothing really. My fiancé ate them all. I used my favorite childhood sugar cookie recipe straight from nothing else but the Betty Crocker Cookbook. I fashioned up some simple royal icing and with my two surgeon gal pals, we delicately iced the ladylike cookies. So thanks girls and I’m so proud of you!
Sugar Cookies from The Betty Crocker Cookbook
Makes about 50 IUD cookies
T shaped cookie cutter (purchased at Sur La Table and the only thing in the ENTIRE store that costs $1)
1 ½ cups powdered sugar
1 cup (2 sticks) butter softened
1 tsp vanilla
½ tsp almond extract
1 large egg
2 ½ cups all purpose flour
1 tsp baking soda
1 tsp cream of tartar
4 cups powdered sugar
6 tbsp heavy cream or 4 egg whites
Beat powdered sugar, butter, vanilla, almond extract and egg in large bowl. Stir in remaining ingredients, cover and refrigerate for at least 2 hours. Heat oven to 375. Roll dough to ¼ inch thick on floured surface, cut into T shape. Bake 7-8 minute or until edges are light brown.
Combine icing ingredients until smooth. Color some and leave some icing white. Pipe shape with pastry tube.
If you are interested in an IUD, please discuss with your doctor. I might be a doctor soon, but I’m not yours. There are other risks and side effects not discussed above.
1. 2003 ACOG News Release. Gallup Survey of Women
OB/GYNs. Available at: http://www.acog.org/from_home/
publications/press_releases/nr12-09-03.cfm. Retrieved February
3 Burkman RT. Association between intrauterine device and pelvic inflammatory disease. Obstet Gynecol 1981;57(3):269-76.
4. Thonneau, PF.; Almont, T. “Contraceptive efficacy of intrauterine devices.” American Journal of Obstetrics & Gynecology, v. 198 issue 3, 2008, p. 248-53.
5. Mohllajee, AP.; Curtis, KM.; Peterson, HB. “Does insertion and use of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection? A systematic review.” Contraception, v. 73 issue 2, 2006, p. 145-53.
6. Shelton, JD. “Risk of clinical pelvic inflammatory disease attributable to an intrauterine device.” The Lancet, v. 357 issue 9254, 2001, p. 443.
7. Hubacher, D., et al. “Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women.” New England journal of medicine, v. 345 issue 8, 2001, p. 561-7.