Q: Is an IUD a sexually transmitted disease? A: No

The Paragard IUD

Dear Go-To Girl,

What's an IUD? I met this girl who said she had one and I got freaked out. Does that mean she has warts on her hoo-hoo?

Love,
All I got was "Abstinence"


The Mirena IUD

Dear AA,

You poor thing. You missed a golden opportunity because the intrauterine device (IUD) is actually the most effective birth control method available! You could've banged away to your heart's content. But, alas, these devices are relatively uncommon in the U.S. and with the state of sex education, it's no surprise that you thought "IUD" meant "disease."

Here's the deal: an IUD is a small, T-shaped device that is inserted into the uterus through the cervix (ouch!). There are two IUDs available and they work slightly differently: The Paragard has copper wire wrapped around it that affects enzymes in the uterus, making it a hostile environment for any fertilized eggs. The Mirena releases a tiny amount of progesterone that prevents ovulation.

Now for the mysterious part: the presence of either IUD in the uterus essentially makes the body think that since there's some foreign object inside, that it can't support a pregnancy. I know that sounds crazy, but it's true.

The IUD is more effective than sterilization. Seriously. The Paragard lasts at least ten years (but you can keep it in longer) and the Mirena lasts five years. They're pretty pricey to start with if your insurance doesn't cover the device (like $200 or so) but spread out over five or ten years, they're the cheapest method out there.

The IUD has a little piece of string (fishing line, basically) that hangs out through the cervix so you can make sure it's still in place. If you contract an STI and don't get treated, this string slightly increases the risk of pelvic inflammatory disease which can, if untreated, lead to infertility. So use condoms, get tested, get treatment if you wind up with an STI.

Side effects include cramping (which, with the Mirena, is more mild than Paragard) and heavier periods, but that's it. None of that birth control pill weight gain or libido loss or generalized craziness. Some women expel the IUD but that's a pretty uncommon occurrence.

If you want to get an IUD, you'll probably have to convince your doctor that you've done your homework. So research the Paragard here and the Mirena here. And if you decide it's the right method for you, don't take no for an answer.

Love,
Go-To Girl (I Heart Paragard)

Economic Meltdown Special: Don't Get Pregnant

Don't let this be you.

Okay, readers. Time to get serious. The economy is in total fucking crisis and soon the financial system will join health care on our list of Systems? We don't need no stinkin' systems! Social Security, welfare, and education may also soon be added.

So since there may very soon be no money, insurance, or oxygen, it's time to get serious about preventing unintended pregnancy until, at least, 2012.

For guys, that means condoms. All the time. I know, I know, they make sex "feel different." And you really find the "Magnum more comfortable." I got it. But $1 per condom < child support for 18 years. And considering that we may all very soon be moving to China to harvest crops, having a kid to deal with (or send money back home to) would be a disaster.

For gals, several options. I've written before about how I'm wildly in favor of the IUD, and I think the the method's long-term (5, 7, or 10 years) use makes it a great depression-weathering investment.

The Pill, the Nuva Ring, the Patch, and the rest of those monthly methods are great, but they're going to seem financially out of reach when we're all standing in bread lines and wearing barrels.



So if you've got a couple hundred bucks in your savings account (assuming your bank hasn't folded yet), take it out and stock the hell up on condoms. Considering that sex is one of the few comforts available in economic depressions, we're gonna need 'em. And since the majority of condoms (except for Trojans) are manufactured overseas, with our new trade deficit and worthless currency there might not be any condoms left before too long. And then you can sell 'em at a markup. Goooo, free market!

Sex 1, Abstinence 0: Sarah Palin's Daughter Knocked Up

Bristol Palin and her son--oops, I mean brother--Trig. Is that short for "trigonometry"? As in, the class she skipped to go and get fucking pregnant?

Okay, seriously. I wasn't going to write since it's LABOR DAY and all, but thanks to L, S, S, S, and Mom for disrupting my day at Barton Springs Pool with the latest proof that abstinence education is a fucking joke: Sarah Palin, who has been the Republican vice-presidential nominee for approximately 5 minutes, has a daughter in the family way.

Knocked up. A bun in the oven. Expecting. With child. Sperminated (thanks, S, for that one). Preggers. Too dumb to use a motherfucking condom.



The best part? Palin, apparently, advocates abstinence education. Which is great and all, except when your teenage fucking daughter starts to fuck and she never learned about condoms and goes and gets herself fucking pregnant.

Am I the only one taking crazy pills here? I haven't even had to write about how ridiculous the Republican nominee is in the first place and then, Surprise! She's got a pregnant daughter.

Look, I'm happy the Republicans decided (nearly 3 decades after the Democrats) to nominate a woman to graciously lose on the national stage. But this candidate just had a baby with Down's Syndrome, her daughter is knocked up, her stepmother in law (or whatever) ran against her and is her enemy back in Alaska--really, Republicans? I didn't realize the Jerry Springer demographic was so up for grabs this election season.

I hope this puts abstinence education in the election discourse. I can't fucking wait for it. If we needed further proof that sex is, in fact, better than abstinence, this is clearly the pudding. As it were.

I hope somebody has told Bristol that there is no condom for the heart.

Q: Boyfriend Hates Condoms A: Blah, blah, blah

Spermicides are gross.

Note to readers: Yes, it's masturbation week. No, spermicide has nothing to do with masturbation. But the urgency of this question (see the postscript) made me want to drop masturbation for a few minutes and answer.
--------------------

Dearest Go-To Girl,

My boyfriend is about to visit for our only time together in the next five months or so, because I'm studying abroad, so obviously sex is a top priority. Normally we just rely on the pill, [we've both been checked for STDs and are clean] but I've been on antibiotics for the past 9 days, which I know can mess with estrogens.

I've suggested using a condom for a few days, but he's completely rebuffed by the idea [could have something to do with his feeling "small" -even though he's not- and like the condoms "don't fit" him.] I went out and bought "snugger fit" condoms, but he still is pretty cool to the idea.

Today, he suggested using spermicide. Now, it could be just me, but putting some crazy chemical in my vag that falls in the categories of herbicide, pesticide, suicide and homicide gives me the heebyjeebies. Also, I've heard that it can really irritate your tissue, and if that happens then our two week stay will be fucked. Or actually, not fucked at all. Which is a problem too.

But MOST of all, I do NOT want to be PREGNANT in MEXICO.

Su ayuda, por favor...,
Feeling Sperimicidal?

PS-He's coming in two days.

Dear F.S.,

Blah blah blah, condoms are too tight for me, blah blah blah, they make sex feel weird, blah blah blah, I can't stay hard, blah blah blah. If I had just a penny for every time a guy has uttered one of the endless litany of excuses not to use condoms, I would be one rich sex blogger.

Your boyfriend is being a total douche. Here's the problem with spermicide:

a) it's a gel/foam/suppository/film that dissolves in your vagina and immobilizes sperm, preventing them from entering the cervix and fertilizing an egg;
b) it's a gel/foam/etc. that you put in your vagina that tastes like fucking gross chemical (doesn't anyone remember how nasty condoms with Nonoxynol-9 were?) and will totally burn your tongue, so oral sex is out;
c) with perfect use, it's only 81% effective. Withdrawal is more effective than that.

You have a couple of options here.

1. Don't have sex unless your boyfriend grows the fuck up and uses condoms.

2. Use spermicide, avoid pregnancy, get a raging vaginal infection. In Mexico.

3. Use spermicide, get pregnant anyway, get a raging vaginal infection. In Mexico.

4. Use condoms. Have all the sex you want. Avoid pregnancy. In Mexico.

5. Don't use anything, take Plan B. If you can get your hands on it. In Mexico.

See where I'm going with this? Spermicide is your worst option. It's not very effective, it can cause serious vaginal and penile infections, it's a chemical that will go into your vagina and smell and taste absolutely gross and then drip slowly out of you after sex. Yuck.


Condoms are clean, don't smell gross, prevent the slow dripping of anything out of you, and are super effective at preventing pregnancy. Order some Kimono Type E's and go at it.

Love,
Go-To Girl

Orgasmic Birth Movie Trailer

Really! Thanks to I for the tip on this. I don't normally talk about what happens if birth control fails (pregnancy, childbirth, screaming brats, whambulances, etc.) here on GTG, but this new documentary about the "sensuous...ecstatic release of childbirth" seemed to cross genres and be appropriate to mention here.

I'm all about homebirth, midwives, and so on and this makes it seem even cooler. Fuck you, medicalized commodified hospital childbirth!

Vasectomy: Long-Term Birth Control for Men?

Vasectomy has been on the brain a lot the last few weeks for a couple of reasons. First, Quaker Earthcare Witness has a program called "Men for Men" that provides financial assistance to men who are either members or regular attenders at a Quaker meeting and want to "permanently end their fertility."

I picked up a copy of their brochure at Gathering and was both excited that QEW has started this program and dismayed that, despite Quakers' concern for overpopulation, Quaker overpopulation is not, in fact, a problem.

Next came this article in the Times about vasectomy and how easy, fast, and effective it is.

On the highways between Austin and Houston you see billboard after billboard that say "VASECTOMY REVERSAL!!!" with an 800 number to call. Nobody seems to be willing to talk about whether or how vasectomy could be used as long-term birth control for men. I know that it is not physician practice to tell men patients that they can plan on a reversal in the future. But if vasectomy reversal is increasingly effective, why not?

A Google Scholar search gave me a couple of abstracts that said that pregnancy rates after vasectomy reversal ranged from about 40% to 60%, depending a lot on the age of the man's woman partner. Forty to 60% is way higher than other fertility treatments, so while it's not a guarantee of pregnancy, the chances are pretty good.

In terms of cost, a vasectomy costs about $500 and the reversal about $5000, so if, say, an 18 year old gets a vasectomy and then a reversal at 28 when he's ready to get a lady pregnant, the per month cost is about $45--just about the same cost as a month of the Nuva Ring or Yasmin.

So why are we so nervous about encouraging vasectomy as a reversible method of birth control? I've seen guys go pale in the face at the mere mention of vasectomy. Considering the parity in cost and the relatively low risks involved, I think it might be time for you guys out there to start thinking about vasectomy.

C'mon, it won't hurt a bit.

Eureka!

For those of you who aren't trying to sound conceited or anything but just, you know, find Magnums more comfortable but don't like that paper bag on your cock feeling, I have amazing news: Trojan Magnum is now available in THIN!

I'll get on the horn and see if I can't get a box of these guys to try out. I was a fan of the Ultra Thins back before I discovered the Kimono Type E, so I'm sure these are great for those guys who, you know, just find the Magnum more comfortable.

Teen Birth Rate Increases: What about abstinence?

From the New York Times:

Teen birth rates are up for the first time in more than 15 years. What does this mean? Well, it means that there is either more pregnancy overall or that a greater proportion of pregnant teens are choosing to give birth instead of having an abortion or, perhaps, a spontaneous miscarriage.

Or...it means that when they are told that questions about birth control are totally off limits in their abstinence-only sex ed class they aren't learning how to avoid getting pregnant.

But don't listen to me--listen to the "expert" at the Heritage Foundation, Robert Rector:

Robert Rector, a senior research fellow with the Heritage Foundation, said that blaming abstinence-only programs was “stupid.” Mr. Rector said that most young women who became pregnant were highly educated about contraceptives but wanted to have babies.

Right. Now listen to a real expert, my advisor at Columbia, John Santelli:

Teenage birth rates are driven by rates of sex, contraception and abortion. In the 1990s, teenage sex rates dropped and condom use rose because teenagers were scared of AIDS, said Dr. John S. Santelli, chairman of the department of population and family health at Columbia University.

And let's hear from Rector one more time:

Mr. Rector of the Heritage Foundation said that teenage and unmarried birth rates were driven by the same factors: young women with little education who are devoted to mothering but see no great need to be married.

Apparently they have "little education" overall but manage to be "highly educated" about birth control methods which they just choose not to use. Way to go, Heritage Foundation.

Rector is an idiot--why not send him an email and tell him so?

Q: Are there any condoms out there that don't suck? A: Found one!

Dear GTG,

I don't know what to do--I've met this guy and things are going great but I haven't used condoms in ages and I don't know which kind to buy. My corner drugstore has a dizzying array and I don't want to spend twelve bucks on rubbers that I end up hating after the first try. I don't like spermicide and I want them to be super thin. Any recommendations?

Rubbergirl

Dear RG,

While my normal advice when it comes to condoms is just "Yes!" I actually have a specific recommendation for you. I'm normally a Trojan girl (Ultra Thins, if you please) but I've discovered a condom that I just adore: The Kimono Type E. Kimono is a fantastic Japanese brand, and the Type E is the best yet. It's green (not its best feature) and has lots of ribs and dots that you can actually feel. The latex is so thin that it's as though it's not there at all.



When you're in the market for condoms, try to hit up a good sex toy store like Babeland or Good Vibrations that have samples out of the wrappers for you to feel. I like to take each condom between two fingers and rub them together--if you can feel heat between your fingers as you rub, you should be able to feel heat when you use them for sex. If you don't have such a store near you, go to the Babeland or GoodVibes website and order a selection of condoms--you can buy them individually and try them out til you find one you like.

Good luck!
Go-To Girl

Q: Do I need to get the Morning After Pill? A: If you have to ask, then yes.

Dear Go-To Girl,

So...this is awkward, because I don't want you to judge me or anything...I was using a condom and, I mean, it didn't break or anything but I think some...you know...might have come out the top. Should I get the morning after pill? I'm pretty regular and I think I'm supposed to ovulate this weekend and I'm really worried. What should I do? Are there bad side effects?

Love,

I'm Totally Responsible

Dear ITR,

The great thing about the morning after pill is that, since you're over 18 and it's over the counter, you can just get it at the drugstore (assuming the pharmacist isn't a dick) and take it.

Plan B isn't 100% effective, but the sooner you take if after sex the better. You can take it within 5 days of unprotected sex but, ideally, you should take it right away. Having an extra dose or two laying around is a great idea, just in case you need it again sometime and run in to an asshole activist pharmacist who won't give it to you.

The side effects are usually mild and the most common are nausea and breast tenderness. But considering the nausea and breast tenderness one experiences during pregnancy, a wee bit with Plan B is a small price to pay.

If you need help finding Plan B, go here. And while you're at the drugstore, get two or three doses. Men can buy it, too.

You can also use regular birth control pills as emergency contraception. Here is a chart that explains how many pills of each brand to take.

Love,
Go-To Girl

Q: I don't want to sound conceited or anything, but I really think Magnums are more comfortable. A: Riiight.

Dear Go-To Girl,

I don't want to sound like a douchebag, but I really think that the Magnum condoms are more comfortable. I never thought that I was that big, but hey, can't argue with an unbiased product, right?

Hope to see you soon,
Apparently Magnum Size, PhD

Dear Dr. AMS,

Wow! Congratulations on your discovery. You'd be amazed how often guys tell me this. I'm sure the guys around the sandbox will be pumped to hear about how you "have" to use Magnums. Maybe you should have a contest to see who can pee the farthest.

But seriously. Not to burst your bubble, but there's some bad news here. The base of a Magnum condom--the part that most guys complain is too tight on regular condoms--is exactly the same size as a regular Trojan condom*. I can't tell you why I know this, but I guarantee that it's true. So just because you find the Magnums more comfortable doesn't mean that you're bigger than average.


Straight cylinder Ultra Thin

The difference between the Magnum and, say, the UltraThin is that the condom is shaped like a baseball bat, so it's wider at the top whereas a traditional condom is the same circumference at the bottom and the top. I think that the reason it feels less tight at the base is because loosening up a condom at one end probably allows more blood flow in the penis overall and makes you feel less...suffocated in there.


Baseball-bat shaped Magnum

Some 90% of people's interpretation of and satisfaction with penis size is psychological, so if buying Magnums makes sex feel better for you and provides you with some advantage with the ladies (or dudes, as the case may be) then go forth and fuck appropriately. But you're not the only guy trying to play the Magnum card, pal. Sorry.

Love Always,
Go-To Girl (Aka Mrs. Magnum)

* The Magnum XL is actually slightly bigger at the base.

Q: Demon seed? (Or, "Is unprotected sex causing urinary tract infections?") A: Yup.

Dear Go-To Girl,
First of all I want to assure you that I am a consistent and correct user of condoms. Except, you know, when I'm on the rag. Then my boyfriend and I like it raw. Sounds good, right? Except, here's the rub: the last few times we've had period sex sans condoms, I get a mild painful feeling evocative of past urinary tract infections. I don't know what about having sex on my period could possibly be causing this; is my blood infected with nasty bacteria? Is God punishing me?
Love,
Crotch Rot

Dear CR,
Congratulations on being a part of the .0000001% of the world who correctly and consistently uses condoms. Seriously, way to go. The only group more exclusive is the regular flossers, who count Go-To Girl among their ranks. What can I say? I love my teeth and gums. And I kinda like it when my gums bleed--like I'm whipping them into submission. But enough about me.

Sorry about your UTIs--few things are worse than a UTI in full effect, so I really sympathize. While it may seem that God is punishing you for having unprotected sex, there is a much simpler, less Old Testament-y explanation for your discomfort.
Contrary to popular belief, semen (aka, "cum") is not an inert substance; it is highly alkaline. (For those of you who didn't take 5th grade science, that means it has a very high pH) The alkalinity protects the wee sperm from the acidic vaginal environment so that they can make their way up into your egghouse and whatnot.

Under normal circumstances, the vagina has an acidic pH and has a mixture of yeast and bacteria that maintain it. When either your yeast or bacteria is out of balance, you know it: you have a yucky yeast infection or unbearable bacterial vaginosis, respectively. Both totally suck, and mean that God is in fact punishing you for having sex outside of heterosexual marriage. Just kidding!

Certain outside influences--hormonal contraceptives, douching, and semen among them--can alter the vagina's pH enough that bacteria or yeast can overgrow and cause nasty problems (each pH extreme allows the overgrowth of one or the other; you'll never have both too much bacteria and yeast at the same time).

In your case, your boyfriend's super-sperm is changing the pH in the vagina enough that bacteria are becoming dominant and, most likely, making their way up into your urinary tract as that cum oozes out of you. And, you guessed it, bacteria in the urinary tract is the cause of those sucky UTIs.

Here's a few ways to prevent this problem, in descending order of realisticity/desirability:

*Practice abstinence
*Use condoms, even when you have your period
*Have the boy pull out and come on your face
*Pee right after sex
*Rinse your area thoroughly with water after sex and let all the cum drip out (seriously, all of it)

Love,
Go-To Girl

(I'd like to note that when Crotch Rot called her gynecologist, s/he confirmed my belief about the semen pH/UTI connection.)

Q: Where can I find a totally weird condom demonstration video? A: Here.

Hey kids. As we all know, I love to talk about condoms, hand them out to unsuspecting people, and keep large numbers of them all over my apartment. (Sorry, roommate)

So it is with great pleasure that I inform you of a brand new, totally useless innovation in condom technology. Apparently, the "patented Pull-Strip™ system means eliminating that air bubble that often forms in the tip of the condom. This very important feature offers greater safety and greater sensitivity."

I guess that for those people for whom putting on a condom is really their least favorite activity, this product presents an alternative. But the only people for whom I can imagine this product being of use are people who have difficulty using their hands, either due to spinal cord injury or, perhaps, cut off fingers for fun.

See the Pullitt Condom Demonstration video here.

Good Catholics Use Condoms

I'm not making this up.

http://www.condoms4life.org/

Best "Off Label" Use of NuvaRing Ever!

I'd like to thank Gavin, my F/friend and reader, for sharing the following fucking great idea.

"You say "nobody's partner has, um, felt it up in there" - by which I assume you mean that no man has reported to you, directly or via his partner (or, I suppose, via the grapevine), having felt the NuvaRing inside his partner during intercourse. I have.

It's not unpleasant, and can even be a little stimulating. This is, of course, easily avoided, in a playful move that turns NuvaRing into c**kring. Either partner can easily (and gently, guys!) reach "up in there", catch the ring with a finger, and (assuming the man in question is not monstrously huge - it's a slightly stretchy ring, and several inches in diameter) drop it over the top of a nearby penis. That can be as stimulating as you want it to be, or not. The guy is not likely to forget to return the ring, which is designed to be left out for some small number of hours per day. Hours. If you're sleeping with a man who might just leave without returning the ring, you need to a) go back to condoms, b) ditch the loser, and c) get tested for STDs and pregnancy."

Way to go, Gavin.

OTC Woes: Emergency Contraception on the Cheap

I've long been trying to make clear to people that one doesn't need Preven or Plan B for morning after contraception. I'm pasting below a table from Planned Parenthood's website that shows dosages of regular birth control pills to be used for emergency contraception purposes. It is my opinion that routine use of the MAP is going to end up being really, really bad for a woman's health, so don't do this regularly. But if you find yourself in a bind and have a pack of pills (or a friend's pack of pills, or whatever) here's how you can solve your problem. And then see my response to 'WTF' below. (PS-If you take Yasmin or another pill that isn't listed, just take a bunch of pills, like 5 and 5. But don't tell anyone I told you that. Oh, and you can't sue me.)

Pill Brand Manufacturer 1st Dose 2nd Dose (12 hrs later)

Progestin-only Pills
Plan B® Barr 1 white pill 1 white pil or 2 white pills in one dose
Ovrette® Wyeth-Ayerst 20 yellow pills 20 yellow pills
or 40 yellow pills in one dose

Combination Hormone Pills
Alesse® Wyeth-Ayerst 5 pink pills 5 pink pills
Aviane® Duramed 5 orange pills 5 orange pills
Cryselle® Barr 4 white pills 4 white pills
Enpresse® Barr 4 orange pills 4 orange pills
Lessina® Barr 5 pink pills 5 pink pills
Levlen® Berlex 4 light orange pills 4 light orange pills
Levlite® Berlex 5 pink pills 5 pink pills
Levora® Watson 4 white pills 4 white pills
Lo/Ovral® Wyeth-Ayerst 4 white pills 4 white pills
LowOgestrel® Watson 4 white pills 4 white pills
LuteraTM Watson 5 white pills 5 white pills
Nordette® Wyeth-Ayerst 4 light orange pills 4 light orange pills
Ogestrel® Watson 2 white pills 2 white pills
Ovral® Wyeth-Ayerst 2 white pills 2 white pills
Portia® Barr 4 pink pills 4 pink pills
Seasonale® Barr 4 pink pills 4 pink pills
Seasonique® Barr 4 light blue-green pills 4 light blue-green pills
Tri-Levlen® Berlex 4 yellow pills 4 yellow pills
Triphasil® Wyeth-Ayerst 4 yellow pills 4 yellow pills
Trivora® Watson 4 pink pills 4 pink pills

With a regular 28-pill birth control pack, use any of the first 21 pills for emergency contraception. Don't use the last seven pills in a 28-day pack. They are only reminder pills that contain no hormones. With Enpresse, use only the orange ones. With Triphasil or Tri-Levlen, use only the yellow ones. With Trivora, use only the pink ones.
(from http://www.plannedparenthood.org/birth-control-pregnancy/emergency-contraception/how-to-take.htm)

Advice: I hate condoms! (Who doesn't?)

Hey Go-To Girl:
My partner and I have just started to have sex without condoms, but I'm not on birth control. I'm
wondering what my options are, because I'd like to continue not using condoms, but am also under the impression that unless I want a baby that using nothing is about the dumbest thing EVER (any thoughts on that are appreciated, too, because for some reason he's not as worried about me getting pregnant...and I'm definitely open to the possibility that I just don't know too much about this).
Anyway, I'm really NOT wanting to use highly hormonal birthcontrol, and a midwife friend of mine mentioned a few weeks ago about a kind that is mild but effective, and that you insert/replace once a month.
Does that sound familiar?
Whatchu got for me gal?
Love,
Wants Total Freedom

Dear WTF,
You're right: using nothing is the dumbest thing ever. I won't address my feelings about your partner who seems unconcerned about you accidentally winding up pregnant (but where I come from, we have a word for a guy like that...) but here's the lowdown on condoms and nonhormonal methods.
a) Have you been vigilantly tracking your menstrual cycle for the past year and found that you have a predictable, regular cycle?
If the answer is "no," don't pretend that you understand the Rhythm Method and can decline to use condoms at certain times of the month. While the chances of getting pregnant during certain phases of the cycle are remote, finding out you're pregnant is a bad way to retrospectively predict when you ovulate.
b) Have you and the guy had the STD conversation?
If the answer is "no," you should be using condoms even if you're sure you can't get pregnant.
c) I hate condoms, too. A lot. That's why I got a ParaGard IUD.
The upside: It's nonhormonal and more effective than sterilization (seriously). It lasts 10 years (seriously). None of that weight gain/depression/moodiness/lack of libido/generally hating everything that you get with the Pill. It's the most popular contraceptive method both worldwide and among women OB/GYNs.
The downside: Cramps are worse, and my period lasts a bit longer. If you have bad cramps now, getting an IUD will make them worse, perhaps even debilitating. But if you don't (I had no cramps before my IUD) then it won't be that bad.
d) The once-a-month method your friend mentioned is the NuvaRing, which is a ring that you insert into the vagina each month. It releases a lower dose of hormones inside the body, so the side effects are supposed to be milder than with other hormonal methods. From people I know who have used it, they report high levels of satisfaction and nobody's partner has, um, felt it up in there. But if you're anti-hormones over all (as I am) then it's a no-go.

If you've used hormonal methods before, any side effects you experienced are likely to return. Some MDs are hesitant to give IUDs to women who haven't had children, but I've done the research and, trust me, if you're STD free you can get one.
If you have any STDs, you shouldn't get an IUD, because having an IUD and an STD can blow up your risk of pelvic inflammatory disease, which can cause infertility and death. But the IUD by itself DOES NOT cause PID or infertility. Nurse Midwives are also able to insert IUDs as long as they've been trained to do so and I prefer them for Gyn care in general.

To sum up: buy a box of condoms, and use them until you get your shit together. My favorite are Kimono MicroThin.

Love,
GTG

For more:
http://www.condom.com/kimono.html
www.paragard.com
www.nuvaring.com