The Hoely Hour - E172 The History of the IUD

Episode Date: February 23, 2024

Liz takes us on a herstorical journey and shares the history of the IUD. Learn more about your ad choices. Visit podcastchoices.com/adchoices Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

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$15 per month equivalent. Taxes and fees extra. New customer offer for initial plan term only greater than 50 gigabytes. me slow when network is busy see terms it's a weird name jeff jeff jeff jeff jeffery jeffery jeffery i jeffrey allen white that's jeremy oh jeffrey allen white is like his lesser brother yeah the off-brand version of jeremy allen white we have jeremy's at home it's just jeffrey allen white welcome to the holy hour a podcast about sex relationships mental health and everything in between i'm amelia samson and i'm liz ball follow us on instagram and tiktok at the holy hour i'm

on instagram and tiktok at amelia samson and i'm on instagram and tiktok at liz ball so hard you can also watch us on youtube or listen ad free on patreon at patreon.com slash the holy hour Check out our merch at TheHolyHour.com and email us your spicy stories at HolyHourPodcast at gmail.com. I'm excited to get my knowledge on. I just, I was so tilted after this last episode going on my rant about IUDs. Tilted? Yeah. That's a good word.

mr liz uses it to describe when he um gets mad playing counter-strike i'm so fucking tilted right now dude yeah it's a good word i like it you want to hear what i'm tilted about this week fuck yeah tell me it just happens your gears happened an hour ago i was walking polly and there was a man who lives in the neighborhood with his dog with his yeah i'm a man so i'm mad what makes him think he can be in my presence no so he was walking his dog and I introduced Polly and then asked his name and he told me his name and then I told him my name and he was like yeah I'm only gonna remember Polly this man's like in his mid-60s and I was like that's kind of funny whatever like at least it's honest and then we circled back around and we crossed paths

again and Polly was sniffing his dog and this car came like speeding down the road and he was like of course it's like it's always stupid women boo now i don't feel bad booing him and i was like what and he was like yeah it's just like always like the students like that go to college around here it's like i'm like yeah it's probably students in general yeah what do you mean stupid women um i mean did you want to rattle off some bro car accident statistics to him yeah anyway so that's what that's what I'm tilted about this week I think that's fair I think that's a good thing to be tilted about his name isn't Jeff well he sounds like a fucking Jeff big Jeff energy yeah BJE okay let's get our knowledge on I'm so excited okay so for today's

episode um I'm doing a book report oh it's actually not a book report um I'm going over the history of the iud because over the weekend i was smoking a little weed as you do sometimes and i was like read or no i took i took an edible oh i took an edible and then i was reading more about the iud and because i had some questions and then the edible started to hit as i was learning and I was getting like so deep into the the IUD lore and also getting very upset I'm so jealous you can take edibles I love it I love a gummy you see I've really scaled back my weed use I mean I honestly like even just like a five milligram moment sends me to space in the worst worst way oh the worst way like I wish my tolerance was low like that again

i just hallucinate i end up outside it's a mess anyway continue well so um that's what we're gonna do today i brought my ipad so i could read it to you whoo um serious serious day today i'm excited so the history of the iud iud for those of you who don't know stands for intrauterine device and how it's inserted during the insertion process health care providers use a speculum to find the cervix which is the opening to uterus it looks like a little donut they pinch the cervix to stabilize it open with a teniculum yeah and then use an insertion device it looks like a little straw they use an insertion device to place the iud in the uterus and the insertion device goes through the cervix so your cervix dilates when you're giving birth so just think about

it's not dilated and you're forcing something in there it is it's not loose no but um and that's probably why they make you they like try to do it on like the first day of your period or the last day of your period i think like the first day because you'll already be bleeding yeah yeah like you won't know the difference but it's because your cervix will be yeah it's lower yeah oh lower okay yeah it's probably more open but um i included a picture of a ten a teniculum if you would like to describe it for our listeners sweet jesus okay it looks like little like um eyebrow scissors but they have little like pincers at the end of them like they're like curved in they're like little pointy that is the most terrifying thing i've ever seen yeah so that's the thing that they

clamp onto your cervix they like yeah it feels like yeah that's exactly what it feels like it would look like yeah that's like one of the most painful parts um so that's how it's inserted brilliant and the copper iud as we know it today is a t-shaped iud um and the rest of but uh sorry the copper iud and the rest of the iuds that we know today are typically t-shaped um and the way non-hormonal iuds work is by causing like an inflammatory foreign body reaction in the uterus which creates a hostile environment for sperm so it doesn't technically need to be copper a copper iud there are just plastic ones but copper is a spermicide so iuds with copper are more effective and then the hormonal ones um obviously use hormones and

they were originally created uh for like i think menstrual cycle purposes i included that information at the end so we'll review okay um most other non-hormonal iuds are made of plastic or stainless steel and in china inert iuds are the most common form of contraception so an inert iud is one that isn't hormonal and doesn't have copper okay um so it's literally just plastic um the precursor to iuds was first marketed in 1902 so this is just like the the it was just like a twinkle in um some crazy gynecologist's eye wow you know yeah so so they were developed from stem pessaries in 1902 um and a pest i think i'm saying that right pessary pessaries um it's a prosthetic device inserted into the vagina for structural structural and pharmaceutical purposes

so it was mostly used to treat um stress urinary incontinence and pelvic organ prolapse um so from what i could tell they weren't actually used to prevent pregnancy but the idea that you could put something into your your vagina to prevent pregnancy um i've included a couple of pictures oh great from the 1900s oh i'm already scared this is what it looks like i think it looks like a penis oh right oh what doesn't it look like a penis it kind of does i mean like like it it has like the like a door it also kind of looks like a door stopper it looks like this is like the new test you know how they like the ink block test um and then i so that one's from like the early 1900s and then this one's from 1920 what the fuck yeah describe what you're seeing um okay it looks

like that actually looks like a doorstop to me it has like the coil on the bottom like the that a doorstop has but then there's two like ears sticking up from it with like little paddles at the end of it wow and then at the bottom is like a circular thing holding it all together what a terrifying device so i'm pretty sure this is the part that would be inserted into like your cervix okay but what the fuck i know isn't that terrifying i don't like it and obviously it looks a lot bigger than it is but it's still probably pretty fucking giant because your cervix is not big no i was gonna say like are you can you have sex with that in probably not i don't think you're supposed to because this was just made for like uh prolapse right uh right yeah so you're just kind of fucked

yeah exactly well you're not fucked i guess um early iud models were frowned upon in the medical community um because they caused a high amount of infections a lot of um pelvic uh infections were happening um and then the first few were inter-uterine devices opposed to intra-uterine devices because they cross both the vagina and the uterus um which is what causes the high rate of pelvic inflammatory disease makes sense um but the first iud was made in germany in 1909 by dr richard richter so dr dick richter dick richter what a dr dick richter um it was a ring made of silkworm gut uh and it was not widely used and i couldn't find like a lot of information on it um i couldn't find a picture of it or how it was supposed to sit inside but i would assume it

kind of just like went around your cervix but i i don't know for sure the thing the creativity and like i mean that in a derogatory way that like the medical community used to use to create things like back in the early 1900s is it's like why silkworm guts like there was nothing else available like what benefit does that what provide what were you thinking about when you were like this should work right it was like one white guy that was like yeah well believe me bro and then everybody did it and even just looking at these like precursor devices that led to the creation of the iud or like imagining of the iud imagine how fucking painful those words those were to insert yeah and no wonder there was like a high rate of infection yeah with these things right um

so then the next iud was introduced in 1929 um also by a german physician ernst graffenberg uh that is the most german name i've ever heard also you may remember him ernst graffenberg was also uh he named the g spot after himself oh yeah but which is weird because most of his work was focused on like the urinary tract um so it's kind of weird that they were like we're gonna name the g-spot after this guy but he was like one of the first and few to like research women's bodies and like women's um pleasure like that it exists so i hope that man was like really good at sex i'm like he was either really fucking weird or he was like like a sex god yeah it's like yeah you know Fun fact, baby girl, they named the G-spot after me.

Even though I was looking into urethras. Anyways, it was introduced in 1929 and it was a ring and it was made of silk suture. I think I'm saying that right. Probably not. But that's what you would know that as like the things that the thread that's used for stitches. OK, so that's essentially what it is. Yeah.

um and in later versions there was a silver coil wrapped around it um turns out the silver had been contaminated with copper and that led to the creation of future copper iuds but unfortunately his work and research was cut short by the nazi regime um because contraception was considered a threat to aryan women fun fact isn't that interesting also he was a jew so i was gonna say yeah um he was not allowed to continue working do you know if he like survived the holocaust do you know yes he did this just looks like those um hair ties that have the like the coil hair ties that's exactly what it looks like so uh this would go around your cervix okay i'm pretty sure um and then in 1934 a japanese physician tenrei ota developed a similar mechanism made of silver

or gold that has a supportive structure in the center, um, to lower the expulsion rate. So that was like a huge issue with early IUDs is, um, the, the two biggest issues were expulsion and infection. So they were always trying to find a way to keep it in, to keep it inside, um, and not fall out or whatever, be removed. Um, but both their IUD rings cause really high rates of infection and the grafenberg ring stopped being used in 1939 but i think it's interesting that it just kind of like opened the door for more exploration yeah and then in 1949 it's a double entendre the hall stone ring was made by grafenberg's colleagues who took up his research after his death and it was later renamed um the the inhiband like inhibitions cute in a band cute

um the in a band didn't have a great track record so 346 346 women were part of the trial um 46 ended up choosing to get a hysterectomy um 41 they just stopped following up with 25 got pregnant 14 experienced expulsion and uh 53 others had it removed for medical reasons oh so it didn't it just it was not available for a very long time because it just had a lot of issues yeah um and then also although the insertion of the rings was like relatively painless it was it was on the less painful side um they were hard to remove and then they had just a high rate of infection um they put all their energy into naming it that's why yeah they're like ran out of budget all we got a circle yeah um you guys have any other ideas circle yeah let's put some metal on

that bitch uh and then they had a brilliant idea to um use plastic so the next iud was created in 1958 and it was the first plastic iud and it's called the the margul margulis marjulius i don't know i've been calling it the margles coil in my head i know that's probably not how it's pronounced how's it spelled m-a-r-g-u-l-i-e-s yeah that's tough marjules marjules um the marjules coil it was large uh and it had a hard plastic tail so obviously it caused women a fuck ton of pain but then it also caused their partners pain yeah i was about to say and i think since men were like sex isn't good because it hurts now they were like oh shit we got to rethink this right um but i've included a picture and i would love if you could describe this what the fuck yeah this

looks like a tapeworm this looks like all of the medical photos of tapeworms um it's like a it looks like somebody took an icing bag and like made a little swirl and then gave it a little like um hook like a cute tail yeah and then there's like some weird that is the strangest looking thing i've ever seen yeah um it's it's terrifying and then i i found this picture because i was like we need to see iuds in general aren't like big in the scheme of things yeah because when you see them you're like that little thing caused me so much fucking pain but um i looked up a picture that has a lot of different iuds and this these are the coils so holy shit look at these in comparison to like just this big ass guard yeah holy shit wow it's like i don't know if this is

a pair guard or just a copper iud but like oh it's fucking big yeah that's enormous it's like oh my god it's like twice the length so this one is at least yeah absolutely so fucking big like no wonder it hurt people and like this is pretty archaic too for like 1958 to go from um like a tiny little circle to this gigantic plastic coil i can't even imagine what insertion was like so it caused a lot of pain um i hate how they say discomfort i'm like we know that's what they always say when you go into discomfort like the consultation before you go to get an iud is like it's it's a little it's uncomfortable it'll cause you some discomfort that's what they always say like i'm about to cause you some fucking discomfort um and then the the one after that

so this one wasn't around for super long 1958 um by 1962 the lippis loop was launched and it was slightly smaller with a string um it's thermoplastic so it could bend for insertion and retain its shape and then it was discontinued in 1980 for economic reasons i think maybe they were just like we want to make more money or something um but this is what the loop looked like the squiggly one uh-huh it's not at all oh i guess the loop's at the bottom that's not a loop yeah i don't know weird um but this was like the first one that had a string at the end got it to remove uh our modern iud starting to take form i know wow but obviously so you can see in comparison like the the lip is loop compared to the margolis coil yeah it's significantly smaller i want to

understand the like how that sits inside i think it a woman person so i'm pretty sure there were some issues with uh perforation with yeah i bet the loop the the mark or no what's this one um the lippis loop um because when i looked at i looked it up because i looked at a bunch of pictures when you look at x-rays it's always in a place where it shouldn't be yeah but it and it can like it turns so it's like a but it was designed to be more of the shape of your uterus so like while it's sitting in there oh uh it feels like they like made it like zigzaggy like to be like cute it's like it's flirty women want this yeah it's cool that's why they coiled the other one yeah she's so quirky i'm gonna love this um so that was like i would say probably the

the first like actual success that ieds started to see because they were very like largely frowned upon in the medical community for a long time like um the early 1900s probably through the 1950s just because they had such a high rate of infection i'm kiana and i leveled up my business with Shopify. Once I figured out that Shopify was a thing, I never turned back. I can create a site with my eyes closed. Shopify thinks ahead of us, you know, and it thinks about the customer more than anything. Every day I'm thinking about some other new business, but Shopify is doing it to me because it's so easy to use. It's like, I can't stop. I'm addicted. Start your free trial at shopify.com um and then a stainless steel ring was developed in 1970 and it was mostly used in

china but the chinese government banned production in 1993 due to high failure rates wow um the failure rate was up to 10 a year um but i have more info on that later uh it's not happy yeah i bet none of this is i would bet um in 1968 a u.s doctor howard tatum just considered like the t shape that we see now um and that's the one we best know um another doctor named jamie zipper in chile it's a fun name chile uh he thought to wrap the plastic tea in copper to just improve its effectiveness so it was kind of like a meeting of the minds with these two guys like we have the plastic tea concept because that is kind of like the shape yeah you know you got the the tea in here and then the long the long pipe part which when you look at it inside of a uterus makes so

much sense it's like why did that take so long for them to get there yeah yeah no they're like first we gotta try a squiggle yeah um first let's try a ring and you know what I understand the thought process of the ring it's like okay this isn't a big clunky thing yeah should be pretty easy to place yeah relatively painless in comparison to all this other shit right but at the end of the day who gives a fuck if women hurt yeah especially back then well so here's the thing that I was getting so up in arms about no you know what I'll circle back I'm gonna save my rant for the end okay um so that that the first like copper iud that we kind of see now um that was concepted and created in 1968 so that's pretty cool um and it had a much lower expulsion rate so

that was another part of the appeal um and this brings us to our climax of the story so to speak um yeah it's a climax you don't want yeah it's very painful um this brings us to the iud that ruined it all for people in the u.s this is the one that became the reason that new iuds are basically impossible to get in the u.s the dalkin shield and i'm going to show you a picture that's a scary name it's a scary iud i'm going to show you a picture and you're going to describe it what the fuck you were not expecting that no it looks like a like a hieroglyphic of a beetle like it looks like a cave wall drawing of a bug it's like kind of guitar pick shaped with a circle in the middle and then like little tiny legs why like spiky legs what is that and then it has a

string what yeah the string looks like it was just like tied on by like a third grader yeah it's it's just a string it's like not a medical string no it's just like a loose string yarn yeah it literally looks like it's from an art arts and crafts thing um so why are there so few i why are there so few iud options in the u.s uh this is the big reason why um well another one is pharmaceutical companies have chosen to invest in promoting the contraceptive pill because it's more profitable for them so that's why you don't really see as much like advertisement or support like publicly for ieds in america also other countries don't have like pharmaceutical commercials the way we do yeah we live in such a weird simulation yeah we really do comparison to the rest of the world

um so in the 1970s the dalkin shield was produced by the a.h robbins company in in the u.s and it was placed directly into a woman's uterus to prevent pregnancy i'm fairly confident they had to dilate your cervix I was gonna say like that's you can't unless it like bends but that doesn't look like bendy material no it does not do you know how it sits um did you see pictures of how it's no I I need to look that up let's let's look I'm so curious because I I was wondering that too because I'm like oh my god oh no here's how it sits in your uterus okay so it sits how like modern iuds do but like so like the ow there's no way that doesn't hurt because like it's the it essentially has spikes where it looks like it has little legs those are spikes

to keep it in place i was saying a few weeks ago when you're talking about iuds like when i got my first iud i could feel it cramp it like when i would cramp i could feel the arms that probably felt fucking crazy for people i have no doubt yeah and if it went like there's no way like at least the t-shaped iuds it has flexible plastic and it still hurts when it pops open but like it's at least kind of the shape of your uterus it's somewhat intuitive um so this had i'm pretty sure your cervix had to be dilated and to explain that to to our listeners your cervix dilates when you give birth and that is probably the only time it dilates and should dilate so to force your cervix to dilate when your body is not prepared because

at least when you're giving birth your body is designed to do that so you have some kind of aware you're you're mentally prepared for it you've been preparing for it you know that this pain is temporary like it's completely different so to force your cervix to dilate to insert this fucking torture device i can't even imagine how painful it was no no like even considering like consider like medical technology in the 50s and 60s i guess this is the 70s but still it's not great and so that this was the start of people like there being like a stigma not stick but like a like a hate for iuds well it was withdrawn from sales pretty quickly due to a large number of lawsuits and lawsuits filed by women who suffered severe injuries from it

which i don't think surprises anybody um court testimony shows that robin's officials knew about the wicking problem as early as june 1970 which is six months before the shield even went onto the market um so by 1974 at least 17 women had died from complications linked to this specific iud oh shit but the actual number is probably higher absolutely if you look on the wikipedia page um it's only site seven i got this from a different article um so scary it was the design is incredibly flawed as we have as you've seen um it was cheap and made of plastic and i think that was like part of the appeal to this pharmaceutical company is like it was cheap to make um it was shaped like a crab with locks lots of little spikes on the sides and um small amounts

of copper to act as spermicide okay so it was non-hormonal yeah it was non-hormonal hormonal iuds weren't created i think until i think 1978 anyways um they also had a string at the base to help with removal the fucking arts and crafts string but to no one's surprise uh ended up just being a means for bacteria to quickly travel up and infect your uterus yeah i mean also like can you imagine pulling that thing out fuck no with the arms like embedded in your uterus what the fuck were they thinking i don't know um it also wasn't effective so like a step backward yes absolutely um it wasn't effective patients still got pregnant and the failure rate was about 10 it led to many issues like uterine infections miscarriages ectopic pregnancies and

i put this in quotes complications so severe that some women had to later have their uteruses removed oh my god so god i think i do this is the time for me to go on my rant um when i was learning about all of these and just thinking about how archaic medicine was even then i iuds have been like in existence since the early 1900s and since then obviously we've developed more and throughout all of this time women have experienced like the most gut-wrenching pain having these things inserted and we've never implemented any sort of like painkiller or pain management into this and like this torture device like you said it's like a step back and even just the thing that you use to hold your cervix in place is like a needle scissors yeah and I just

I was so repulsed and I was explaining to Mr. Liz like this experimental birth control for men where they literally just inject a gel into yep into one of your one of your tubes one of your veins and that's it and that was already pre-approved yep for local anesthetic and I just was like women's pain is fetishized yeah it's and it just made me so disgusted like it's almost like i think that medical violence against women is purposeful and maybe like every time we say something like this i don't think it's intentional like i don't think people are um consciously well i do think it's intentional i don't think they're consciously aware of like the fact yeah the fact that like they have been indoctrinated into a society that glorifies women's suffering like

wants to cause women pain yeah i think it's also like twofold in that like there's this whole idea that like women's pain tolerances are higher so like they'll be fine but then also there's like women's pain has never been taken seriously it's like oh she's just being dramatic like that's you hear that so much that it's like oh if like this IUD insertion which is obvious would obviously be painful yeah I could see it being like oh well women are really fragile so like it makes sense like it's fine it's not that bad like I could see that being the mentality around it like okay let me stick a pointy thing up your penis and tell me how it feels yeah let's have a little conversation about that i just thought experiment like the more i thought about it just

the more like again tilted i was getting yep because i was just like i can't fucking believe how long we have been using and creating iuds and pain management is like dismissed yep i have never heard a single fucking person be like yeah getting it inserted was such a breeze and I felt great like I ran errands afterwards yeah no you never ever you there are I hear that from almost every other procedure that gets done like tonsillectomies I've heard people be like oh yeah I had a really easy tonsillectomy or like I had a really easy wisdom tooth removal while other people are like oh my god it was awful I have never ever like you're saying heard like one person be like oh yeah I was nothing like I was fine like yeah I took that I took 800 milligrams of Advil and I

was great yeah everybody is like nope I had to take work off for the day I like was like like you said last week I was throwing up at the parking lot like there's just the hassle they give you as well when you ask for like some sort of pain management is appalling and after they do so many of these too they know what they know the reaction that people have when they get these inserted like why is it why do they act like it's like such a crazy thing to be like i just want to try and understand why causing women pain especially in a medical setting is like fetishized it does feel like some sort of like repulsive kink where this is an acceptable place for you to cause violence against women i don't know maybe that's a stretch but controversial yet

i do think that um it's like with any job depending on the setting it's going to attract the wrong type of person on occasion like it is going to attract people who want to cause violence against women and get away with it because they can because it's a medical setting yeah i mean we've heard so many stories about that yeah and it's like the same with like teachers like most teachers just want to be teachers but there are going to be teachers who are fucking pedophile creeps yeah and it's because this is a career that allows for you to be around the thing that you know is like wrong but you still want to harm others with doctors in particular it's crazy to think about how much like these people will go to school for forever

spend all this money getting a PhD and then they just like abuse their power and there's so much like well if you're that smart I'm sure it's pretty easy to intellectualize your abuse probably probably I mean like there it just it's it's tough because like doctors I there are so many incredible doctors like like 99% of doctors come from a good place and that 1% like it makes people not trust doctors it's like teachers it's like people wanting to homeschool their kids because like there's people like sleeping with their 13 year old students anyway i'm going off on a tangent i'll continue i mean you're right yeah so thank you i think i am too um jumping back into where we left off so uh yeah just it wasn't very effective it caused a lot of problems

and um i just can't help but like laugh at this fucking string like this isn't even like medical grade thread or why wouldn't you use like even the very first one used what's known as like what you need for stitches like yeah right they probably was probably an afterthought they were probably like oh fuck we need a string how are we gonna get this out they were going into the meeting to get approved and they were like oh god fuck uh does anyone have a string tie it on there real quick yeah um so some doctors caught on to these design flaws pretty early so Dorothy Lansing a pennsylvania ob-gyn women have entered the chat refused to offer it to patients uh citing the spikes which made removal tough for the doctor and painful for women she precisely called it

a vertible instrument of torture and refused to buckle under pressure exerted by the a.h robbins nagging salesmen so i think they just had like really good salesmen yeah of course everything and they were so pushy yeah um so the company that designed the dalkin shield um knew at least before a year before it went on the market that i had design flaws yet they pushed sales anyways and then in 1972 as like suspicion and controversy started rising um they started dumping a bunch of discounted unsterilized devices overseas when people started raising suspicions that the device was unsafe so they were like selling these like un unsterilized fucking cheap iuds to other countries of course fucked up um and then the fda also didn't do their due diligence obgyns who were

early whistleblowers um and had patients like dying mysteriously started raising concerns to fda who dismissed their concerns um it wasn't until 1974 after a doctor published an article with their findings that the fda started taking taking the concerns seriously i don't understand how they justified like immediately immediately obgyns were like no this thing is it's killed my patients who are otherwise healthy um it's causing infections it's a fucking torture device like no one's and then the fda is just like not paying attention they're like oh that's damn that's crazy um and then as a result of the complications with this device specifically um congress passed the safe medical devices act so this like once the fda finally did take it

seriously it was like completely removed it it was well known that it caused all of these issues because there were obviously all of these like um litigations and settlements with women who you know were harmed by this device specifically so it was so bad that congress um passed the safe medical devices act so everything from pacemakers to band-aids have to meet specific requirements thank god then in the 90s uh defective heart valves and silicone gel breast implants caused controversy and further restricted medical devices so things that were already under this like safe medical devices act became even more litigious like you had to meet even more requirements to get something to get a medical device approved by the fda and then iuds started to be regulated as

a drug which is even more strictly regulated that's amazing so like there's some good that came out of this awful awful device like sort of yeah i mean like for the greater good you know like for the for like health care in general or i guess like drugs in general i definitely think like the safe devices medical act is like important but i can't believe that didn't exist before i know that's crazy the 80s you said this happened uh yes 80s and 90s fucking crazy um that is too no this is 70s like when all of this awful shit happened um i don't know what year they passed the safe medical devices act but by the end of 1974 was when they were like fuck this device it's we're like discontinuing it this is illegal now um but obviously like kind of adding all of

these things in place i think it became a necessity because we have turned um health care into like what am i trying to say like a money yeah like a sales game yes yeah it's like we we've made healthcare into like another capitalist yeah money grab yeah um it's all for profit it's it's not it doesn't actually exist to help people it only exists to make money i highly recommend i don't know if you've seen it but also our listeners watch the john oliver um episode about pharmaceutical sales reps it is exhausting but it really explains it well like how money cash is ruling everything yeah in pharmacy well and then in america i just think like having shit sold to you constantly is yeah the expectation and the norm and that the fact that we've done that to our health care system

now mandates like laws like this that it should just be implied it should be obvious that you shouldn't be like marketing things that kill people just so you can make money yeah i don't know yes absolutely i mean that feels like a no-brainer but yes i mean like in in a perfect world the people who are like in these careers to help others and save lives and whatever all have good intentions but that's never gonna be true and no ever yeah yeah in every in every industry i believe most doctors want to help people yeah yeah there's always a fucking few ruin it for everyone um anyways uh so iud started to become regulated the same way that they like regulate drugs uh and then the fda aired twice first by failing to listen to early whistleblowers

voicing concern about the the dalkin shield safety and then second by regulating iud's so strictly in the embarrassing aftermath of the incident that fewer brands could be approved and reached market in the decades after so that is why there are so few iud options in america because this device was so like traumatizing and embarrassing specifically for the fda but traumatizing for people yeah that um they just like over corrected yeah and made it iuds were really stigmatized until recently like most doctors wouldn't even recommend an iud wow because um it just had this stigma right i mean that would scare me out of ever recommending it to go through something like that as a professional despite all these other iuds that

had mounting success you know they were on their way yeah to making improvements and then this one you know takes one bad seed so steps back that's why it's so difficult to get new iuds approved and i i learned about two more types of non-hormonal iuds um but first i'm going to talk about the hormonal iud because that is present day here we are with the hormonal iud that we all know and resent um some of you may love it and i love that for you the hormonal iud was invented in the 1960s and 70s and initially the goal was to mitigate the increased menstrual bleeding associated with copper and inner iuds so yeah yeah copper iuds um if you've ever read about paraguard which has not changed since the fucking 80s uh first of all like we said last

episode it's big but if you read like stories on reddit like there are a lot of problems with like perforation with the copper iud it makes people's periods worse um and it is for women who have already given birth so i've had friends that have gotten a copper iud like in their early 20s more than one of my friends has had a period for like three months and has like they've like lost a lot of like nutrients and like a lot of color in their face and they were just like sick all the time because they were just bleeding constantly well and something interesting too that i think i forgot to mention it in my notes um when that first iud t-shape was like coming to fruition um those two doctors realized the amount of copper didn't make a difference

so they only needed to use some so it's just like oh obviously it should fucking be smaller yeah if you can make it smaller you should uh-huh um so that was why the hormonal iud was originally created um so the first model is called progest what is it progesticert i i'm glad they have like different names progester start what's the ugliest name uh it was conceived by antonio scamenga and created by tapini jv lucan and lucanian but the device only lasted for one year of use oh shit um progester progester was manufactured until 2001 okay so imagine having to get your iud replaced every fucking year nope couldn't be me um and then one commercial hormonal iud which is currently available marina was also developed by the same

guy lou kenyon and released in 1976 so marina has been around since the 70s um but the manufacturer of marina is bayer and uh they became the target yeah they became the target of multiple lawsuits over allegations that Bayer failed to adequately warn users that the IUD could pierce the uterus and migrate to other parts of the body because wasn't Mirena also made for post yep uh postpartum women yeah yeah the first time I got an IUD I got a Skyla because they I wasn't measuring out like that where Mirena would make sense but then the second time I did which is interesting because i didn't give birth well it lasted or wait you chose marina yeah but it was like while he was inserting it he was like you're measuring for marina do you want a marina and i was like okay

sure it like already hurt you know i was like whatever just put whatever just put an iud in there but um well marina's now approved for eight years i know i get to get it replaced in 2025 so that's the most recent thing that the u.s has been like approved it's just approved that you can keep it in for longer yeah it's the only they're like that's way less work for us we'll just approve it um but they did yeah they didn't warn users that it could migrate to other parts of the body and that's like a risk that you take with any iud especially like the t-shaped ones yeah it could migrate yeah and that's rare so i don't want to scare people totally i mean and they also make you sign so much paperwork before you get it so you're going to get that warning anyway but like

that's really with any sort of implant device in like IUDs um the one that goes in the arm I've had some friends that have they've inserted it underneath the muscle yeah by accident and then it's not it doesn't work it's not like it just loses all of its painful it's the word I'm looking for potency yeah I guess it's yeah it's not potent effectiveness yeah it's not effective that wasn't the word I was looking for but that's a better word um and so she had to get it taken out but she has this like huge scar here now because somebody just inserted it too deep i've also never heard a good uh story about the arm yeah yeah i've only heard bad things yeah i've had some friends that i've really loved theirs but i mean i've yet to meet one couldn't be me i had

one i know one person who did like it but then the tissue scarred over it and it became so thick that it like had to be essentially surgically removed jesus christ anyways um there's another piece i had mentioned at the beginning um iuds with china so i think it's important to mention the medical violence forced on women in china um specifically related to iuds in china the use of iuds by state health services was part of the government's effort to limit birth rates so from 1980 to 2014 324 million women were inserted with iuds in addition to the 107 million who had tubal litigation yeah okay uh women who refused could lose their government employment and their children could lose access to public schools so they forced they extorted these women to

getting iuds um the iuds inserted uh in this way were modified such that they could not be removed in a doctor's office so they were meant to be there indefinitely jesus and surgical removal is usually needed um i did read that uh it was in a different article because i was trying to look up some of the different like devices um and uh immigrants who would come to like it was Canada the one that I was reading they were saying that the inner IUDs like the steel ring or just the straight up plastic IUDs women would come from China to get them removed well not specifically like they immigrated there and in Canada like you don't have the devices you need to remove them because you've never like been trained to remove these types of IUDs and then specifically they

were inserted so you couldn't remove yeah and um it was really difficult to get them removed i i just can't even imagine that kind of medical trauma no me neither um and then if they're forcing you to do it of course they're not going to like be caring about your pain management um but uh until the mid 90s the state preferred iud was the stainless steel ring which had a higher rate of complications compared to other types of iuds um it gave rise to the idiom uh meaning insert a loop i think that's probably just an idiom in china i've never heard it here no um and nowadays uh the iud include t and v shapes and the former is the most common and easiest to remove i've never seen a v shape me either um and to implement the two child policy the government

announced that iud removals would be paid for by the government so iud's remove iud removals are free to women who are allowed to have another child or who cannot continue to have an iud for health reasons okay so not so good it's that's like a half atrocious yeah they're not admitting any wrongdoing yeah but they're like all right well like fine we'll take them out for free but it'll probably have to be surgical yeah and it'll probably only be your hand rolling you don't complain it's disgusting yeah it really is um but amongst my research i discovered two other types of non-hormonal iuds modern iuds available um not in north america of course these aren't even available in canada so i can't even go to canada oh shit can i have one um so

the first one is called gynafix needs a different it needs a new name yeah gynafix is a frameless iud um it's a very small copper based iud that uh offers over 99 effectiveness wow at preventing pregnancies over five years and it's smaller than any iud um and it's made up of four copper tubes or six tubes because there's two different lengths attached to a surgical thread and then the upper part of the thread has a small knot that holds the iud in place in the womb wow okay um and then the upper and lower tubes are like crimped on the thread to keep them in place so i have a picture for you wow so this is just a regular you know like paraguard iud and then this is a frameless iud kind of looks like a little like um it's like a little friendship bracelet a little firework

yeah yeah i like it i'll give you an iud that doesn't hurt oh um so this frameless iud was conceived in 1985 so it's been around for a minute so i'm surprised it's not more available um it was developed to minimize three major problems frequently associated with discontinuation of iud use which is expulsion bleeding and pain um the unique design characteristics of the gynefix uh frameless flexible and then it's fixed to the fundus of the uterus have resulted in optimal tolerance and almost complete absence of expulsion so what's the fucking issue i know it's almost it's probably like the most effective iud and the least painful yeah that makes no that's a no-brainer essentially yeah it's probably it's probably the least

painless because you don't have that tea and it just hangs there and um it has everything you need which is just the copper that's so aggravating and it's on like a surgical thread how long why don't we think of this uh five years but i'm sure it could probably last longer um why wasn't this the first creation you know why don't we think of this the first time it's so simple um but the framelessness and flexibility explain the absence of side effects and adverse events caused by dimensional and compatibility between the frame of conventional iuds and the uterine cavity and may also explain the absence of pid um and ectopic pregnancies so it's available in austria belgium france hungary the netherlands people's republic of china spain switzerland and

the united kingdom i knew switzerland was going to be in there they're doing everything right yeah uh and then this next one probably the best the the i don't know these two these two sound pretty fucking great um so this one is technically an iub as in boy um because it's a ball uh it's called ballerine cute cute name and um it's inserted the same way but it takes on a ball shape when it's deployed so imagine like having a ball like chilling in your uterus versus like this the tea this hard plastic tea yeah um and its purpose is to reduce risks of preparation malposition expulsion and the pain caused by iuds so if you get cramps you're not going to feel those arms poking you and i um have some pictures for you so this is what it looks like when it's

unrolled okay oh wow yeah so oh it's tiny it's this little ring that has like 17 copper beads and then um it's like a it's one long wire type thing okay you know yeah and then it has the strings yeah that looks like a friendship bracelet yeah wow i love it um and then uh here it is wow it's pretty little guy i was curious how it's inserted because i'm like how is it a ball but um so this is when it's in its little straw okay oh cool it's insertion straw and then it shows how it comes out so when it when it it's deployed it uh retakes the ball shape yeah which i think is so cool that's awesome yeah so wow that is the ballerine oh it's beautiful and i was like where the fuck can i get this you can't even get it in certain places in um europe oh so it's only

available in certain countries in europe uh mr liz and i were like we should plan a trip to like france and italy and they have it in italy oh and then i was like do i want to do that because then there's like the language barrier also italian health care kind of sucks like yeah it's just like that it's at least and you have to pay out of pocket yeah that too yeah pharmacies there suck they yeah anyway that was my experience in italy but also that's what they warned us about before we studied there maybe i'll go to the netherlands yeah go to the netherlands yeah it's called medical tourism oh that's like people going to turkey for plastic surgery yeah i didn't know that was a thing until a month ago yeah i have a friend that went i have two friends that

went together one got a nose job and one got veneers and they turned out great i'm still a veneer hater people go for hairline treatments I have heard a lot of that yeah but anyway I'm like at what point is it like is it cheaper right because you have like all of the other costs of like flying yeah traveling but if you want to go to Turkey anyway I guess it's like two birds yeah um thank you so much for doing all of that research yes I was so like thrilled learning about it yeah i mean it and also furious yeah because well so then when i was telling mr liz before i came over about the ball iud and then the frameless iud he was like well can you do the same thing that you were talking about last week with um getting like the mona lisa mini and just

having a doctor here insert it or just going to vancouver and getting it inserted and i was like well since it's not available in those countries like even if I bought it and had it shipped here they don't know how to insert it they won't know how to remove it so that's one of the other complications like if I come here and I have like if I need to get my my little ball IUD removed like they're they don't know how they're supposed to remove it you know yeah so that's tough yeah I wonder if there are private gynecologists like you were saying like that will just like be like you're signing away any risk like of their responsibility for anything going wrong i wonder if they've seen enough of them that they would know how to take them out yeah i think that

they probably i think taking it out would be easier than putting it in if you've never like but honestly that ball one it's beautiful that up it's so easy yeah it's full proof you just launch it and then it becomes a little ball that is so aggravating that those things are just not available here i know like what the fuck fda and i am one of the lucky ones that have also the fda they don't do shit okay no they approved that torture device yeah even when other people were like um excuse me yeah maybe not there's problems with this yeah um i'm one of the lucky ones that i've had such good luck with my hormonal iuds oh i've heard plenty of positive stories about a lot of really awful stories it's painful and then if you also just don't want to have a hormonal

birth control type yeah like because I don't because it makes me miserable yeah yeah no I know a lot of people have a really hard time with it but um like I mean I can't even imagine the frustration around the options that are available to us not being good like not being enough for you like that is the most frustrating thing because I have a lot of friends that just aren't on any kind of birth control yeah and they just have to kind of like spray and pray every month you know um or you could just use condom right but it's like then like those will break or like sometimes it's like oh let's just do it like one time without and then they end up with a kid and it's just like there just needs to be better options I that that's what I'm saying

you know and i just i feel like there needs to be a trade-off here okay we need to reason with the government if you're gonna take away our reproductive rights can you at least give us a few more non-hormonal birth control options yeah as a treat as a treat yeah just like a little like i don't know we'll just have like maybe less of a violent revolution yeah a little concentration maybe we'll spare you maybe just like i don't know maybe we'll spare you in the next civil war if you give me a little iud just give me some more give me a little ballerina a little ballerina for baby anyway thank you again for doing all that research that was very informative and aggravating uh-huh totally infuriating listen everyone on this podcast who

are everyone listening to this podcast this is just you me and paulie on the podcast at the moment but everyone listening in this podcast will be the first people to know if i find a workaround or if i have a little medical tourism experience hell yeah vlog it get that youtube yeah being a medical tourist to get a copper iud get ready with me to board my flight to get an iud in turkey iud in turkey i woke up and i had some turkey bacon i also got a little bit of a nose job yeah why not yeah two birds one stone yeah it's already here um cool well i'm excited to see what people think about this episode me too like i hearing from y'all is the best thing in the whole fucking world first i know we have a few overseas listeners so if you have

any of these other types of iuds or you didn't even know about them please reach out to us yes we would love to hear tell us your experience maybe i'm just romanticizing i'm not romanticizing italy i'm romanticizing the ability to get the iud that i want yeah and you know what romanticize italy it's a cool place romanticize my iud my dream iud hell yeah um cool well i think uh it's a good place to end lit we we love you but not our iud options thank you somebody told us that this that last week was their favorite outro and i've really taken that to heart oh they did that's funny yeah i need to read that all right okay bye