If you’re partial to a cup of coffee minus the caffeine, then next time you’ve boiled the kettle you should raise your mug in memory of Friedlieb Ferdinand Runge.
Runge was a 19th-Century German chemist who had come to the attention of Goethe – the poet and statesman who was also a keen science scholar. Goethe had heard of Runge’s groundbreaking investigation into belladonna, otherwise known as nightshade. Runge had isolated the compound that caused eye muscles to dilate if it was ingested.
Goethe had been recently given a case of coffee beans, and so he asked Runge to perform an analysis of the beans. What Runge discovered is arguably the most consumed drug in the modern world – caffeine.
Caffeine is present in other drinks and foods – notably tea and chocolate – but it is inextricably linked with coffee. It’s a stimulant and an appetite suppressant, a dependable pick-me-up for students cramming for exams, workers on nightshifts and anyone else needing a wake-up.
But caffeine has a darker side, too.
It can cause anxiety, insomnia, diarrhoea, excess sweating, racing heartbeat and muscle tremors. For many people, the pleasure of drinking coffee is outweighed by the caffeine-fuelled negatives.
As the taste for coffee has grown, devaffeinated coffee's flavour has improved (Credit: Getty Images)
Could caffeine be removed from coffee? The answer, as any supermarket aisle will tell you, is yes – but the process isn’t as simple as you might think.
The first person to hit upon a practical decaffeination method was another German, Ludwig Roselius, the head of the coffee company Kaffee HAG. Roselius discovered the secret to decaffeination by accident. In 1903, shipment of coffee had been swamped by seawater in transit – leaching out the caffeine but not the flavour. Roselius worked out an industrial method to repeat it, steaming the beans with various acids before using the solvent benzene to remove the caffeine. Decaffeinated coffee was born.
Benzene, it turned out, was a possible carcinogen, so the search was on for new techniques that could prise out the caffeine from the bans – and yet leave the flavour intact.
Chris Stemman, the executive director of the British Coffee Association, says most of those techniques from decaffeination’s earliest days are still being used today. But the process isn’t as straightforward as you’d expect.
“It isn’t done by the coffee companies themselves,” says Stemann. “There are specialist decaffeination companies that carry it out.” Many of these companies are based in Europe, Canada, the US and South America.
If you were to try and decaffeinate roasted coffee you’d end up making something that tastes a bit like straw – Chris Stemman
You might think that it would be easier to roast the coffee, grind it into the required powder (espresso, filter or instant) and then begin the decaffeination process. Not, so says Stemman.
“It takes place when the coffee is green, before roasting.
“If you were to try and decaffeinate roasted coffee you’d end up making something that tastes a bit like straw. So that’s why with 99.9% of decaffeinated coffee to this day, the process is done at the green coffee stage.”
There are several ways to decaffeinate coffee but the most prevalent is to soak them in a solvent – usually methalene chloride or ethyl acetate. Methalene chloride can be used as a paint stripper and a degreaser as well an agent to remove caffeine.
Caffeine has to be taken out of coffee beans before they are roasted (Credit: Getty Images)
Ethyl acetate, meanwhile, is a natural fruit ether usually made from acetic acid – the building block of vinegar – and it’s also used to make nail polish remover (it has a distinctive sweet smell, much like pear drops).
The beans are first soaked in water and then covered in a solution containing either of these solvents. The caffeine is then drawn out by the solvent.
The solvent-laced water is then reused again and again until it is packed with coffee flavourings and compounds – pretty much identical to the beans, except for the caffeine and solvent. By this stage in the process the beans lose very little flavouring because they’re essentially soaked in a concentrated coffee essence.
Soaking coffee beans in solvents doesn’t sound like a particularly healthy enterprise, but both of these agents have got a clean bill of health. In 1985 the US’s Food and Drug Administration said the likelihood of any health risk from methalene chloride was so low “as to be essentially non-existent”. (FDA rules allow up to 10 parts per million of residual methylene, but coffee decaffeination usually uses solutions with one part per million).
Decaffeination became much more widespread as instant coffee became a staple
Two other methods use water. The Swiss Water method sees the beans soaked with water; the caffeine rich solution (full of flavours) is then strained though activated carbon which captures the caffeine. Starting in Switzerland in the 1930s, the process was first used commercially in 1979. It gained favour because it was the first decaffeination method not to use solvents.
There is another method, Stemman says, which involves the use of “super critical carbon dioxide”. Beans that have been soaked in water are put in a stainless-steel extractor which is then sealed, and liquid CO2 blasted in at pressures of up to 1,000lbs per square inch. Like the Swiss Water method, it’s the C02 which binds with the caffeine molecules, drawing them out of the unroasted bean. The gas is then drawn off and the pressure is lowered, leaving the caffeine in a separate chamber.
It’s an ingenious method but it does have one big drawback, according to Stemman. “It can be enormously expensive.”
Coffee companies don't usually remove the caffeine themselves - it's done by specialist companies (Credit: Getty Images)
Decaffeination became much more widespread as instant coffee became a staple, says Stemman. But the early incarnations of instant decaff coffee were not a roaring success.
“If you look back 20 or 30 years ago, we [in the UK] really were a nation of instant coffee drinkers,” he says. “And the one thing that instant coffee didn’t really taste of was coffee. Decaff was even worse.”
Stemman says that as people have become more used to quality coffee – for instance, the UK now boasts some 24,000 coffee shops – this has forced coffee-making companies to find ways of enhancing flavour even in decaffeinated instant coffee.
“Decaffeination can be a complicated piece of chemistry, which is why there are these very sophisticated companies doing it.”
The centenary of decaffeination – 2006 – went by with little in the way of public fanfare. In the UK at least, the number of people stumping for a decaff coffee has fallen markedly even as the quality has improved – while as many as 15% of coffee drinkers chose decaffeinated brews in the 1980s, that’s fallen to about 8% today.
And does Stemman drink decaffeinated himself? “Generally, no, if I don’t want the caffeine, well I just won’t have a coffee or a tea.”
And there’s another thing. While each of these methods will take most of the caffeine away, there’s no such thing as a completely decaffeinated drink. If you really want to avoid any caffeine at all, it’s probably better to drink something that never had a trace of it in the first place.
Do you often feel tired, short of breath or can you feel you heart beating away inside your chest? Have your friends commented that you look unusually pale?
If so, you may have iron-deficiency anaemia, the world's most common nutritional disorder.
In the UK, it is particularly common among young women.
An analysis by the government's Scientific Advisory Committee on Nutrition (SACN) on iron and health in 2011 indicated 21% of women aged between 19 and 34 had below recommended levels of ferritin (how iron is stored in the body).
I recently suggested to a friend with these symptoms that she might want to get herself checked out by her GP. A blood test revealed she was so anaemic it was surprising she could still walk upstairs. A few iron tablets sorted her out.
It's worth adding that you should talk to your GP if you're considering taking them - you might not need them and your symptoms could be caused by something else.
Where can you get your iron from?
Our bodies can't produce iron, so you have to get it in your diet - whether through foods that naturally contain it or those that have been fortified with iron, such as white bread and breakfast cereal.
The problem is that not all of that iron is in a form you can actually absorb.
How to get the most iron from your food
Eat leafy green veg raw or steamed
But do lightly boil your spinach
Eat or drink something containing vitamin C with your meal
Fermented breads are best
Trust Me I'm a Doctor asked nutrition scientist Prof Paul Sharp, from King's College London, to find the foods you should be eating to boost iron levels naturally.
Red meat is particularly rich in the sort of iron bodies find easy to absorb but these days many people are either cutting back on their red-meat consumption or cutting it out altogether.
And there are good sources of iron in dark-green leafy vegetables, such as kale and spinach, and pulses, such as peas and lentils. The problem is you don't absorb as much iron from plant sources as you do from red meat.
Then, there is the iron you can get from fortified bread and breakfast cereals, though again it is not always in a very absorbable form.
To demonstrate this, a neat party trick is to grind up the cereal, add some warm water and you can actually use a magnet to draw the iron filings out of the mush.
Wait for your coffee...
How you prepare your food and what you drink with it can also change how much iron you absorb.
To demonstrate this, Prof Sharp carried out some experiments to mimic human digestion.
The tests mimicked the effect of the enzymes involved in digesting food and the chemical reaction that occurs in human gut cells to show how much iron would be absorbed.
Prof Sharp showed that if you drink orange juice with your fortified breakfast cereal you absorb much more iron than when eating the cereal on its own - because orange juice contains vitamin C, which makes it easier to absorb iron from food.
But, disappointingly, if you drink coffee with your morning bowl of cereal, then that will mean you absorb significantly less iron.
Why? Well, according to Prof Sharp, it's because coffee is full of chemicals called polyphenols that are very efficient at binding to the iron and making that iron less soluble.
So, if a fortified cereal is your breakfast of choice, then having a small glass of orange juice or an orange will help increase your iron uptake. You might also want to consider postponing your morning coffee until at least 30 minutes after you've eaten.
But what if you prefer getting your iron from more natural sources? Raw cabbage is a good source of available iron but we found that steaming it lessened the amount of available iron while boiling reduced it even further.
That's because, like oranges, cabbage is rich in vitamin C - and when you boil it, the vitamin C is released into the cooking water.
So, if you want to get the maximum nutrients from your cabbage, eat it raw (an acquired taste) or steam it.
The same is true of other veggies that contain both iron and vitamin C, such as kale, broccoli, cauliflower and watercress.
But, strangely enough, spinach is completely different. We found that when we boiled the spinach, it actually released 55% more "bioavailable" iron than when eaten raw.
Prof Sharp says: "Spinach has compounds, called oxalates, and they basically trap the iron.
"When we cook spinach, the oxalate is released into the cooking water, and therefore the iron that remains will be more available for absorption."
Finally, what about the bread?
We found the best bread for delivering iron was sourdough bread. That's because wheat contains a chemical called phytic acid that slows down iron absorption by the body.
When sourdough bread is made, the fermentation process breaks down the phytic acid so the iron that remains is more available for absorption.
Drinkaware explain the latest guidelines around alcohol, the benefits of reducing your intake, and their top tips if you're trying to cut back.
According to a recent YouGov poll, two-thirds of regular drinkers say they would find cutting down on their drinking more difficult than improving their diet or exercising more, while one in five of UK adults are drinking more than the current recommendations.
We asked Drinkaware for the facts about alcohol and for top tips to help us cut back and drink responsibly.
How much is too much alcohol?
The UK Chief Medical Officers’ Low Risk Drinking Guidelines say that, for both women and men, it's safest not to drink more than 14 units a week on a regular basis.
If you regularly drink as many as 14 units per week, it's best to spread your drinking evenly over three or more days rather than ‘saving up’ and drinking them all on one occasion.
What counts as binge drinking?
The NHS says, 'Binge drinking usually refers to drinking lots of alcohol in a short space of time or drinking to get drunk.'
Because everybody processes alcohol differently, it’s difficult to say exactly how many units in one session counts as binge drinking. The Office for National Statistics defines it as drinking more than eight units in one session for men, and more than six units in one session for women.
To put this into perspective, six units is equivalent to:
Between two to three 175ml glasses of wine (13% ABV)
Between two to three pints of beer (4% ABV)
What are the benefits of cutting down on drinking?
Cutting back on alcohol can improve your health and your mental and physical well-being.
Weight management
Alcohol is made by fermenting (and sometimes distilling) starch and sugar. Because of this, it's high in calories, containing seven calories per gram – almost as many as fat.
Calories from alcohol are described as 'empty calories', as they have no nutritional value. Some alcoholic drinks contain traces of vitamins and minerals, but not usually in high enough amounts to contribute significantly to our diet.
When you drink alcohol, your body also burns less fat as energy. We can store nutrients, protein, carbohydrates and fat in our bodies but we can't store alcohol, so our bodies try to process it as soon as possible. This disrupts the other processes that would usually take place (including absorbing nutrients and burning fat).
Swapping alcoholic drinks for non-alcoholic, lower-sugar drinks is a great way to cut down on the calories that you're drinking and may help you to manage your weight.
Better sleep
You might think alcohol helps you to nod off, but the truth is that even just a few drinks can disrupt your sleep cycle and make you feel tired and sluggish. When you fall asleep after drinking, you may fall into deep sleep quicker than usual – but over the course of the night you actually spend less time in deep sleep and more time in the REM (Rapid Eye Movement) stage of sleep, which is much less restful. This means you’re more likely to wake up feeling tired, even after a full night in bed.
In contrast, having alcohol-free days may help you to sleep better and find it easier to wake up in the morning.
Better mental health
Alcohol is a depressant, which means it slows down the brain and the central nervous system's processes. This means that, while it may feel as though alcohol relieves stress in the short term, in the long term it can contribute to feelings of anxiety and depression.
There are lots of easy and practical ways that help you to cut back.
Schedule some drink-free days into your week. Taking a break can ‘reset’ your tolerance to alcohol and help you enjoy some of the benefits listed above, such as better sleep and less stress.
Practise portion control. Go for bottles or halves instead of pints, order smaller glasses of wine or have single shots of spirits in mixed drinks.
Get mixing some mocktails. You can still enjoy a delicious drink without adding any alcohol – try our alcohol-free cocktail collection.
Try the free Drinkaware app. You can track your alcohol consumption and spend over time, calculate units and calories and set goals to help you moderate your drinking.
How to be responsible while drinking
Eat before or with your drink. Drinking alcohol on an empty stomach means the alcohol is absorbed into your bloodstream quicker, so try to have a balanced and filling meal before you have your first drink, or enjoy a glass of wine with dinner.
Don’t drink and drive. If you’re organising a night out, make sure you have a designated driver or pre-book a taxi home. Read more about the legal alcohol limit.
Stick to one type of drink and alternate with soft drinks. Mixing drinks makes it harder to keep track of how many units you’re consuming, so it’s likely you’ll end up consuming more. A good tactic is to alternate alcoholic drinks with water or low-sugar soft drinks.
Know your limits. When you’re planning a night out, it’s a great idea to choose a limit for yourself and make a mental note to stick to it during the evening. Choosing to buy your own drinks instead of participating in rounds can help you stay on track – and you’re likely to spend less, too.
Who should I speak to if I’m worried about myself or someone else?
Speak to your GP if you’re worried about your alcohol intake. They will be able to suggest ways to help you manage your drinking habits and can also refer you for counselling or support services.
It's not just for reheating leftovers – a microwave can cook a range of quick, easy meals, from mug cakes to mash. Here's how to make the most of this handy machine.
Getting the most from citrus fruits – pop a lemon in the microwave for 10-20 seconds before juicing it and much more liquid will come out
Things to remember
Never use anything metal in the microwave. That includes foil, cutlery or any crockery with a metallic design detail.
Don’t tuck in straight away. Microwaved food will continue to cook for a minute or so after the machine is turned off. Let the food stand for a minute for the molecules to finish bouncing round.
Stir, stir, stir. Microwave cooking isn't even, because it works by agitating the water molecules. These might not be evenly distributed within the food, so you need to stir the food halfway through to make sure the heat can be spread around.
Don’t overfill your container. Liquid in the food can bubble up or splatter in the microwave, so either loosely cover what you’re heating with a microwave-safe plate or make sure it's in a bowl big enough to allow for this. Some cooks also suggest putting the bowl or mug you're cooking in on a second plate to catch anything that overflows.
Easiest ever microwave recipes
Vegan mug cake
Make a single portion of this simple sponge pudding – perfect if you need a dairy-free dessert at the last minute. Serve with a drizzle of coconut cream, or a scoop of vegan ice cream if you like.
Put 3 tbsp dairy-free milk in a microwave-safe mug.
Add a pinch of lemon zest and 1 tsp lemon juiceand leave to sit for 2-3 mins. It may start to look a bit grainy, as if it has split, but that’s fine.
Stir in 1 tbsp sunflower oil, 4 tbsp self-raising flour, 2 tsp caster sugar and a pinch of bicarbonate of soda. Mix really well with a fork until smooth.
Drop in 4 fresh or frozen raspberries then microwave on high for 1 min 30 secs, or until puffed up and cooked through.
Mushrooms
Mushrooms apparently keep more of their nutrients if microwaved, which is mega news for fry-up cooking. No more fried eggs with grey edges, more space in the pan for an extra sausage, and the mushrooms are better for you – triple win!
Simply put a generous handful of sliced mushrooms into a bowl, cover with a plate and then cook for 2-3 mins, stirring halfway through cooking. If the slices are still not quite tender, keep cooking in 30-second bursts until they're as you like them.
Microwaved fish supper
Salmon or trout, wrapped up in a baking parchment parcel with some crème fraîche, herbs and green veg, cooks in 5 mins in the microwave. Try it with leeks, tarragon and peas. You can prepare the parcels earlier in the day and keep in the fridge until you want to cook them.
Clean 4 small to medium-sized potatoes then prick them all over with a fork. Lay a piece of kitchen roll on a microwave-safe plate and pop another sheet on top.
Microwave for 4 mins, then take them out and turn them over (be careful, as they will be hot). Re-cover with kitchen roll and cook for another 4 mins.
Keep cooking in 1-2 min bursts until the potatoes feel soft all the way through and the skins are wrinkled. Take them out and leave them to cool.
Once cool enough to handle, peel off the skin and discard – rinsing them under a cold tap can speed this up. Put the cooked, peeled potato in a bowl and mash with a potato masher or fork.
Add 2 tbsp milk, a handful of grated cheese and 1 tsp butter, stir, then return to the microwave for 2 mins or until the mash is hot and the cheese has melted. Stir until smooth and season with salt and black pepper.
Fast truffle fudge
This easiest ever chocolate treat is a great last-minute dessert – or a storecupboard winner if you’ve forgotten a birthday.
Line a 18cm x 18cm brownie tin or similar-sized square food box with cling film.
Put 250g dark chocolate and 25g butter in a heatproof bowl and microwave until melted, stopping to stir the mixture every 30 seconds.
Add 30g sour cherries along with 350g caramelor dulce de leche. Mix everything together, then put into your prepared tin.
Chill in the fridge until set (around 1 hr) then turn it out onto a board and remove the cling film. Chop into squares to serve.
Parmesan crisps
Put a couple of little mounds of grated parmesan (about ½ tsp each) onto a piece of baking parchment and microwave in 10-second bursts until melted and bubbling. Leave to set for 1 minute then peel off the paper. These lacy, cheesy discs are best broken into pieces and crumbled on salads, pasta or risotto.
What closely resembles an alien insect and decapitates sperm? If you answered the ‘coil’, otherwise known as the intrauterine device (IUD), congratulations! You’re correct.
About the length of a paperclip, these bizarre objects come in a wide range of shapes, from frilly ovals to four-legged spiders. However, the most common variety in the Western world consists of a T-shaped piece of plastic with a dangling ‘tail’ of threads.
To work, IUDs must be placed inside the womb, where they can remain – depending on the brand and type – for up to 12 years. They’re incredibly good at preventing pregnancy.
In Asia, 27% of women use an IUD for contraception; in North America, 6.1%
In fact, they’re the most effective contraception on the planet – aside from sterilisation or avoiding sex altogether. And apart from those options, they’re also the most popular birth control method worldwide. But that doesn’t mean that most women in every country have heard of them. In Asia, for example, 27% of women use an IUD for contraception. But the rate is just 6.1% in North America… and less than 2% in Australia and New Zealand.
Why is this? And why should more of us know about them?
One reason IUDs aren’t more widely used in the United States might be the lack of marketing. Over the years, pharmaceutical giants have chosen to invest heavily in promoting the contraceptive pill instead, which is more profitable.
“I think patients now are more aware than they were in the past,” says Alyssa Dweck, a gynaecologist based in New York. “But money is obviously important.”
Today’s IUDs are tiny, T-shaped devices no bigger than 32mm by 36mm (Credit: BBC/Getty)
“There are many companies, with many different formulations [of contraceptive pill], with some of the differences hardly noticeable to individuals,” says David Hubacher, an epidemiologist at the non-profit human development organisation FHI 360. “In contrast, if you look at the main IUD we’ve had on the market since 1988, ParaGard, there hasn’t been much advertising.”
Another reason is that they have a bit of an image problem. There are plenty of hostile rumours about IUDs out there – like the idea that they’re painful, cause infertility, or lead to bad sex. In the light of their checkered history, this isn’t particularly surprising.
The idea that placing a foreign object in a woman’s reproductive organs could prevent pregnancy first emerged in the late 19th Century. To begin with, doctors were pretty much just placing random objects in the cervix, the entrance of the uterus, and hoping that this would do the trick. These early precursors to the IUD, called “stem pessaries”, were made from all kinds of materials, such as bone and cat guts. But later versions were mostly metal screws with long, forked ‘tails’.
Past physicians experimented with contraceptives like this ‘wishbone pessary’, developed in Germany around 1880 (Credit: BBC/Wellcome Collection)
The first mainstream IUDs emerged several decades later, in the 1920s. These were popularised by a German doctor Ernst Grafenberg, who is better known today for having the ‘G spot’ named after him.
Grafenberg’s design was a simple ring of metal that was placed in the womb, and he soon began performing scientific studies to see if they actually worked. All was going well, but their development was cut short when the Nazis arrested him. He was later rescued by the queen of birth control, Margaret Sanger, and fled to the United States.
Ernst Grafenberg designed this IUD in the 1920s (Credit: BBC/Wellcome Collection)
From then onwards, IUDs really took off. In China, IUDs were an important tool for implementing the one-child policy, along with forced sterilisations. To this day, the country has its own devices which have been especially designed or altered to make them more difficult to remove; they often require surgery.
In America, meanwhile, there was the Dalkon Shield disaster. This infamous brand, which had a broad ‘shell’ a bit like a horseshoe crab's, was introduced in the 1960s. They were based on the idea that IUDs with a larger surface area would be more effective. Instead, they had an unacceptably high risk of pregnancy. Even worse, they also led to widespread infections and infertility. It was a massive public scandal and more than 50,000 women ultimately filed successful lawsuits against the manufacturer.
“Women are always going to be concerned about their future fertility. It took a long time to make IUDs in a way that was considered safer, and to reorient women’s views,” says Dweck.
Introduced in the 1960s, the Dalkon Shield had a high risk of pregnancy – and of infections (Credit: BBC/Wellcome Collection)
Luckily, modern versions are quite different. There are two main types: those that contain copper, and those that slowly release a low dose of the hormone levonorgestrel.
“The products we have today are very safe and effective,” says Hubacher. He points out that even when IUD use was at an all-time low, IUDs were five times more popular with female doctors than the general public. “And if you just look at the subset who were OB-GYN [specialists in reproductive medicine], the rates were up to nine times higher.”
To get to grips with this enthusiasm, it helps to compare them to other contraceptives.
If you take the pill the human way, over 10 years you have a 61% chance of getting pregnant
Millions of women across the globe, from Melbourne to Mumbai, woke up this morning and punched a small pill out of its packet. They must remember to take one nearly every day, which is surprisingly difficult.
Theoretically, the combined contraceptive pill gives women less than a 1% chance of becoming pregnant in any given year. In reality, most of us accidentally miss around five pills each month – so the rate of pregnancy is actually more like 9%. That means that if you take the pill the human way for 10 years, you have a 61% chance of getting pregnant overall. In other words, more likely than not, you will get pregnant.
Millions of women rely on the contraceptive pill, but not all realise that there is a 61% chance of becoming pregnant on it over a decade (Credit: BBC/Wellcome Collection)
The issue of compliance is common to most contraception, from condoms to the contraceptive patch. Human nature (and sexual behaviour) being what it is, these just aren’t used in real life as they are intended.
But IUDs are different. Because they require no maintenance aside from insertion, which is done by a medical professional, they’re exactly as effective as they say on the packet. Copper IUDs give women roughly a 1% chance of getting pregnant each year, which works out as an 8% risk over 10 years; hormonal versions provide less than a 1% chance each year or a 2% chance over a decade. The hormonal version comes with what many women see as an added bonus – one in five users find that their periods stop altogether.
Anna Foley, from New Zealand, decided to get a hormonal IUD a few years ago. “In general for me, I loved it because I always sucked at remembering to take the pill,” she says. “Plus I found that I had some negative side effects to the hormones, while the Mirena [IUD] had a lower dose.”
People used to think that IUDs mainly worked after conception, by making it impossible for a fertilised egg to implant. But experts no longer believe this to be the case.
Instead, IUDs work for two reasons. The first is that any object in the womb leads to an inflammatory response: a certain type of white blood cells rushes to the area, where they eat sperm and produce waste that is toxic to sperm. One study found that IUDs increased the number of these cells in the womb by 1,000%.
The IUD has come a long way since this version, made of catgut loop and bone, used in the early 20th Century (Credit: BBC/Wellcome Collection)
The second reason depends on the type of IUD. Hormonal versions modify a woman’s body to make it more difficult for sperm to reach a woman’s egg, and make her womb inhospitable in case one is fertilised. Copper IUDS, on the other hand, are fearsome sperm killers. As copper ions dissolve into the womb, they paralyse and even decapitate sperm – though exactly how remains a mystery.
Still, even modern IUDs come with some risks. The most serious is the possibility the device will be pushed through the wall of the uterus while it’s being inserted, which is classed as a medical emergency but only happens very rarely (one in every 1,000 insertions). There is also a slight increase in the risk of infections, pelvic inflammatory disease and of ectopic pregnancy among other things, but these disappear once it is removed. Of course, other methods of contraception come with risks too – roughly one in every 1,176 women on the pill are at risk of developing a blood clot in any given year, for example.
In terms of the intensity of the pain, I would have told you it was a 10/10 – Anna Foley
But one major concern many women have is that having an IUD inserted will be painful. And while this isn’t always the case, it certainly can be. Foley doesn’t mince words about her own experience. “In terms of the intensity of the pain, I would have told you it was a 10/10. It was really, really bad. And whenever I thought about the pain for the rest of the day I’d just start crying.”
Generally the most intense pain goes away within minutes – it’s like a fleeting spasm – and women are left with a dull ache for the rest of the day. And as several women have pointed out, it’s much less painful than one possible alternative: childbirth.
The copper IUD paralyses and even decapitates sperm, making egg fertilisation highly unlikely (Credit: BBC/Getty)
In fact, for years doctors thought that the pain of inserting an IUD would only be bearable for women who had already given birth, because their birth canals would be slightly stretched. This had an unfortunate effect: for years, many women didn’t hear about this method from their doctors. We now know that it doesn’t make a lot of difference – women who have already given birth tend to rate their pain as a “level four”, as opposed to a “level six”.
Many doctors are now arguing that all women should be given the option of having a local anaesthetic before insertion, in the hope that this will increase the number of women getting IUDs. Regardless, the popularity of these ingenious, sperm-slaying devices has been increasing steadily since the 2000s. “There’s a big push to recommend IUDs as a first-line option,” says Dweck. Though they’re expensive to buy and insert, over, say, a 10-year lifespan, they can be more cost effective than birth control pills – and health providers have caught on.