Everything you need to know about intrauterine contraceptive devices (IUD)

If you’re looking for a safe and effective birth control option, intrauterine contraceptive devices (IUD) are one option that you should not overlook. 

IUDs are considered the most effective and safe contraceptive devices for women and they are long-lasting as well.

There are many women who find it cumbersome to take a daily pill or are medically unsuitable for the tablets or injections as birth control options. As for others, they feel that condoms restrict their sexual pleasure and sensation. For these women, intrauterine devices (IUD) are a boon that comes as a safe and effective method of contraception.

What is an intrauterine device (IUD)?

IUD is an abbreviated form of intrauterine device. Intrauterine devices are a method of contraception in which a small T-shaped device is inserted into a woman's uterus by a trained doctor or an experienced nurse to prevent pregnancy.

They aid in the prevention of pregnancy and birth control in the following manner

• They thicken the cervical mucus & prevent the sperms from reaching into the fallopian tube and fertilizing the egg.
• They make the lining of the uterus thinner & unsuitable for implantation of a zygote.
• The hormonal IUD’s partially suppress ovulation.

Intrauterine devices are very popular all around the globe and are one of the most used contraception methods to avoid pregnancy. It should be considered here that IUDs is not a good option for those women who are at high risk of contracting sexually transmitted disease (STD).

Intrauterine devices are used to prevent pregnancy by interrupting the process of implantation of the zygote & retarding the movement of the sperms but they will not protect you from sexually transmitted diseases.

How are intrauterine devices inserted?

You should consult an experienced doctor and he or she will help you to know whether intrauterine devices are the best contraception method for you or not.

Intrauterine devices will be inserted into your uterus by an experienced doctor or a trained nurse. It can be placed at any time when it is certain that you are not pregnant, usually, it is done on the 4th or 5th day of your period when the blood flow has reduced.

Your doctor will insert an instrument called a speculum to visualize your vagina & cervix and insert the IUD through the cervical opening into the cavity of the uterus.

This whole process will take less than 15 minutes and can be performed with or without anaesthesia. You could feel some discomfort and little cramps during & after the process, which can be taken care of by a simple pain-killer medicine.

It is very important to regularly check for the first few months that the intrauterine device is in its place and has not moved.

There are very few chances of getting it expelled through your uterus by the vagina. To check your intrauterine device

• First, wash your hands with soap and water.
• Insert your fingers into your vagina so that you can reach your cervix.
• Search and feel the string ends (Do NOT pull on the threads while examining).

If you are able to feel the strings and they are normal, then your IUD is in its place. If the strings are short or longer than usual then there might be a problem. And in such cases, you should consult your doctor to check & re-insert the intrauterine device, if needed.

Expulsion of IUD from your vagina is very rare but if it happens, the chances are highest during your periods. There are chances of expulsion in the first few months of the insertion so you should check monthly after your periods if it is in place or not.

Types of intrauterine devices

Intrauterine devices are common of two types

• Copper containing IUD’s
• Hormonal IUD’s

Here we discuss the basics of both types of intrauterine devices so that you get an overview of both of them.

1. Copper Intrauterine Devices 

Copper Intrauterine device is a ‘T-shaped’ device that has a copper coil wrapped around its vertical limb and a thread connected to this vertical end. This thread passes through the cervix into the vagina & can be felt by the examining finger. 
The copper acts as a foreign body & generates a hostile response from the lining of the uterus which makes it unfavorable for implantation of a pregnancy.

Depending upon how much copper is contained in the coil, a Copper IUD may be effective for anywhere between 3 to 10 years.

Not only is a CuIUD long-lasting, but it can also be used as an emergency contraception device!

So, if you had unprotected sex or experienced failure of contraception, then you can get an Intrauterine device inserted within 5 days of the unprotected intercourse and it is 99% effective in preventing pregnancy.

If you have an insertion of Copper IUD in your uterus, you may experience unusually heavier bleeding and more severe cramps while you are on your periods in the first few months, But do not worry because it’s just temporary and it improves after a few months of insertion of IUD.

2. Hormonal Intrauterine Devices

Hormonal IUD’s are similar to copper IUD’s in the sense that they are also placed inside the uterus by the doctor in a similar manner.

The difference is that they contain the hormone Levonorgestrel embedded in the device which releases a specific dose of the hormone into the uterus every day.

This hormone makes the cervical mucus thicker, & also makes the uterine lining thinner. It also partially suppresses ovulation thus preventing pregnancy.

An added advantage of hormonal IUD’s is that they may gradually make the lining of the uterus quite thin and thus minimize the blood flow during periods, to the extent that some women may stop getting periods altogether!

This effect is reversed once the IUD is removed from the body by the doctor. However, many women find this a very useful solution to the problem of heavy periods and it also gives contraceptive benefits.

The hormonal IUD’s protect against pregnancy for 3 to 7 years depending upon the type of IUD inserted. The Commonest brand available in India is effective for a period of 5 years.

Side effects of Intrauterine Devices ( IUD’s)

Some of the side-effects you may experience after having a copper intrauterine device inserted are as follows

• Pain in the back.
• Excessive bleeding during periods- This usually happens in the first few cycles and can be managed with medications prescribed by your doctor to control the bleeding.
• Unusual vaginal bleeding or spotting – It may be normal in the first couple of months but if it persists, you should get yourself checked to confirm that the IUD has not moved from its place.
• Excessive vaginal discharge- This may happen occasionally but if it persists, please meet your doctor to rule out an infection.
• Pain during sexual intercourse if the IUD has gotten displaced from its location.

You can also experience some specific side effects due to the hormonal content of the hormonal intrauterine device which is mentioned below

• Tenderness of the breast.
• Unexpected weight gain- usually temporary.
• Occasional breakout of acne.
• More fluctuation in mood.
• Continuous feeling of nausea for the initial few weeks.
• Headache.
• Soreness of breast.

Most of these side effects are manageable with over the counter medicines but you should consult your doctor if they persist or worsen.

Who cannot use intrauterine devices?

Intrauterine devices can be safely used by most women. if you are someone who has only one sexual partner and are at a lower risk of contracting sexually transmitted disease, then it’s an optimal contraception device for you.

However, some women might need additional protection to prevent STD’s or some may be unsuitable for insertion of an Intrauterine device. You should not use IUD.

• You have a medical disease eg Diabetes, immunosuppressant disease, or if you are taking any such therapy that compromises immunity & that predisposes to pelvic infections.
• You have multiple sexual partners.
• You are pregnant.
• You have cancer of the cervix or the uterus.
• You experience unexplained bleeding from the vagina.
• You have an abnormality in the uterus or cervix that interferes with the placement of an IUD.
• You have a sexually transmitted disease.
• You have an infection in your pelvis.

You should consider using barrier contraception or any other form of contraception instead of hormonal intrauterine devices if you are suffering from liver disease or have breast cancer.

If you have Wilson disease (which causes one’s body to accumulate a lot of copper) or you are allergic to copper, then you should not use a copper intrauterine device as a contraception method.

Intrauterine devices and STIs

It should be carefully noted that intrauterine devices will not protect you from sexually transmitted diseases such as genital herpes, AIDS, etc.

None of the intrauterine devices provides protection from STIs.

Sexually transmitted diseases are transferred from one person to another through body fluids. The best way to get protection from STIs is to use a condom.

Takeaway

Intrauterine devices are the most popular contraception methods among women all around the globe. It is the most reliable and efficient contraception option for any woman.

You could get your IUD removed if you want to get pregnant or simply get it replaced once the duration for its effective action is completed.

Book an appointment with your doctor who will insert your IUD in the uterus with a simple process of fewer than 15 minutes. If you feel any severe side effects after insertion then you should immediately notify your doctor about the same.

For more information on Contraception & Safe Sex, please check our other videos.