Contraception – Intrauterine Contraceptive Device (IUCD)

BASIC INFORMATION
DESCRIPTION

The goal of contraception (or birth control) is to prevent an unplanned pregnancy. The majority of methods of contraception enable sexually active couples to temporarily avoid pregnancy. Permanent birth control is accomplished through sterilization. Be sure you know and understand the different types of birth control available to you, the risks and benefits of each, and any side effects, so that you can make an informed choice.
An intrauterine device (IUD) is a tiny object (usually made of plastic) that is inserted into the uterus (womb) to prevent pregnancy. One of two plastic strings (filaments) attached to the IUD extend out through the cervical canal. These strings enable periodic checking for position and as an aid when the IUD is removed IUDs are visible on x-ray should one become “lost”. The IUD interferes with the transportation of both the sperm and egg with the end result that fertilization does not take place. One type of IUD, containing a hormone (progesterone) needs to be changed every year. A second type containing copper is effective for 8 years. Other types of IUDs are being researched and may soon be available.

ADVANTAGES

  • IUDs are quite effective for birth control (97-99%).
  • The device is easily fitted and tolerated by most women.
  • Enjoyment of spontaneous sexual intercourse; freedom from concern once IUD is in place.
  • The IUD requires no daily routine.
  • Although they cannot be discontinued as easily as discontinuing a daily pill (oral contraceptives), they can be removed at any time by a trained health care provider.
  • With the progesterone-containing IUD, there will probably be less bleeding during menstrual cycles.
  • Fertility for a woman after removal of the IUD should probably be the same as it was before using the IUD.

DISADVANTAGES

  • Cramping and bleeding may occur the first few days after insertion.
  • Spontaneous expulsion of the IUD. Occurs more frequently within the first 3 months to one year. It is noted in most instances, but some women may not be aware of the device being expelled.
  • Occasional bleeding between menstrual periods and changes in amount of flow and increased pain with periods.
  • IUDs offer no protection against sexually transmitted diseases (STDs). A form of barrier protection needs to be used by those at risk.
  • IUD may perforate the uterus and travel into the abdomen. “Lost” IUDs require special examinations.
  • IUDs can increase the risk for pelvic infections such as pelvic inflammatory disease (PID) which can impair future fertility.
  • If pregnancy occurs with an IUD in place, there is a 50% chance of miscarriage. The IUD should be removed.
  • IUDs may increase the risk of ectopic pregnancy.
  • Not usually recommended for women who have a diagnosed gynecological problem or are pregnant, women who have certain chronic disorders or STDs, women who have not yet had a child and women with multiple sexual partners.

GENERAL MEASURES
INSTRUCTIONS FOR USE:

  • You will have a full medical examination including a pelvic exam, Pap smear testing, breast exam, pregnancy test and tests for STDs before being given an IUD.
  • The device will be inserted by a trained health care provider.
  • The timing for the insertion can vary; it may be done during a menstrual period, between periods or 6 weeks after childbirth or abortion.

To insert:

  • The IUD is straightened out in a plastic tube (like a straw) and the tube is inserted through the cervix and vagina into the uterus. The IUD is pushed through the tube and it springs back into shape in the uterus.
  • The tube is removed and the IUD stays in the uterus with its string dangling into the vagina. You will be instructed on how to check for the string.
  • There may be pain during the insertion and sometimes, cramping for the rest of the day.

To remove:

Consult your doctor.

MEDICATIONS

Ask your health care provider about the need for pain medication during and after the insertion procedure. This is better explained to you by a trained professional.