Intrauterine contraceptive devices – Everything you need to know
These days intrauterine devices are a popular form of contraception worldwide. Let us first understand what an IUD actually is?. We are premier full stack teritary level abortion clinic in chennai city and we have some of the top specilist in family planning employed in our clinic. Our consultants wrote this blog to help you through understanding everything about the intrauterine contraceptive device
What is the intrauterine contraceptive device?
Intrauterine contraceptive devices are small t-shaped devices which are inserted into the uterus so as to prevent pregnancy. The shape of the device is congruent with that of the uterine cavity. So it sits snugly within the uterus. Depending on the type of intrauterine device, it releases various substances into the uterine cavity at very slow rates.
Intrauterine contraceptive devices are reversible forms of contraception, which means that the fertility of a woman in her reproductive age is restored on removing the IUD. It is also a long-acting contraceptive and can be used for a period of 5-10 years depending on the type.
If you are trying to make a choice between the different types of intrauterine contraceptive devices available, some information regarding each of them would be of great help.
Types of intrauterine contraceptive devices:
- Non hormonal intrauterine device or copper T.
It is in the form of a t-shaped frame that is wrapped with a copper wire. It is approved for use for a period of 10 years from the time of insertion, beyond which it has to be replaced with a new one.
It acts by reducing sperm motility, inhibiting transport of ovum and sometimes by damaging the sperm or ovum.
- Hormonal intrauterine device
They have a hormone reservoir containing levonorgestrel. The most popular variety is known by the name Mirena and releases about 20micrograms of hormone per day. It is approved for use for about 5 years. There are various other brands of hormone-releasing IUD’s available in the market and the approved duration of use is specified for each of them by the manufacturer. The hormone levonorgestrel acts by thickening the cervical mucus and thereby preventing the sperm from reaching the ovum for fertilization.
You may not be eligible for IUD use if you have any of the below-detailed contraindications.
Contraindications of the intrauterine contraceptive device:
- The distorted uterine cavity as a consequence of uterine infection or instrumentation in the past.
- Unexplained vaginal bleeding with the possibility of pelvic malignancy
- Molar pregnancy
- Active pelvic infection
- Levonorgestrel IUD is contraindicated in women with a history of breast cancer or in women with benign or malignant liver tumor.
- Copper IUD is contraindicated in women with copper allergy or Wilson disease which is a copper storage disorder.
If you have decided on getting an intrauterine contraceptive device inserted it would be wise to be informed about the possible side effects of an IUD.
Mirena side effects:
- It is known to have increased risk of causing ovarian cyst.
- Missed periods
- Spotting in between periods
- Heavier bleeding in the first few weeks after insertion
- Low back ache
- Weight gain
- Breast tenderness and pain
Copper t side effects :
- Copper-containing intrauterine contraceptive devices are associated with increased risk of heavy bleeding.
- Menstrual cramps
- Pain during sexual intercourse
- Vaginal discharge
Misconceptions related to intrauterine contraceptive device side effects:
- It is a common myth that intrauterine devices lead to infertility. Even on long-term use, intrauterine devices do not make it harder for women to become pregnant. Fertility is restored rapidly following discontinuing use.
- A woman is supposed to have her period regularly to be healthy. A period indicates the end of a woman’s body preparing for pregnancy. So periods are required only if a woman desires pregnancy. The thickness of the endometrial lining is kept under check by the intrauterine device so as to decrease the risk of endometrial cancer.
- Intrauterine devices are to be used only in older and parous women. If benefits outweigh risks, it can be used in nulliparous women and adolescent girls too with adequate care.
Apart from contraception, intrauterine devices confer some health benefits in women. It would be interesting to find out what are the non-contraceptive uses ofIUD.
Noncontraceptive uses of IUD:-
- Some studies have shown a decrease in the incidence of endometrial carcinoma in women using both copper T and Mirena IUD.
- Though contraindicated in cervical and other pelvic cancers, levonorgestrel IUD has also been used in women for control of endometrial cancer who desire fertility.
- Menorrhagia and anemia may be treated very effectively with Mirena and may be an alternative to hysterectomy in treating bleeding problems
Levonorgestrel IUD may be used in hormone replacement therapy.
Though an IUD can be inserted at any time during your menstrual cycle, provided pregnancy is ruled out by urine pregnancy test, one may want to know if there is any specific time which is best suited for IUD insertion.
When is the best time for IUD insertion?
Ideally, IUD insertion should be done during the first 7 days of the menstrual cycle to decrease the possibility of pregnancy occurring during the same time.
Copper T is effective from day 1 of insertion and for the same reason, no backup contraception is needed following insertion.
IUD can also be inserted immediately following spontaneous or elective abortion.
If you have recently delivered a baby and are considering copper T as an option for contraception, you may be wondering about how early you could get a copper T inserted.
Time of IUD insertion after delivery
The safety and effectiveness of IUD insertion during the immediate post-delivery period, i.e even within 10 minutes of delivery has been proven by several studies. Immediate post delivery insertion of IUD is possible following both vaginal and cesarean delivery. If the woman has chorioamnionitis or endometritis, IUD should not be inserted immediately post delivery.
IUD removal and replacement:
Just as with the insertion of IUD, it is possible to remove the IUD at any point during your menstrual cycle. But it may be easier and less painful to remove the IUD during your period as the cervix becomes naturally soft while you are menstruating.
If you wish to replace your IUD it can be done in the same sitting.
Are IUD’s safe?
We will list out the safety profile of intrauterine contraceptive devices. IUD’s can be safely used by women with:
- Breastfeeding child
- History of ectopic pregnancy
- History of pelvic surgery
- Heart disease
- History of deep vein thrombosis
- History of migraine
- Smoking habit
- History of sexually transmitted infections or pelvic inflammatory disease,provided it has been treated and cured completely.
Following unprotected sex, it is usual for a woman not wanting pregnancy to feel anxious and to look out for methods of emergency contraception. If the woman prefers to prolong contraception without having to pop pills on a daily basis, does she have the option of inserting an IUD?
Can IUD be used as emergency contraception?
Yes, copper T IUD can be used as an emergency contraception. Copper T has to be inserted within 5 days of unprotected sexual intercourse so as to prove effective in preventing pregnancy. The copper released from the IUD prevents the implantation of the embryo within the uterine lining and is the most effective form of emergency contraception.
As you are preparing to get an IUD inserted you may want to be informed of the possible complications.
Complications of the intrauterine contraceptive device are :
- Most common complication of IUD is the spontaneous expulsion of the device which occurs in about 2-10% of the women. Women should be encouraged to feel for the IUD string on a regular basis to confirm correct placement. Immediate post delivery insertion is associated with higher chances of expulsion than delayed post delivery insertion.
- Uterine perforation is a rare complication of IUD.
How to prepare for IUD procedure?
The woman needs to be evaluated in detail by a gynecologist prior to IUD insertion. A detailed counseling should be done and informed consent obtained. No anesthesia or analgesia is needed for IUD insertion procedure. Mild pain and discomfort during insertion are to be expected.
Post IUD insertion care:
Following IUD insertion, women are expected to follow up after 4 weeks. During the follow-up visit issues are discussed if any and an examination is done to confirm the IUD strings are visible extending from the cervical opening.
If the strings are found to be absent, the possibility of IUD migration and unrecognized perforation needs to be considered and evaluated in detail.
Can I get pregnant with IUD?
Though the efficacy of IUD is comparable to sterilization, as in any form of contraception there is some risk of failure. The failure rate of IUD is about 0.2%-0.8%. If pregnancy occurs with IUD in place it is more likely to be an ectopic pregnancy. Intrauterine pregnancies that continue with an IUD in place are associated with high risk of complications such as spontaneous abortion and septic abortion.
This page brought to you all that you need to know about intrauterine contraceptive devices and copper T.