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| Basic Information |
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| Definition |
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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 pre- vent pregnancy.
One or 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 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.
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| 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.
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| 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.
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| Treatment/Post Procedure Care |
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| General Measures |
- 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 six weeks after childbirth
or abortion.
- 1) 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.
- 2) To remove:
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| Medication |
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Ask your health care provider about the need for pain medication
during and after the insertion procedure.
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| Notify Your Healthcare Provider If |
- You are interested in an intrauterine device (IUD) for
contraception.
- Following insertion of an IUD, unexpected side effects
develop including excessive or irregular vaginal bleeding,
painful cramps in the abdomen, vaginal discharge, signs of
infection (fever, chills, muscle aches).
- You cannot find the string of the IUD when you search for
it.
- The IUD has been in place for the length of time recommended
for the type of IUD you had inserted.
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