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Contraception and IUDs
This article provides some useful answers to commonly asked questions about Intra-Uterine Devices (IUD). It does not take the place of talking to your doctor about different contraception methods and the most appropriate approach for you.
What is an Intra-Uterine Device (IUD)
An IUD is a small contraceptive device that is placed inside the uterus to prevent pregnancy. An IUD is a long-term contraceptive solution, can easily be inserted and removed by your doctor, and is a highly effective birth control method.
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There are two kinds of IUD:
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1.Copper IUD:
The copper IUD is a small plastic device with copper wrapped around its stem.
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2.Hormonal IUD:
Hormonal IUD – The progestogen IUD is a small T-shape device with a cylinder containing progestogen around its stem.
How do IUDs work?
Both copper IUDs and hormonal IUDs prevent pregnancy by changing the way sperm cells move and survive in the uterus (womb), inhibiting the egg fertilisation process to prevent pregnancy.
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The IUDs work in the following ways:
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Copper IUD – Sperm doesn’t like copper, so the copper IUD makes it almost impossible for sperm to get to the egg.
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Hormonal IUD may help prevent pregnancy in two ways:
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They thicken the mucus that lives on the cervix, which blocks and traps the sperm; and
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The hormones also sometimes stop eggs from leaving the ovaries (called ovulation), which means there’s no egg for sperm to fertilise.
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A hormonal IUD also changes the womb's lining (endometrium) so that it is unsuitable for pregnancy and prevents an egg from developing if it becomes fertilised.
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IUDs have been used for more than 30 years to help prevent pregnancy.
How well do Intra-Uterine Devices work as a Contraceptive?
IUDs are upwards of 99% effective in preventing pregnancy.
Important note – No contraception device is 100 per cent effective.
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Statistics from: The Women’s Hospital Website.
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Advantages of IUDs
Both the copper and hormonal IUDs have the following benefits:
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Highly effective, long-term contraceptive devices
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You can’t forget to use it as you might the Pill
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They are a long-term, relatively inexpensive form of contraception (more expensive at first but cheaper over the long term)
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You may attempt to get pregnant as soon as it is removed
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The hormonal IUD may have the added benefit of reducing menstrual bleeding.
Disadvantages of IUDs
Both the copper and the hormonal IUD have the following disadvantages:
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The IUD can potentially be expelled from the uterus (usually during a period)
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If an IUD fails and pregnancy occurs the IUD must be removed as soon as possible (an IUD may increase the risk of a miscarriage)
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There is a small risk of infection in the three weeks following insertion (pelvic infections can lead to infertility)
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The IUD may injure the wall of the uterus.
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There is the risk of an ectopic pregnancy (where the fertilised egg implants in the fallopian tube) if the IUD fails
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The copper IUD may cause your periods to become heavier and more painful.
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The hormonal IUD can also have the following side effects:
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May cause irregular bleeding or periods in the first three to five months after insertion
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May cause a slight increase in the likelihood of vaginal dryness, flushing, headaches, nausea and acne.
Who can use an IUD for contraception?
Your doctor may recommend IUD as a form of contraceptive if you are a female at low risk of contracting sexually transmitted infections or cannot or do not wish to take the Pill.
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Who is not suitable for an IUD?
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If you are female and at long-term risk of contracting sexually transmitted infections (STIs) or have undiagnosed vaginal bleeding or have pelvic inflammatory disease (PID) your doctor may not recommend an IUD as a contraceptive solution.
Having an IUD fitted
Your doctor may recommend the following before you consider IUD as a form of contraception:
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Have a cervical screening to test for any infections
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Undertake a pregnancy test
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The IUD insertion process includes:
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A speculum will be placed in your vagina and your cervix cleaned with an antiseptic.
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The length of the uterus is measured and the IUD is placed inside through the cervix or the opening to the uterus.
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The string is cut so that it is well up into the vagina. (You or your sexual partner won’t notice it but you should be able to feel the string if you reach right up into your vagina.
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You will be asked to wait by your doctor for about 15 minutes to ensure that there is no discomfort or pain after the procedure.
Important note – Do not have intercourse or use tampons for 48 hours following the IUD insertion to help prevent potential infection.
What if you feel that something is wrong?
Contact your doctor if you experience:
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String problems – If you can’t feel the string at all or if it feels shorter or longer than normal. This may mean that the IUD may have shifted (check the length of string after each period).
Pain and fever – If you experience persistent abdominal pain or fever
Bleeding – If you experience unusual discharge or bleeding or there is pain with intercourse
Sexually transmitted infection – If either you or your partner have had increased exposure to a sexually transmitted infection.
