The IUD
 
 


What is an IUD?

  • IUD stands for Intrauterine Device. You may also see it referred to as an IUC (Intrauterine Contraception).
  • The IUD is a small, T-shaped device that is placed inside the uterus to prevent pregnancy.
  • There are two types of IUD available: the Mirenaã IUD and the ParaGardã IUD.

How does an IUD work?

  • There is no single explanation for how an IUD works. There are several ways that IUDs prevent pregnancy and it is believed that these different ways work together.
    • IUDs work by thickening the cervical mucous:
      • It is believed that this thicker mucous prevents sperm from passing through the cervix into the uterus.
    • IUDs work by preventing fertilization of the egg:
      • It is believed that the presence of the IUD in the uterus makes it difficult for the sperm to travel. If the sperm cannot reach the egg, fertilization cannot occur.
    • IUDs work by changing the lining of the uterus:
      • If the lining of the uterus is not prepared for a pregnancy, an egg will not implant and a pregnancy will not occur.

How effective is the IUD?

  • The IUD has been shown to be 99% effective in preventing pregnancy.

What should I know before I have an IUD inserted?

  • You should not have any intercourse for at least 2 weeks before your IUD is inserted. If there is any possibility that you could be pregnant, your IUD insertion will likely need to be rescheduled.
  • If you start your period, you should still be able to have your IUD inserted.
  • Many women will experience cramping during the insertion of their IUD. It is suggested that you take 800mg of Ibuprofen about 1 hour before your IUD insertion to minimize the discomfort from this cramping.

Does the IUD protect against sexually transmitted infections?

  • No. Always use condoms to decrease your risk of contracting a sexually transmitted infection.

What can I expect during the insertion of my IUD?

  • You will lay down on the exam bed and a speculum will be placed in your vagina, just like during a normal pelvic exam.
  • The IUD is loaded in a thin tube, or catheter, that will be passed through the natural opening in your cervix (called the cervical os). This may cause cramping.
  • If the IUD catheter does not pass easily through this opening, your doctor may use instruments to make the cervical os open a little wider.
  • The catheter will be placed inside the uterus and the IUD will be released. The catheter will then be removed.
  • Thin, flexible strings are attached to the end of the IUD. Your doctor will cut these strings to an appropriate length.
  • Your IUD is now in place.
  • A follow-up appointment will be scheduled for you to come back and see your doctor in a few weeks to ensure the IUD is still positioned correctly and that you  are not having any problems.

What should I expect after my IUD is inserted?

  • Many women experience spotting or light bleeding for 1-2 weeks after their IUD is inserted.
  • Some irregular bleeding can occur over the next few months. Your doctor will discuss this with you and let you know what to expect.
  • You should check once each month to make sure you can still feel your IUD strings inside the vagina. This will tell you that the IUD is still in place and that you are protected against pregnancy.

What is the difference in the two types of IUD?

  • The Mirenaã IUD:
    • The Mirenaã is a hormonal IUD that can be used for up to 5 years.
    • The IUD is made of flexible plastic and contains the hormone progesterone.
    • Some common side effects of the  Mirenaã:
      • It can be common for women to have irregular bleeding for 3-6 months after insertion of the Mirenaã.  
      • Many women will then experience lighter of less frequent periods.
      • Some women have no periods at all after the Mirenaã is inserted.
  • The ParaGardã IUD:
    • The ParaGardã is a copper IUD that can be used for up to 10 years.
    • The IUD is made of a flexible plastic that is wrapped with thin copper wire.
    • Some common side effects of the ParaGardã:
      • It can be common for women to have spotting between their periods.
      • Some women experience stronger menstrual cramps.
      • Some women notice that their periods may last longer and their bleeding may be heavier.
      • There may be an increase in vaginal discharge.

What if I decide I would like to become pregnant before my IUD "expires?"

  • While the IUD is good for up to 5-10 years (depending on which IUD you choose), you can decide to have your IUD removed at any time.
  • As soon as the IUD is removed, women have a rapid return of fertility.

What if I want to continue using an IUD after mine "expires?"

  • Your IUD will need to be removed by your healthcare provider on or before its expiration date.
  • If you decide to continue with an IUD, a new IUD can be placed at the same time that your old one is removed.

What are the risks associated with having an IUD?

  • The IUD may fall out. While this is rare (happening in about 1-7% of all women using an IUD), you should call your doctor if you cannot feel your IUD strings.
  • You may be more prone to sexually transmitted infections. The IUD is suggested for women who are in a monogamous relationship (partners are exclusive to one another and do not have any other sexual partners).
  • In rare cases, the IUD may puncture the wall of the uterus. If this occurs, surgery may be required to remove the IUD.

When should I call my doctor?

  • If you suspect you are pregnant or have any symptoms of pregnancy (breast tenderness, morning sickness, etc) check a pregnancy test and call the office.
  • If you cannot locate your IUD strings, call the office for a quick appointment to check IUD placement.
  • If your IUD strings are uncomfortable for your partner during intercourse, you should see your doctor to have the string length adjusted.
  • If you have symptoms of a vaginal infection or sexually transmitted infection you should call your doctor right away for an appointment.

 



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