An intrauterine device (IUD) is a small T-shaped device inserted into the uterus to prevent pregnancy. This form of long-term, reversible contraception works by preventing fertilization of eggs and implantation of any egg that becomes fertilized.
Types of IUDsThere are two types of IUDs available in the United States:
- Copper IUD (Paragard): Copper wire is coiled around the stem of the IUD. It works by releasing small amounts of copper into the uterine lining, which creates a toxic environment for sperm. Copper IUDs are effective for up to 10 years.
- Hormone-releasing IUDs (Mirena, Skyla): Progestogen hormone is released slowly into the uterus, preventing fertilization. Hormone-releasing IUDs are effective for 3-5 years depending on the type.
Both types of IUDs have a string attached to the end that protrudes out the cervical opening into the upper vagina; this allows you to feel for the string to check that the device is still in place.
Benefits of IUDsAdvantages of using an IUD for contraception include:
- 99% effectiveness
- Allows for spontaneity of sexual intercourse
- Does not affect breastfeeding
- Hormone-releasing IUDs decreases menstrual flow in women suffering with heavy periods
Risks and Disadvantages of IUDsThe drawbacks and shortcomings of IUDS include:
- Small risk of uterine perforation on IUD insertion (1 in 1000)
- Small risk of uterine infection (1%)
- Increased incidence of ectopic pregnancy
- Increase in menstrual cramps and flow with copper IUD
- Irregular bleeding or spotting between periods (especially in the first few months after insertion)
- Spontaneous expulsion rate is 5%, so you need to check for the string regularly
Doctors Who Insert IUDs
Pelvic examinations, including IUD discussion and insertion may be performed by:
- Gynecologists: Physicians who focus on the health of the female genital system and associated conditions. They are directly involved with contraceptive techniques for women.
- Nurse practitioners: Professionals who focus on prevention, wellness and patient education. There are nurse practitioners that specialize in gynecology and are trained in contraceptive techniques.
- Family physicians/general practitioners: Doctors who deal with prevention, discovery and treatment of illnesses in all age categories. Some of these doctors include contraception as part of their regimen and are trained in insertions.