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 IUDs

There 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 IUDs

Advantages of using an IUD for contraception include:

  • 99% effectiveness
  • Allows for spontaneity of sexual intercourse
  • Reversible
  • Long-acting
  • Does not affect breastfeeding
  • Hormone-releasing IUDs decreases menstrual flow in women suffering with heavy periods

Risks and Disadvantages of IUDs

The 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.