What is an IUD? An intrauterine (in-trah-U-ter-in) device, or IUD, is a very effective (useful) form of birth control. It is also called an intrauterine contraceptive (kon-trah-SEP-tiv) device, or IUCD. An IUD is made of a small, flexible piece of plastic with a string on the end of it. It is put into your uterus (womb) by a caregiver. It can be removed by a caregiver if you decide to have a baby later. An IUD can prevent pregnancy for one to ten years, depending on the type of IUD that you have.
What are the different types of IUDs? The two most common types of IUDs are the copper IUD and the hormone-releasing IUD. Both types are shaped like a "T," and both have strings attached to them. This string hangs down into your vagina (vah-JEYE-nah). Checking the string can help you and your caregiver make sure that your IUD is still in place. Your caregiver will help you decide which IUD is best for you.
Copper: This type of IUD works by slowly releasing a small amount of copper into your uterus. It must be removed and replaced by a caregiver about every ten years.
Hormone-releasing: This type of IUD works by slowly releasing a small amount of the hormone progesterone (proh-JES-te-rohn) into your uterus. Progesterone is a chemical that is normally made by your body to help control your periods. A hormone-releasing IUD must be removed and replaced every one to five years.
How does an IUD work? IUDs are thought to prevent pregnancy by making the womb "unfriendly" to sperm and eggs. Sperm is either killed, or kept from reaching and fertilizing (FER-til-eyez-ing) an egg. An IUD also may keep a fertilized egg from attaching to the womb and growing into a baby.
Why would I want to use an IUD?
You can count on it to prevent pregnancy. The IUD is one of the most effective forms of birth control available. The IUD may be 98 to 99 percent effective in preventing pregnancy. This means that for every 100 women who use an IUD, only one or two will become pregnant.
It can be removed by a caregiver if you later decide to have a baby. You may be able to get pregnant as soon as the IUD is removed.
It starts working right away. An IUD protects you from pregnancy right after it is inserted. You do not need to wait for weeks for it to start working, like you need to do with birth control pills.
It will not "spoil the mood." An IUD stays in all of the time. You do not have to stop sexual activity to use it, like you need to do for some other forms of birth control. You and your partner may enjoy sex more, since you do not have to worry about becoming pregnant. You do not have to think about an IUD every day, like you must do when using birth control pills. The only thing you have to remember to do with an IUD is to check to see that the string is still there after your period.
Copper IUDs are a safer for some women than "the pill." The copper IUD is a safer choice for women who should not use hormones (birth control pills). Examples include women who smoke or who have a history of blood clots.
Hormone-releasing IUDs may help certain problems. A hormone-releasing IUD may help decrease bleeding and cramping in women who have these menstrual (period) problems.
Who should not use an IUD? Talk with your caregiver about whether or not an IUD is the best kind of birth control for you. An IUD may not be right for you if:
You have more than one sex partner, or your partner has other partners. This is because an IUD does not protect you from sexually transmitted diseases (STDs).
Your uterus is not a normal shape.
You are a teenager.
You have not had a baby. It is more likely for an IUD to slip out of the uterus if you have not had a baby.
What are the possible risks and side effects of using an IUD?
No protection against STDs: An IUD does not protect you from HIV (the virus that causes AIDS) or other sexually transmitted diseases. A condom should always be used during sex if you or your partner have sex with other people.
Problems due to IUD placement: You may have some blood spotting and cramping during the first weeks after the IUD has been inserted. These symptoms should go away within a few months. There is a small risk of an infection (in-FEK-shun) within the first 20 days after the IUD is placed. Infection can lead to pelvic inflammatory disease (PID). PID can cause infertility (not being able to become pregnant). Rarely, the IUD may make a hole in the wall of your uterus when it is inserted. If this happens, it could cause serious problems.
Menstrual changes: A copper IUD may cause your periods to be heavier or more painful. This is more common during the first few months after getting your IUD. If your bleeding or pain becomes very bad, you may need to have your IUD removed. You may have spotting (bleeding) between periods, especially if you have a hormone-releasing IUD.
Displacement: An IUD can slip partly or all of the way out of your uterus without you knowing it. If this happens, you will have no protection against getting pregnant. This is more likely during the first year that you have your IUD, but can happen at any time. Checking the string of your IUD monthly can help you find problems early.
Pregnancy: The IUD is a very good form of birth control. However, there is a small chance that you could get pregnant when using an IUD. If this happens, your IUD may be removed to decrease the risk of miscarriage or other problems. Sometimes the IUD cannot be removed after you get pregnant. You may then have a higher risk of having a miscarriage if your IUD cannot be removed. You also have a higher risk of an ectopic (ek-TOP-ik) pregnancy if you get pregnant while your IUD is in place. An ectopic pregnancy is when the fertilized egg starts to grow someplace other than your womb. An ectopic pregnancy is serious and can be life threatening if not treated.
What happens when I get an IUD? Ask your caregiver about what to expect when you get an IUD. The following are things you may need to know about your procedure.
Informed consent: The risks and benefits of IUD placement should be explained to you in words that you know. You should be told what tests, treatments, or procedures may be needed in order to place your IUD. You may be asked to sign a consent form. A consent form is a legal piece of paper that tells you exactly what will be done. Before giving your consent, make sure that all of your questions have been answered.
Precare and tests: Before getting your IUD, you will need to take a pregnancy test to make sure that you are not pregnant. You may also need tests to be sure you do not have an infection. You will need a pelvic exam, which is an exam of your female organs. You may need to take antibiotics (an-ti-bi-AH-tiks) before or after the procedure. To decrease discomfort, you may be asked to take ibuprofen (eye-bu-PROH-fen) or acetaminophen (a-seet-a-MIN-oh-fen) before the procedure.
The procedure:
The IUD is usually inserted during your monthly period. This may help decrease the amount of discomfort you have during the procedure. It also helps to make sure that you are not pregnant.
You will need to take off your clothes below your waist. A sheet will cover you. There will be another woman in the room during the procedure. If there is not, you can ask for one to be present. You will be asked to lie on a bed with your knees bent and spread. Your feet will be put in holders called stirrups. You will need to move your bottom to the end of the bed.
Your caregiver will carefully put a metal or plastic speculum (SPEK-u-lum) into your vagina. The speculum allows your caregiver to see the inside of your vagina and your cervix (SER-vicks). The cervix is the bottom part, or "entrance" of your uterus. Your cervix will be cleaned with a germ-killing liquid to prevent infection. You may be given one or more shots of numbing medicine into your cervix. Tell your caregiver if you are allergic to lidocaine or any dental or numbing medicine.
To place the IUD, a long, thin plastic tube is gently passed through your cervix and into your uterus. This tube has the IUD inside of it. The IUD is pushed out of the tube and into your uterus. You may have a small amount of cramping as the IUD goes into your uterus. The tube is removed after the IUD is in place. Ask your caregiver about other things that may be done when your IUD is placed.
How can I make sure my IUD is still in place? An IUD has a string or "tail" which is made of plastic thread. About one or two inches of this string hangs into your vagina. You cannot see this string, and it will not cause problems when you have sex. Check your IUD string every few days during the first few months that you have your IUD. After that, check the string after each monthly period. You may not be protected against pregnancy if you cannot feel the string or if you feel plastic. Do the following to check the placement of your IUD:
Wash your hands with soap and warm water. Dry them with a clean towel.
Bend your knees and squat low to the ground.
Gently put your index (pointing) finger high inside your vagina. The cervix is at the top of the vagina and feels like the tip of your nose. Find the IUD string coming from your cervix. Never pull on the string. You should not be able to feel the firm plastic of the IUD itself. Wash your hands after you are done checking your IUD string.
For more information: For more information on birth control options, talk to your caregiver or contact the following:
Planned Parenthood Federation of America 434 West 33rd St. New York City, NY 10001 Phone: 1-800-230-7526 Web Address: http://www.plannedparenthood.org
Family Health International PO Box 13950 Research Triangle Park, NC 27709 Phone: 1-919-544-7040 Web Address: http://www.fhi.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
