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DESCRIPTION
The goal of contraception (or birth control) is to prevent an unplanned pregnancy. The majority of methods of contraception enable sexually active couples to temporarily avoid pregnancy. Permanent birth control is accomplished through sterilization. Be sure you know and understand the different types of birth control available to you, the risks and benefits of each, and any side effects, so that you can make an informed choice.
An intrauterine device (IUD) is a tiny T-shaped object (usually made of plastic) that is inserted into the uterus (womb) to prevent pregnancy. One or two plastic strings (filaments) attached to the IUD extend out through the cervical canal. These strings enable periodic checking for position and as an aid when the IUD is removed. IUDs are visible on x-ray should one become "lost".
There are two types of IUDs in use in the United States. The Copper T 380A has copper wrapped around the arms and the stem of the "T." It works for up to 8-10 years. Like other methods, a client may have her IUD removed whenever she wishes. After 10 years, however, the Copper T must be taken out and replaced by a health care provider. The Copper T is also called Para Guard. The Copper T will only be discussed here, because this is the only IUD which can be used for emergency contraception.
The IUD interferes with the transportation of both sperm and egg with the end result that fertilization does not take place. With an IUD in place it is very unlikely that sperm will be able to meet with the egg. The IUD may also cause the egg to move through the fallopian tube at a different speed.
The copper in the Copper T may be toxic to sperm. This would keep healthy sperm from reaching the egg. The IUD also changes the lining of the uterus so if an egg and sperm meet, the fertilized egg may not be able to attach to the lining.
The IUD works in different ways. No one fully understands all the ways the IUD works to prevent pregnancy. The information above describes the understanding we have at this time.
ADVANTAGES
IUDs are quite effective for birth control (97-99%).
The pregnancy rate for the IUD, when used as an emergency contraceptive method, is about 1%. This means that for every 100 women that use this method, 1 pregnancy may occur.
A woman using an IUD should check for the string as often as advised. The IUD also needs to be replaced in a timely fashion. The IUD can last up to 10 years, if kept in as the ongoing method of contraception. A woman should also watch for warning signs of infection, especially during the first few months after insertion.
Is a safe and effective means to prevent pregnancy in an "emergency" situation.
The device is easily fitted and tolerated by most women.
Enjoyment of spontaneous sexual intercourse; freedom from concern once IUD is in place. It doesn't interrupt sexual intercourse.
The IUD requires no daily routine.
Although they cannot be discontinued as easily as discontinuing a daily pill (oral contraceptives), they can be removed at any time by a trained health care provider.
If you have not started menstruating within three weeks after the IUD was inserted or if you experience symptoms of complication, such as a pregnancy in the fallopian tube (tubal pregnancy), or abdominal infection, you need to go to your health care provider and have the IUD removed.
Fertility for a woman after removal of the IUD should probably be the same as it was before using the IUD.
DISADVANTAGES
Cramping and bleeding may occur the first few days after insertion.
Spontaneous expulsion of the IUD. Occurs more frequently within the first 3 months to one year. It is noted in most instances, but some women may not be aware of the device being expelled.
Occasional bleeding between menstrual periods and changes in amount of flow and increased pain with periods.
IUDs offer no protection against sexually transmitted diseases (STDs). A form of barrier protection needs to be used by those at risk.
IUD may perforate the uterus and travel into the abdomen. "Lost" IUDs require special examinations.
IUDs can increase the risk for pelvic infections such as pelvic inflammatory disease (PID) making the woman very sick which can impair future fertility or infertile.
If pregnancy occurs with an IUD in place, there is a 50% chance of miscarriage. The IUD should be removed.
IUDs may increase the risk of ectopic pregnancy.
Not usually recommended for women who have a diagnosed gynecological problems or are pregnant, women who have not yet had a child and women with multiple sexual partners.
MoonDragon's Contraception Information: IntraUterine Device (IUD)
GENERAL MEASURES
INSTRUCTIONS FOR USE
You will have a full medical examination including a pelvic exam, Pap smear testing, breast exam, pregnancy test and tests for STDs along with your medical history before being given an IUD. The health care provider will help you decide if it is safe for you to use an IUD for emergency contraception.
The device will be inserted by a trained health care provider.
The IUD can be inserted up to five days after unprotected intercourse.
1. To insert:
- The IUD is straightened out in a plastic tube (like a straw) and the tube is inserted through the cervix and vagina into the uterus. The IUD is pushed through the tube and it springs back into shape in the uterus.
- The tube is removed and the IUD stays in the uterus with its string dangling into the vagina. You will be instructed on how to check for the string.
- There may be pain during the insertion and sometimes cramping for the rest of the day. Right after the IUD is put in, you may feel dizzy or have cramps. For the first few weeks, it is normal to have some spotting, heavier menstrual bleeding or cramps.
- Check for the strings often. Check for the strings before each time you have intercourse and after the periods ends. Also check once after each period and check any time you have abnormal cramps when menstruating. Use a clean finger to reach into your vagina and feel near the cervix for the strings. In the middle of your cycle, your cervix is higher so the strings may be harder to find. If the strings haven't changed, the IUD is in place. If you can't find the strings or you feel any plastic, the IUD may be out of place. If it is out of place, you may not be protected against pregnancy. Rarely, the IUD may be pushed out of the uterus without a woman knowing it. If you think the IUD is out of place or has been pushed out, its advisable not to have intercourse until you get checked. If you do have intercourse, use a back-up method of birth control.
2. To remove:
- Consult your health care provider about removing the IUD. It will need to be done by your health care provider.
Remove the IUD when it stops working. The IUD needs to be replaced every 8 to 10 years.
If you think you might be pregnant or if you want to get pregnant.
If you want to stop using it for any reason.
See your health care provider if you experience any IUD warning signs.
Side Effects:
- Longer or heavier periods or spotting. This may cause enough blood loss to cause anemia.
- Painful menstrual cramps.
COMPLICATIONS
Infection or Pelvic Inflammatory Disease (PID). This is most likely to occur during the first few weeks after insertion. It is often caused by STDs that were present when the IUD was put in. It requires quick and careful treatment. If not treated, a woman may lose her fertility. She can also become very sick and even die.
Tear or hole in the uterus or cervix. This is a rare complication of insertion.
Expulsion of the IUD. Signs of the IUD coming out include vaginal discharge, abdominal cramping or pain, spotting, change in the length of the string, and the feel of hard plastic at the cervix.
Miscarriage. If a woman does get pregnant while using an IUD, there is a 50% chance that she will have a miscarriage.
Ectopic Pregnancy. If a woman with an IUD gets pregnant, she is more likely to have an ectopic pregnancy than a woman without an IUD.
IUD WARNING SIGNS
Period late, abnormal spotting or bleeding (could mean pregnancy or infection).
Abdominal pain, pain with intercourse (could mean ectopic pregnancy infection).
Infection exposure (any STD), abnormal discharge (possible infection).
Not feeling well, fever, chills (possible infection).
String missing, shorter or longer (IUD may be missing or dislodged).
MEDICATION
Ask your health care provider about the need for pain medication during and after the insertion procedure.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You are interested in an emergency intrauterine device (IUD) for contraception after you have had unprotected sexual intercourse. There are some reasons why a health care provider may advise against the use of this method. Most are related to the risk of PID during the first months of use. These include current or past STDs, PID or other pelvic infections or a past tubal pregnancy. Risk factors for STDs, such as the number of sex partners, will also be assessed by the health care provider. If a woman wants to have children in the future, your health care provider may suggest a different method. This is because if PID occurs, there is a chance that a woman could become infertile. Also, if a woman has abnormal vaginal bleeding, the cause needs to be known before the IUD is put in.
Following the insertion of an IUD, unexpected side effects develop including excessive or irregular vaginal bleeding, painful cramps in the abdomen, vaginal discharge, signs of infection (fever, chills, muscle aches).
You cannot find the string of the IUD when you search for it.
The IUD has been in place for the length of time recommended for the type you had inserted.
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