Options for Sexual Health

What is an IUD, and how does it work?

An IUD (intrauterine device) is a small T-shaped device that is inserted inside a woman's uterus by a medical practitioner. A thin string attached to the IUD hangs down through the cervix into the top of the vagina, which allows you or your doctor to check that it is in place.

There are two types of IUDs available.

• Copper IUDs are made of plastic and copper. They prevent pregnancy by stopping sperm from fertilizing an egg and preventing implantation. Copper acts as an effective spermicide (to destroy sperm).
• The Mirena intrauterine system is made of plastic and contains a small amount of the progesterone hormone. The hormone is continuously being released at low levels to thin the lining of the uterus, thicken the cervical mucus making it difficult for sperm to fertilize an egg, and can stop the release of an egg from your ovary.

IUDs prevent conception. They do not cause an early abortion.

How is an IUD inserted and removed?

• The procedure can be done in a doctor's office or clinic and can be inserted postpartum or after a surgical abortion.
• IUDs can be inserted at any time during the menstrual cycle.
• Some women experience a brief sharp cramp or sting on insertion.
• Testing for sexually transmitted infections (STIs) can be done at the time of insertion or in advance of insertion.
• Removal of an IUD is done by a doctor during an office or clinic visit. If the strings are visible at the cervix, the physician can easily remove the IUD by gently pulling it out.

How effective is it?

• An IUD is an excellent method of birth control—approximately 99% effective immediately after insertion.
• An IUD is effective from two and one-half to five years before needing to be replaced (the amount of time depends on the kind of IUD you choose.
• A copper IUD is an extremely effective form of emergency contraception if inserted within 5 days of unprotected intercourse.

Advantages

• Convenience. The IUD is always in place. There is nothing to do before you have intercourse.
• It is a good method for breastfeeding mothers or women who cannot use estrogen methods of birth control.
• It is reversible.

Disadvantages

• Requires at least one doctor's visit
• Does not protect against STIs
• Mirena is at least twice as expensive as a copper IUD

Who might not be able to use it?

Women who:

• Have an active or recent pelvic infection
• Are pregnant
• Are allergic to copper (for copper IUDs copper) or adverse effects from progesterone (for the Mirena IUD)
• Have unexplained uterine bleeding or anemia
• Have an abnormal cervix or unusually shaped uterus
• Have heart or blood diseases
• Are immunosuppressed individuals

Could there be complications?

Although rare, perforation of the uterine muscle or wall by the IUD can occur. Infertility may be a consequence of an IUD user who is at risk from untreated STIs.

Early Warning Signs:

If you experience any of these, call a clinic or go to an emergency department immediately.

Which IUD is right for me?