Intrauterine Device

INTRAUTERINE DEVICES

General Information

The intrauterine device (IUD) is a small, plastic, T-shaped object with a string attached that is inserted into the uterus to prevent pregnancy. It is put in place and removed by a health care professional.

Two types of IUDs are used in the United States today. One, which can remain in place for 10 years, has a copper wire wrapped around the plastic body of the device. The other, good for five years, releases small amounts of the hormone progesterone. IUDs are believed to work by preventing sperm from fertilizing the egg and by changing the lining of the uterus to prevent the egg from attaching. The string, which comes through the cervix, allows a woman to check once a month and feel that the IUD is still in place.

IUDs do not protect against AIDS or any other sexually transmitted disease (STD). If you become pregnant with an IUD in place, it should be removed as soon as possible. It should also be removed if you become menopausal.

Benefits

  • It is a relatively safe, very effective and inexpensive form of birth control.
  • It prevents pregnancy immediately after it is inserted.
  • You do not have to take pills, get shots, or use condoms, diaphragms or spermacidal creams.
  • It does not interfere with or interrupt your lovemaking.
  • It can be used if you are breastfeeding.
  • The progesterone IUD may help slow down menstrual bleeding if you are having heavy menstrual periods.
  • The copper IUD can be used as emergency contraception if it is inserted within five days after unprotected intercourse. It can then be left in place for future birth control.
  • It can be used in women with certain medical diseases (diabetes, blood clots and liver disease).
  • It is easily reversible, and pregnancy can occur quickly after removal of an IUD.

Risks

  • Your body may expel the IUD. This occurs infrequently and usually within the first year of use.
  • The IUD may puncture your uterus. This does not happen often and, when it does, usually occurs during insertion.
  • You may get pregnant despite having an IUD in place. This could result in an ectopic pregnancy (one which the egg implants outside the uterus) or a pregnancy that could result in a miscarriage or infection.
  • Although it happens only rarely, you may develop an infection in the uterus within the first three weeks after insertion of IUD.
  • You may develop infections of the uterus, fallopian tubes and ovaries (pelvic inflammatory disease). This is especially true if you have more than one sex partner because that puts you more at risk of developing an STD.
  • The copper IUD may cause an increase in blood flow and cramps for the first two to three months or longer.
  • The progesterone IUD may cause mild acne, a decrease in sex drive, a slight increase in premenstrual syndrome, headache, nausea, depression and breast tenderness.
  • You may have spotting or bleeding between periods.

When the IUD Should Not Be Used

Some women should not use IUDs. Do not use an IUD if:

  • You are pregnant.
  • You have a sexually transmitted disease.
  • You have cancer of the female organs.
  • You have had a pelvic infection within the last three months.
  • You have had an infection following a pregnancy or an abortion within in the last three months.
  • You have an infection of the cervix, vagina or vulva.
  • You have unexplained bleeding.
  • You have an abnormally shaped uterus that would make inserting an IUD difficult.
  • You have a history of toxic shock.

If you are allergic to metals, do not use the copper IUD. Women who want to use an IUD and who have certain medical conditions such as anemia, heart disease or a compromised immune system will need to discuss it with their doctor.

WHEN TO CALL YOUR DOCTOR FOR INTRAUTERINE DEVICES

Call Your Doctor Right Away (night or day) If

  • Your periods have doubled in flow, especially if you are passing blood clots and never have before.
  • You develop pain in your abdomen and have a fever of 100 degrees F or higher.

Call Your Within 24 hours If

  • If you want the IUD for emergency contraception.
  • You have a positive pregnancy test and an IUD in place.

Call Your Doctor During Regular Office Hours If

  • You missed your period.
  • You think you are pregnant.
  • You develop vaginal discharge that has a bad odor or is discolored.
  • You cannot feel the string when checking the IUD after a menstrual period.
  • You can feel the IUD at the opening of the cervix or in the vagina.
  • Your sex partner has discomfort on his penis when you have intercourse.
  • You feel you need something stronger than over-the-counter medications for cramping or discomfort with your period.
  • You want the IUD removed.
  • You have bleeding between periods after you have had an IUD for two menstrual periods.
  • You have an IUD and become menopausal.
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HOME CARE ADVICE FOR INTRAUTERINE DEVICES

  1. If your periods are uncomfortable or if you have cramping with the IUD, take over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Motrin). Avoid taking aspirin because it may increase bleeding.
  2. Examine yourself after every menstrual period and feel for the IUD string to be sure the device remains in place.
  3. If you think you may be pregnant, take a home pregnancy test immediately.
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References

  • American College of Obstetricians and Gynecologists ACOG Practice Bulletin, Number 59, 2005.

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Disclaimer:

Peer-Reviewed by the Faculty of the University of Colorado Denver Department of Obstetrics and Gynecology

This content is reviewed periodically and is subject to change as new healthcare information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional