Contraception - Intrauterine device (IUD)

There is some controversy surrounding the safety of IUDs. Although most women have not been well educated about the real facts of them. This has been because they have received a lot of bad publicity, and in some ways the publicity that they have had is correct. However the problems with them only occur in a minority of women, and if there are to be problems, they will usually occur within the first few months of having one inserted. And if tolerated well, they are an effective and safe form of contraception. They have 98-99% efficiency in the prevention of pregnancy, and become effective as soon as they are inserted.

IUD is a contraceptive device made out of either steel or plastic; some may have a copper wire around them, or may contain hormonal material within them. An IUD is inserted usually around the time of menstruation. This is because there can sometimes be cramping similar to that of period pain. They are inserted into the uterus, and can only be performed by a doctor that specialises in performing this procedure. If the IUD is inserted when the woman is not menstruating, then bleeding may occur, along with cramping. This will only last a short time, and is not abnormal. Insertion will not effect the natural cycle of menstruation.

The way in which an IUDs works is still unclear, but it appears that they cause the environment within the uterus to be unsuitable for the embryo to implant. If an IUD has hormonal material within it, that material can thicken the cervical mucus to stop sperm reaching the uterus, along with thinning the lining of the uterus causing an inappropriate environment for a fertilised egg to implant. Another theory (for IUDs not containing hormonal material) is that it causes the uterine environment to be unsuitable for the sperm to migrate towards the female's egg. Once inserted there is no need for any other form of protection against pregnancy. If an IUD is tolerated, then it may remain in the uterus for between 3-5 years. After this time it can be changed if the woman chooses.

Problems that can arise with IUDs

The bad publicity has arisen from the increased likelihood of infection within the uterus. The statistics however, are quite contrary to this. Infection rate only rises by about 2% for those with IUDs. One infection within this 2% is pelvic inflammatory disease (PID), which is an infection of the reproductive organs. If this infection is ignored, it can result in infertility.

Another problem that can arise is during the insertion of the device is perforation of the uterus. Perforation will only occur if doctors who are not experienced insert the IUDs. So doctor shop for those who have performed this procedure many times.

The body can naturally expel IUDs, if this does not occur in the first few months, then it is unlikely to occur at a later stage.

The benefits of an IUD

• Effective as soon as it is inserted
  
• Protection against pregnancy is permanent for years, as long as the devise stays in place.
  
• Can lighten and shorten period pains (although it can do the opposite in some women).
  
• Can reduce the severity of period pains (again can do the opposite in some women).
  

When it should not be used

• IUDs are not often recommended for those who have not given birth before, as expulsion is more likely to occur.
  
• Obviously this device should not be used during pregnancy.
  
• Those with very heavy periods should avoid using IUDs
  
• Those how have had an ectopic pregnancy (you would need to discuss this option of contraception with your doctor).
  
• If you have had cancer of the uterus or ovaries.
  
• If you have arterial disease.
  

There are side effects for every contraceptive method (even condoms - some people are allergic to latex). If you are with a stable partner, and do not want to have children for some time, it is a device that should be considered.


- Louise Ganey