Intrauterine Device (IUD): Long-Term Contraception

The full name of "IUD" is "Intrauterine Device". It is a type of contraceptive device available for women which is in the shape of "T". It is made of plastic and is fitted inside a woman's uterus. IUD protects the woman's pregnancy by preventing the male partner's sperm from reaching and fertilizing the egg.

If you use IUD correctly, the risk of pregnancy is less than 1%. It is an effective and long-lasting birth control method. However, if you ever want to get pregnant, IUDs can be easily removed as they are not permanent contraceptives like sterilisation.

IUDs can provide protection against pregnancy from 3 years to 12 years depending on the type you use. There are two types of IUDs, copper and hormonal, which are described in more detail below.

IUDs do not provide protection against sexually transmitted infections (STIs). If you are at risk of STIs, the best way to reduce your risk is to use a condom when you have sex with your sexual partner. If your partner does not want to use a condom, you can use a female condom.

(Read more - How to Use Copper T)

There are currently two types of IUD available as a contraceptive method for women -

1. Hormonal IUD
The hormonal IUD is a small T-shaped device that consists of a cylinder that contains a hormone called progestogen. There are three hormonal IUDs available in India - Skyla, Mirena and Liletta. They release a small amount of the synthetic hormone progestin into your body.

Depending on which type of IUD you use, hormonal IUDs can protect you from pregnancy for 3 to 6 years and may be a good option if you suffer from menorrhagia (heavy menstrual bleeding, heavy menstrual bleeding) as it can reduce your menstrual bleeding.

(Read more - Heavy periods (Menorrhagia))

Hormonal IUDs can take up to a week to take effect, so ask your doctor if you should wait a week to have sex or use another method of birth control, such as condoms, as a back-up during that time. This type of IUD may also be called an intrauterine system (IUS).

2. Non-Hormonal IUD
The non-hormonal IUD is a small plastic device with copper wrapped around it. The only type of non-hormonal IUD available in India is called “ParaGard”. It is made of plastic and a small amount of natural and safe copper.

ParaGard does not affect your menstrual cycle and can protect you from pregnancy for up to 12 years if used correctly. The duration is almost double compared to hormonal IUDs.

The specialty of non-hormonal IUD is that it starts protecting you from pregnancy immediately after it is fitted inside the vagina. In fact, the Copper-T IUD is a very effective method of emergency contraception, it can prevent pregnancy even if it is fitted within five days of unprotected intercourse.

(Read more - Menstrual Cup: How to use)

IUDs affect the ability of sperm to enter and survive in the uterus (womb) so that they cannot reach the egg to fertilize it. IUDs also change the inner lining of the uterus (endometrium) so that it is not suitable for pregnancy and so that even if an egg is fertilized, it cannot develop.

Both the copper IUD and the hormonal IUD prevent pregnancy by changing the way sperm cells move so that they cannot get to the egg. If the sperm cannot reach the egg, pregnancy cannot occur.

(Read more - Family Planning)

The ParaGard IUD uses copper to prevent pregnancy. Sperm do not like copper, so the ParaGard IUD makes it nearly impossible for sperm to reach the egg. The hormones found in Skyla, Mirena and Liletta IUDs prevent pregnancy in two ways – first, they thicken the mucus lining the uterus, which blocks the path of sperm.

Second, the hormones sometimes prevent eggs from leaving your ovaries (called ovulation), which means there are no eggs for sperm to fertilise. If there are no eggs available, pregnancy is not possible.

(Read more –Mirena Intrauterine Delivery System)

Most experts agree on the fact that if you are healthy and have a uterus, you are probably fit to use an IUD. This is true even if you are young, have never been pregnant or do not have children yet. It is also a better method for new mothers who have just given birth to a child, even if they are breastfeeding.

This method is safe for most women but some conditions may increase the risk. Talk to your doctor to see if this method is right for you. This method should not be used if you have any of the following problems:

• Cervical cancer
• Cervical cancer that has not been treated
• If you think you could be pregnant 
• Pelvic infection or STI (sexually transmitted infection)
• Vaginal bleeding (other than your period)
• Pelvic tuberculosis 
• Torture in the uterus (during insertion of the IUD)

Although this is very rare, it is possible that during an examination your doctor finds that the IUD cannot be fitted properly in your uterus. This depends on the particular shape or position of your uterus.

Do not use the copper IUD (ParaGard) if you are allergic to copper, have Wilson's disease (a genetic disorder that prevents the body from removing copper and causes it to accumulate), or have a bleeding disorder that makes it difficult for your blood to clot.

You should not use a hormonal IUD if you have severe liver disease or breast cancer. If the above conditions make it unsafe for you to use an IUD, consider using other effective methods of birth control and consult your doctor.

(Read more - Light periods)

If you are thinking of using a contraceptive called an IUD, you need to talk to your doctor. She will assess your body, medical history and lifestyle. If this method is right for you, a medical examination may be done and you may also need to be tested for STIs or other infections. The vagina and other organs may be examined before the IUD is fitted. Your doctor will also check for any pelvic infection. If a pelvic infection is found, it will need to be treated first.

(Read more - Navigating Hormonal Imbalance in Women)

This procedure can be done at any time during your menstrual cycle, but it is better if it is done in the middle of your menstrual cycle. Because at this time the womb is most open. This procedure can also be done after pregnancy or after an abortion operation.

The IUD is inserted into your uterus by a trained doctor or nurse. After visiting the family planning center, your doctor will insert the IUD into your uterus. Your doctor may suggest taking an over-the-counter pain medication a few hours before the procedure to reduce the pain during the procedure.

To place the IUD inside the uterus, the nurse or doctor will insert a speculum into your vagina and then use a special instrument to insert the IUD into your uterus through your cervix. The procedure usually takes less than five minutes.

The procedure may make you uncomfortable and you may experience cramping or bleeding, but these should subside within a few days. Some women may feel dizzy due to vaginal pain.

(Read more - Endometrial ablation)

Your IUD can be removed at any time by a trained doctor or nurse. If you have had your IUD removed but do not want to become pregnant, start using additional contraception, such as condoms, 7 days before it is removed. It is possible to become pregnant as soon as the IUD is taken out.

If you think you may be pregnant, see your doctor to have your IUD removed as soon as possible. If the IUD is not removed while you are pregnant, the risk of miscarriage increases. If you decide you want to have the IUD removed, the best time is during your menstrual period. Your doctor removes the IUD by pulling the string. You may feel pain for a few seconds.

(Read more - 2 periods in one month)

The benefits of the IUD as a contraceptive are as follows -

• It can last for 5 years or more.
• It is possible to become pregnant as soon as the IUD is removed.
• It does not interfere with the pleasure of sexual intercourse. 
• It is safe for you to use an IUD even if you are breastfeeding. 
• If you do not want to take the pill, you can use it.
• With the IUD called Mirena, menstrual pain is reduced in most women and bleeding also decreases. In some women, menstruation stops.

Any birth control method can have some advantages and some disadvantages, IUD can have the following disadvantages -

• When an IUD is inserted, there is about a 1% chance that you may get a vaginal infection.
• There may be a possibility of a hole in the womb in about 1 out of 1000 cases while inserting an IUD. You can still get pregnant even if the IUD is in place, but this happens in very rare cases.
• You may have an ectopic pregnancy (in the fallopian tubes).
• The copper IUD may cause heavy bleeding and pain during menstrual periods.
• Some people may also be allergic to copper.
• The IUD may sometimes come out on its own in about 5% of cases. You can check the string of the IUD inside your vagina after each menstrual period or at the beginning of each month to see if it is in the right position.
• The IUD called Mirena may initially cause irregular menstrual periods, less bleeding for more days than usual.

(Read more - Bacterial Vaginosis)

The IUD (Intrauterine Device) is a contraceptive device that is inserted into the uterus. It is a safe and effective way to prevent unwanted pregnancies. Types: There are mainly two types of IUDs—copper IUD and hormonal IUD. Copper IUD prevents sperm movement and fertilization, while hormonal IUDs make the ovaries and uterus environment unsuitable for pregnancy by releasing progestin hormone.