An intrauterine device (IUD) is a small contraceptive device that is inserted into your uterus (womb) to prevent pregnancy. IUDs are more than 99% effective in preventing pregnancies and provide a very convenient method of contraception than can last up to 10 years. The IUD is also the perfect choice if you are planning a family as your natural fertility will return soon after the device is removed.
No single method of contraception (birth control) is suitable for everyone and each type of birth control has its pros and cons. Hormonal IUDs might not be a good choice if you have been treated for breast cancer or severe liver disease. The copper IUD is probably not the right choice for you if you have heavy periods, low iron levels or endometriosis. Your healthcare professional can advise you on the best choices for your lifestyle, plans and medical history.
IUDs do not protect you or your partner from sexually transmitted infections (STIs) so you should use a condom with your IUD should you need to protect against STIs.
What Kinds Of IUDs Do You Get?
There are 2 types of IUDs available, namely copper IUDs (also called the non-hormonal copper IUD) and hormonal IUDs (such as the Mirena). The hormonal IUD only contains progestogen while the copper IUD has no hormones.
Copper IUDs are a good option for people who prefer non-hormonal contraception or cannot use methods with hormones for medical reasons.
Non-hormonal IUDs use copper to prevent pregnancy. Copper affects the way sperm move which prevents the sperm from reaching and fertilising an egg. The copper also thickens the cervical mucous, which makes it difficult for sperm to reach an egg. It can also prevent a fertilised egg from being able to implant itself in the uterus.
The copper IUD can be used as emergency contraception to prevent pregnancy after unprotected sex if inserted within 120 hours after sex. It is the most effective form of emergency contraception.
Copper IUDs can cause cramps, longer and heavier menstrual periods, and spotting between periods.
Hormonal IUDs, such as the Mirena, release small amount of hormone to prevent pregnancy. The Mirena can prevent pregnancy for up to 8 years.
Hormonal IUDs, which only contain progestogen may be a good choice if you have difficulty taking the hormone oestrogen. Hormonal IUDs, however, should not be used by women with liver disease, breast cancer, or are at a high risk for breast cancer.
How Is An IUD Fitted?
An IUD can be fitted at any time during your menstrual cycle if you are not pregnant. It is advisable to have an IUD fitted during your period as the cervix is usually more dilated (open) at this time. The appointment takes about 20 minutes, and fitting the IUD takes around 5 minutes.
Before your IUD is fitted, your doctor or nurse will check inside your vagina to check the position and size of your uterus. The vagina is held open using a speculum (like during a Pap smear). The IUD is inserted through the cervix and into the uterus.
Having an IUD fitted can be painful, but you can request to have a local anaesthetic to help. You should discuss this with your doctor or nurse beforehand. You should let the person fitting your IUD know if you feel any pain or discomfort during the procedure. You can ask to stop at any time. You may get period-type cramps afterwards, but painkillers can ease the cramps. You may also bleed for a few days after having an IUD fitted.
An IUD has 2 thin threads that hang down from your uterus into the top of your vagina. Your healthcare provider will teach you how to feel for these threads so that you can check that the IUD is still in place. You should check your IUD is in place a few times in the first month and then after each period, or at regular intervals. Although it is unlikely that your IUD will come out on its own, you should contact your healthcare provider to have it checked if you cannot feel the threads or you think that it's moved.
What Are The Benefits Of IUDs?
An IUD is one of the best methods to use if you want the lowest chance of getting pregnant. This is mostly since IUDs can last for up to 10 years which means that you are fully protected against unwanted pregnancies during that time.
Additional benefits of IUDs include:
- When inserted correctly, IUDs are more than 99% effective.
- They are one of the easiest birth control methods to use correctly.
- An IUD works as soon as it is inserted and lasts for up to 10 years, depending on the type.
- It can be put in at any time during your menstrual cycle, as long as you are not pregnant.
- It can be removed at any time if you have side effects or want to have a baby. Your fertility will return immediately.
- If you are 40 or over when you have an IUD fitted, it can be left in until you reach the menopause.
What Are The Disadvantages Of IUDs?
Although IUDs are one of the most convenient and safe methods of contraception available, there are some risks and disadvantages associated with their use. These include:
- Some women find the fitting of the IUD uncomfortable or painful.
- Your periods can be heavier, longer or more painful in the first 3 to 6 months after an IUD is fitted.
- You might get spotting or bleeding between periods.
- There is a small risk of getting an infection after it has been fitted.
- There is a small risk that your IUD might move or slip out of your vagina.
- Occasionally an IUD can cause a perforation in the uterine wall. If this happens you will need an operation (laparoscopy) to remove the IUD.
- It may not be suitable if you have had previous pelvic infections.
- IUDs are not a good choice if you have been treated for breast cancer or severe liver disease.