Even though over 25% of women depend on oral contraception, some women have challenges remembering to take the pill, or they merely do not want to take it. For most women, intrauterine contraception serves as the best alternative to oral contraception; one of the reasons is they won’t need to think about it once they have gone through the procedure. If you are considering intrauterine contraception as a birth control method, you should visit a gynecologist to walk you through all you need to know about it.
At All Women’s Care, not only will we tell you everything you want to know, but we will also help you to determine if you are the right candidate for the procedure. If you are a candidate, we will conduct the procedure in simple, comfortable steps to achieve the best possible results. We have served many clients in Los Angeles who can attest to our expert services. We invite you to contact us if you are seeking Intrauterine contraception or have questions regarding other contraception methods.
Overview of an IUD
An intrauterine device, abbreviated as IUD, is the most commonly used method of long-acting reversible contraception since it is cost-effective, easy to use, safe, and highly efficient. IUDs provide a non-surgical option to prevent pregnancy that’s as efficient as surgical sterilization. The most frequently used IUDs have a plastic frame. They release either hormone progestin or copper to amplify the contraceptive act of the device.
Numerous terms are used to describe Intrauterine devices, including intrauterine contraception and IUD. The progestin-containing device or hormonal IUD is also called an intrauterine system. An IUD refers to a slight contraceptive device usually placed into the uterus (womb) to stop a pregnancy from taking place.
Types of Intrauterine Contraception
There are five different IUD brands approved by the FDA for use in the U.S. They include Mirena, ParaGard, Kyleena, Skyla, and Liletta. These brands are further divided into two main types: hormonal IUDs (Kyleena, Liletta, Skyla, and Mirena) and Copper IUDs (ParaGard)
A copper intrauterine device does not have hormones. It’s a slight plastic device that has copper wire wrapped around it with a fine nylon thread attached to its end. When the IUD is in position, the thread protrudes via the cervix into the top of the vagina. The thread enables you to check if the device is still intact. It also gives a doctor an easy time when taking the device out. You can’t feel that the thread is there except if you insert your fingers deep into your vagina. A copper IUD can protect you from getting pregnant for a maximum of ten years.
The hormonal IUD is a slight plastic device that assumes the shape of letter T and contains the progestin hormone, which stops pregnancy. Progestin is a synthetic form of the progesterone hormone that women generate naturally. A hormonal IUD has a membrane (coating), which regulates the releasing of progestin in the uterus. Just like copper IUD, hormonal IUD has a fine nylon thread that’s attached to the edge to make its removal and checking easier. Mirena will work for a maximum of seven years, Kyleena five years, Liletta up to seven years, and Skyla for up to three years.
Why is Intrauterine Contraception a Good Choice?
IUDs offer long-term and effective contraception. They may be used in premenopausal women of all ages, and this includes teenagers. Among the various advantages, IUDs:
- Eliminate the need for interrupting sexual intercourse for contraception
- Do not require the participation of your partner.
- Can be taken out at any given time, then you will quickly go back to your usual fertility state
- Can be inserted even during the breastfeeding period— although your doctor will likely suggest that you wait between six and eight weeks after delivery since earlier insertion elevates the danger of harming the uterus in the course of the placement
- Do not carry the threat of the side effects associated with birth control options containing estrogen.
- Are over 99% effective in stopping pregnancy from taking place
- Can remain intact for a long time (five to ten years)
- Once they have been inserted, you’ll only have to check the thread every month
IUDs can reduce menstrual bleeding after using it for three months or more. Approximately 20% of women cease menstruating after a year of IUD use. Also, IUDs can reduce:
- Severe period pains as well as pain associated with endometriosis
- The likelihood of pelvic infections
- The danger of developing endometrial cancer
Due to these benefits, IUDs are often recommended for women that have:
- Pain or cramping with periods
- Heavy menstruation
- Endometrial hyperplasia
IUDs aren’t ideal for every woman. Your doctor may discourage you from inserting an IUD if you’ve got:
- Unexplained vaginal bleeding
- Liver disease
- Cervical, ovarian, or uterine cancer
- have had or have breast cancer
- Had an infection in the pelvis
- Current pelvic inflammatory disease
- Recently had an STI
- Uterine abnormalities like fibroids, which tamper with the retention or placement of the device
- You are pregnant
Inform your physician if you:
- Have migraines
- Have high blood pressure or diabetes
- Have had a heart attack or have a heart condition
- Are on any medication, including herbal and non-prescription products
- Have had a stroke or have blood-clotting issues
- Are breastfeeding or recently delivered
How It Works
An IUD affects how sperms move and stay alive in the uterus, preventing them from reaching and fertilizing the ovum. Also, an IUD can alter the uterus lining to prevent a fertilized egg from attaching to it. The hormonal IUD can cause the fluid at the opening of the uterus thicker, thereby stopping sperms from going through. Additionally, it can affect the ovulation process by altering the hormones responsible for releasing an ovum every month.
When selecting the contraception method that is ideal for you, we recommend that you speak to a nurse or doctor about your choices. Different contraception methods may be best for you at different stages in your lifetime. A nurse or doctor can give you info about the risks and benefits of using the hormonal or copper IUD, and other contraception methods, including injection, contraceptive implant, the combined oral contraceptive pill, or the vaginal ring.
Preparing for IUD Insertion
Your doctor will assess your general health and carry out a pelvic examination before he/she can insert the IUD. You may also be screened to see whether you have any STIs. An IUD can be placed:
- Immediately a termination of pregnancy has occurred
- Anytime in the course of your menstrual cycle, in case you aren’t pregnant. You may need to undergo pregnancy testing to be sure you haven’t conceived
- Immediately after giving birth by C-section or vaginally— although placement shortly after vaginally giving birth elevates the chances of IUD expulsion.
If the IUD is placed more than a week after the beginning of your menses, make sure you use a backup method of contraception for seven days. Taking non-steroidal anti-inflammatory drugs like ibuprofen two or one hour before going through the insertion procedure may lower cramping.
What Should You Expect During & After IUD Insertion?
During the Process
The physician will place a speculum in the vagina and then clean the cervix and vagina using an antiseptic solution. He or she may use a special device to bring your uterine cavity and cervical canal into line gently. Then, he/she will fold down the IUD’s horizontal arms and put the device into an applicator tube.
Afterward, the tube will be placed in the cervical canal, and the IUD is carefully positioned in the uterus. When the physician finally removes the applicator tube, the IUD will remain in position. Your doctor will then trim the IUD strings so they do not protrude so far into your vagina and might record the strings’ length.
The whole procedure for IUD insertion takes approximately ten minutes. During the insertion, you might experience fainting, dizziness, low blood pressure, cramping, a slower than usual heart rate, or nausea. Your doctor will likely recommend that you remain lying down for a short period to let the side effects that you are experiencing pass. It is hardly possible for the intrauterine device to perforate the cervix or uterine wall. Should this complication occur, your physician will direct on the proper management method.
After the Process
After the intrauterine device has been inserted, you might experience temporary side effects like a backache, menstrual-like cramps, heavier than usual periods, irregular periods, and spotting between periods. More severe side effects hardly occur but may include shifting or expulsion of the IUD, pulmonary inflammatory disease, and perforation of the uterine wall.
Once every month, you should check and feel that the strings of the IUD are protruding from the cervix. You should be cautious not to pull out the strings.
After approximately one month after the IUD has been placed, your doctor may examine you again to ensure the device has not shifted and see if there are any signs & symptoms of infections. While you are using the IUD, contact your doctor as soon as you can if you experience:
- Pregnancy signs or symptoms
- Deteriorating pelvic pain
- Foul-smelling or unusual discharge from the vagina, sores, or lesions
- Unexplained fever
- Severe abdominal tenderness or pain
- Unusually heavy and persistent vaginal bleeding
- A probable exposure to STIs
- Migraines or unusually severe headaches
- Yellowing of the eyes or skin
We further recommend that you contact your doctor as soon as possible if you feel or think your IUD isn’t in its usual place. Inform your physician if:
- You bleed after sex or have got breakthrough bleeding
- The strings suddenly seem to be longer, or you cannot feel them
- You feel part of the IUD in the vagina or at the cervix
- Sexual intercourse is painful for you or your partner
Your physician will check the IUD’s location, and if it is displaced, he/she will take it out if need be.
As we have explained, an IUD can stay intact for five or more years. Usually, the device is removed in the doctor’s office. For the doctor to remove it, he/she is likely to use forceps to get a hold of the strings of the device and pull gently. The IUD’s arms will fold upwards as it is withdrawn from your uterus. You may experience cramping and light bleeding during removal. The removal is hardly more complicated.
Before you decide on intrauterine contraception or any other birth control option, you have to discuss its risks and benefits with your physician. You must consider the convenience, side effects, and cost when choosing. Should you try this method, then after some time decide that it is not suitable for you, you can meet your physician and have the IUD removed. We have several other birth control methods available, and your physician can assist you in figuring out which option best suits you.
Below 1% of women that use IUD will conceive within one year of use. In case you get pregnant while using intrauterine contraception, you are at an increased risk of having an ectopic pregnancy. An ectopic pregnancy occurs when the fertilized ovum implants outside the uterus, mostly in the oviduct. However, since intrauterine contraception stops most pregnancies from happening, women that use it face a reduced risk of having an ectopic pregnancy compared to the other sexually active women that aren’t using contraception.
Generally, IUDs are safe. However, it is critical to note that they do not protect against sexually transmitted infections and may cause perforation of the uterus, though it is rare. The perforation risk may increase if the IUD is placed during the post-delivery period.
The side-effects linked to IUD include acne, headache, mood changes, irregular bleeding that may cease after six months of use, breast tenderness, pelvic pain, or cramping. You may also expel the IUD from the uterus. You are likely to expel the IUD if:
- You have never conceived before
- You have prolonged or heavy periods.
- You have ever expelled an intrauterine device before
- You have severe menstrual cramps.
- You are below twenty years old.
- You had the IUD inserted soon after childbirth.
Your doctor may suggest removal of the IUD should you develop:
- Cervical, endometrial, or ovarian cancer
- An infection in the pelvis
- Endometritis (inflammation of the endometrium)
- Severe migraine
- Pelvic pain/pain during sexual intercourse
- Exposure to a sexually transmitted infection
- A substantial increase in blood pressure
- Have a heart attack or stroke
Myths and Misconceptions About Intrauterine Contraception
Numerous factors have restricted the widespread use of IUDs in the U.S, including cases of complications with older types of IUD that led to negative publicity. Examples of these cases include ectopic pregnancy, infertility, misinformation concerning the dangers of infection, misinformation concerning eligible persons to use IUDs, lack of clinical training, misconceptions regarding the mechanism of action of the intrauterine conception and worries of litigation.
Pelvic Inflammatory Disease
The danger of pelvic inflammatory disease among IUD users is low and the same as the danger of pelvic pulmonary disease in women that use etonogestrel subdermal contraceptive implant or oral contraceptives. Studies in the past recorded an elevated risk of pulmonary inflammatory disease among intrauterine device users, particularly within the initial thirty days after the insertion.
However, those studies were faulty due to the uncertainty of pulmonary inflammatory disease diagnosis, wrong control groups, confounding, and bias. As compared to the danger of pulmonary inflammatory disease in women that don’t have IUDs, other studies also deduced that the danger of pelvic inflammatory disease was lower or similar for women using IUDs. In two distinct studies, the recorded risk of pulmonary inflammatory disease was 2% per 1867 patients (about .01% less than 1%.
Disadvantages of Intrauterine Contraception
The drawbacks of using hormonal or copper IUDs include:
- You might have additional costs and challenges accessing the service
- Both of these types of IUDs require placement by a specially trained nurse or doctor
- There’s a slight risk of infection during the IUD insertion and for the initial three weeks
- If the intrauterine device doesn’t be successful and you end up getting pregnant, there might be complications with the pregnancy if you carry it to term
- There’s a slight risk of perforation. Perforation means he IUD making a hole in the uterine wall when it’s put in
- The device can become detached and drop out
- Neither the copper IUD nor hormonal IUD will protect you from STIs
Similarities Between Copper and Hormonal IUDs
Both hormonal and copper IUDs stop pregnancy from taking place by affecting the movement of sperms. They prevent the sperms from meeting and fertilizing the egg. These two kinds of IUDs are almost equally effective. One out of 100 women using either hormonal or copper IUD will conceive in any particular year.
Even though each kind of IUD will protect you against getting pregnant for a different period, they each can be taken out at any given time. Removing the IUD is always allowed should you decide you’re not comfortable with the side effects or want to conceive.
Differences Between Hormonal and Copper IUDs
The primary difference between these types of intrauterine devices is that one type generates hormones while the other does not. Apart from blocking sperms from swimming to the egg, hormonal IUDs thin the uterus lining, thicken the cervical mucus and prevent ovulation.
Each IUD type functions for a different period. Liletta and Skyla work for three years, ParaGard, for a maximum of ten years and Mirena for a maximum of five years.
Copper IUDs begin functioning as soon as they are placed, while it may take hormonal IUDs a week before they start working. You might want to use a backup contraception method during this one week.
Hormonal intrauterine devices should make your menstrual blood lighter and accompanied by slight cramping. When it comes to copper IUDs, your menstruation might briefly be heavier, and you may cramp more than usual.
Once a hormonal IUD has been inserted, you might have between three and five months of irregular and frequent bleeding between menstrual periods. Once this duration has passed, your menstruation may be lighter, less painful, and shorter. About 50% of women do not bleed completely. On the other hand, after the insertion of a copper intrauterine device, you might have irregular bleeding between menstruation periods for a few weeks. After that, your periods might become more painful and heavier.
It’s worth repeating that intrauterine contraception doesn’t protect you from sexually transmitted infections. Therefore, you have to practice safer sex and prevent unwanted pregnancy. The ideal method to reduce the chances of contracting STIs is by the use of barrier methods like condoms for vaginal, anal, and oral sex with any new sexual partner. Condoms may be used with intrauterine devices to help in stopping the spread of infections.
The Cost of IUDs
An intrauterine device may cost anywhere between $0 and $1,300. Usually, the cost varies based on the IUD type and your health insurance. Most health insurance policies cover the costs, and family planning clinics may charge a reduced amount. Since an IUD can last for several years, the cost works out to approximately the same charges as monthly birth control options like the vagina ring or pill.
Find an Experienced Gynecologist Near Me
Intrauterine contraception is an appropriate option for birth control for many women. For one, it is safe, convenient, and effective. However, there are possible side effects of which you have to take note before choosing it. Even though we usually talk in averages, not every woman is the same, and your experience may not be the same as others with IUDs. At All Women’s Care, we will help you determine if you are the right candidate for intrauterine contraception. We will also give you all the information you need to know about this method of birth control, and if you are not the right candidate for an IUD, we will recommend other birth control options, which we also explain in detail. We serve patients in Los Angeles and its surrounding areas by helping them solve their reproductive health problems. Call us at 213-250-9461 to schedule a appointment and go over your contraceptive options.