Intrauterine Contraception Device

Some women want to prevent pregnancy without the need to take a daily contraceptive pill, insert a diaphragm or use other contraceptive techniques. An intrauterine device (IUD) may be an option for these women.
An IUD is also an option for a woman who has finished having her family, but does not want a permanent surgical procedure such as occlusion of the fallopian tubes (commonly known as “having the tubes tied”).
An IUD is a small device placed inside the uterus. It makes the environment in the uterus and fallopian tubes unsuitable for fertilisation and implantation of a fertilised egg. It also decreases the motility of sperm so they cannot reach the egg.

  • Copper IUDs: For each year of use, a copper IUD can prevent pregnancy in about 99 out of every 100 women. A fine piece of copper is wound around the stem of the IUD and works by:
    • Making fertilisation of an egg less likely.
    • Changing the lining of the uterus so a fertilised egg cannot grow there.
  • Progestagen IUDs: For each year of use, the progestagen IUD can prevent pregnancy in about 99 out of every 100 women. It works in three ways:
    • The hormone in the IUD thickens mucus at the cervix.
    • Stops ovulation in some women.
    • Lining of the uterus becomes too thin to allow implantation of a fertilised egg.
    • A progestagen IUD should be replaced every five years.

Insertion of the IUD

Your doctor may order tests to check for infection and possibly do a Pap smear. Any infection must be treated before an IUD is inserted. To reduce the risk of infection, some doctors routinely administer an antibiotic as a single dose before the IUD insertion.
During insertion, most women feel mild cramping or low backache, and some may feel faint. These problems usually settle with rest, pain medication or other medication to treat spasm.

After the IUD is inserted

To reduce the risk of infection, do not use tampons or have intercourse for 48 hours.
It may take time for the uterus to adjust to an IUD. See your doctor for a follow-up visit after your first period, and then once a year to make sure your IUD is in the correct position and that there is no pelvic infection.

Possible side effects of IUDs

IUDs are relatively safe but do have some side effects.

Menstrual changes:

Periods may be heavier and last longer, especially with the copper IUD. Spotting between periods may occur for the first two to three months. Periods may be more painful. About 12 women in every 100 decide to have the IUD removed due to these problems. Some women have no periods.
The progestagen IUD may cause spotting and irregular bleeding for up to six months.

Amenorrhoea (periods stop):

In one woman in five who have a progestagen IUD periods may stop after six months or so, while the IUD is used.

Pelvic infection:

There is a slight risk of pelvic infection in the first few weeks after the insertion of the IUD.

Expulsion:

In about five out of every 100 women, the uterus (a muscular organ) pushed the IUD out of position and into the vagina. In one out of five such cases, the woman is not aware that the IUD has been expelled.

Pregnancy:

While IUDs offer excellent protection against pregnancy, this means of contraception is not perfect.

Perforation:

In about six out of every 1,000 women, the IUD may penetrate the wall of the uterus. Abdominal surgery may be required to remove the IUD.

Other possible side effects:

Three out of every 100 women report symptoms such as mood changes, weight gain, acne, breast tenderness, vaginal dryness and headaches. In most cases, these symptoms settle over time. If they persist or worsen, then the IUD may have to be removed.