After the pill, the IUD is one of the most commonly used contraceptive methods. It is discrete, lasts several years and hassle free. But you also have to watch out for infection and accidental displacement. Is it worth the risk?

The IUD or Intrauterine Device is a prescription-only contraceptive device made of a flexible plastic material that a medical professional inserts in the lining of a woman’s uterus. Once inserted, it has a 99.9 % success rate in preventing pregnancy. The only problems? You have to watch out for infection and make sure it doesn’t accidentally move out of place. Read on to learn more.

What does it look like?

The IUD is a small, generally T-shaped object that is placed in the uterus. Some are made of plastic reinforced with copper while others contain progesterone. Progesterone based IUDs work like the vaginal ring and disperse the hormone in the blood via the mucous membrane.

How does it work?

By its presence in the uterus, the IUD has a permanent inflammatory action which prevents the implantation of the egg in the lining of the uterus. Progesterone based IUDS, like all hormonal contraceptives, prevent the uterine lining from reconstituting itself enough to permit implantation. After hormonal contraceptives (the pill, the implant and vaginal ring), the IUD is the most effective contraceptive method. Risk of pregnancy by women wearing an IUD is only 0.1 %.

Who can insert them?

Either a generalist or gynaecologist will insert the IUD in the uterus through the cervix during the first few days of your period. The procedure is painless. In general, prior to insertion, you will need a full workup (pelvic and breast exam, Pap smear, pregnancy test, etc.). During the three days following insertion, doctors advice against swimming or any kind of vaginal cleansing. Some women might also notice bleeding and slight pain in their pelvis. Once securely in place, however, neither the woman nor the man (during intercourse) will feel the IUD.

How does it stay in place?

A string hangs from the IUD and connects it to the upper part of the vagina. This same string are used later to take out the device. Women, however, must make sure the string doesn’t become longer or shorter, which indicates that the device has moved and that they are no longer protected against pregnancies. You can feel the string by inserting your finger in your vagina or using a mirror. Doctors recommend checking it at least after each period.

Can all women use the IUD?

For a long time, the IUD was exclusively reserved to women who had already been pregnant because of the risk of infection to the uterus and the Eustachian tube. In rare cases, if these infections are not treated, they can lead to a decrease in fertility. With the evolution of materials and the arrival of the copper-free progesterone based IUDs, certain gynaecologists have inserted them in young women. However, the ensemble of the profession does not agree and generally reserve the IUD for older women who have already had children.

Women with certain health problems (repeated pelvic infections, cervicitis, salpingitis, HIV/AIDS, vaginal bleeding, history of Toxic Shock Syndrome, etc.) are not allowed to use IUDs.

What about the risks?

Any time you insert a foreign object into your body, you risk infection. If you notice any signs of infection (significant blood loss, pains and fevers), visit your doctor as soon as possible so that the IUD can be removed. The doctor will also prescribe antibiotics to get rid of the infection. Decreased fertility may occur if the infection is not treated in a timely fashion. Chances of infection increase if you have multiple partners or if your partner has multiple partners.

There is also a small risk of piercing or perforation of the uterine wall during insertion.

Additionally, a woman who gets pregnant with an IUD risks having an ectopic pregnancy (where the fertilized egg attaches itself and grows outsie of the uterus). Ectopic pregnancies can be very dangerous and require immediate medical attention.

Finally, in some women, copper based IUDs can provoke heavier and longer menstrual periods.

When do you take it out?

IUDs can last between one to ten years. Risk of infection is generally highest right and insertion and decreases with time. The removal of an IUD is quick and painless. Be careful not to have the IUD removed during ovulation or you risk pregnancy from recent intercourse.

What are its advantages?

The biggest advantage of the IUD in comparison with the pill is that you don’t have to remember to take a pill every day. Once it’s in place, you can forget about it and have sexual intercourse whenever and wherever you want without fear of pregnancy. It is immediately effective and hassle-free. A check-up once or twice a year suffices.

What are its inconveniences?

In addition to the risks which have already been discussed (heavier periods, decreased fertility, infection, perforation of the uterus, dangerous pregnancies), use of the IUD requires a clinical visit for both insertion and removal. The device also doesn’t protect against STDs and the woman must monitor to make sure it has not slipped out of place.

Do you have to be careful about how you move when wearing one?

No. The IUD is compatible with all physical activities.

Tags: Relationships, Sex and You //