An intrauterine device (IUD) is a small contraceptive device which is inserted into the uterus.
It is a long-term reversible type of contraception and is considered the most effective reversible birth control on the market. There are two types of IUDs, a copper IUD or Copper T or Multi load and hormonal IUD, commonly known as brand name Mirena.
Types of IUDs
There are two types of IUDs, a copper IUD and a hormonal IUD. Many hormonal ( Mirena, Kyleena) and non hormonal Intrauterine devices (IUD) (Copper T) are which work for 5 to 10 years.
How does IUD work in preventing pregnancy?
The copper in the Copper T IUD works as a natural spermicide- it kills the sperm that comes into the vagina. That way, eggs in the fallopian tubes won't get fertilised and you can't get pregnant.
The hormonal IUD or Mirena works by giving off a steady low dose of the hormone progestogen (levonorgestrel). This make the mucus on your cervix thicker. The thicker mucus then blocks the sperm so it can't get to an egg and hence pregnancy can be avoided.
Are IUDs safe?
For the first few months, it's normal to have some side effects.
If you still have side-effects after six months, you should see your healthcare provider to check if everything is normal.
One of the complications that can arise is expulsion. That means that the IUD partially or fully slips out of the womb. If that happens, you can get pregnant. That's why it's important to check if you can still feel the strings once a month.
Another very rare complication is that the IUD pushes through the wall of your uterus. It happens during placement and can be immediately corrected. If it's not, the IUD can damage your internal organs. This is why an IUD should only be placed by a medical professional.
Where do I get an IUD?
You need to see a healthcare provider/ doctor/ gynaecologist to get the IUD. The placement of the IUD should also be done by an experienced provider.
How is an IUD inserted?
Make an appointment with a qualified healthcare provider to have a hormonal IUD placed. The procedure can be a bit painful so ask them if you can take a mild painkiller an hour beforehand.
They will do an internal examination to figure out what size you will need and generally test you for STDs before they place it. Your vagina is opened with a speculum, and the IUD is placed inside the uterus using a thin tube.
It shouldn't take longer than 15 minutes. There may be some spotting and cramping afterwards. Most providers will want a follow-up appointment 3-6 weeks after the IUD is placed to check that everything is okay and that the IUD has stayed in place.
The hormonal IUD can be inserted at any time of the month, but it's best during your period when the cervix is more open and you are unlikely to be pregnant.
You can have sex again as soon as everything feels normal after the placement. This may take a few days given cramping and some bleeding.
How can I tell if something is not right with my IUD?
You need to see your health service provider if you have any of the 'PAINS'-signs:
P: Period pain, or spotting lasting longer than the first few weeks
A: Abdominal pain, pain with intercourse
I: Infection or STD exposure, abnormal vaginal discharge
N: Not feeling well, fever, chills
S: String missing, shorter or longer
What can stop the IUD from working properly?
If the IUD doesn't sit correctly in the uterus, it can be less effective and cause more side-effects. You can check yourself if it's still in its proper place by feeling for the strings. The strings hang out of the uterus and make the removal of the IUD easier.
The best way to check if the IUD is in place is by squatting and inserting two fingers deep into the vagina. Feel around and do not pull on anything because you might displace it. You should feel the wires coming out of your cervix.
If you feel a hard piece of plastic and wires then you know for sure that is out of place.
If you do not feel the wires, see your health service provider immediately. It is recommended to check a few times in the first month to make sure it was placed properly, after that it is less of a concern.
- Very good at preventing pregnancy
- Can be used for years at a time
- Can be used directly after giving birth, while breastfeeding, or after having an abortion
- You can immediately get pregnant once the IUD is removed
- Can decrease periods
- Can sometimes slip out of the uterus (expulsion) or puncture the uterus (perforation)
- It doesn’t protect against STDs
- Risk of getting pelvic inflammatory disease (PID) within three weeks of insertion
- Needs to be placed by a doctor
- Hormonal IUD can be expensive
- If you do get pregnant with an IUD, there is a higher risk of miscarriage and complications which would require immediate medical help