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 and hormonal IUD. Hormonal IUDs are sold under the brand name Mirena. They work for 5 to 10 years.
How does hormonal IUD prevent pregnancy?
The hormonal IUD makes the mucus around your cervix thicker so the sperm can’t get through and it can also stop your ovaries producing an egg. Also, the hormone makes it harder for sperm to travel up towards the egg. And finally, it thins and suppresses the lining of the uterus, so that in the rare case an egg does get fertilized, it can't be implanted.
- Typical use: 0.2%
- Perfect use: 0.1%
What happens to my period while I use a hormonal IUD?
Any problems you may have with your periods may be relieved if you use a hormonal IUD. It's normal that after a few months of use you will stop having heavy periods. Or your periods may stop altogether.
The hormonal IUD may also stop cramps and/or pain before your period.
After one year of use, only about half the women with a hormonal IUD still have their periods. And even if you still have your period, there is up to 70% less blood loss in women with a hormonal IUD compared to those who don't use birth control.
Some women find it difficult to accept that this is normal. In fact, not having their periods is the number one reason for women to stop using the hormonal IUD.
So it is a good idea to think about this before having it placed, and talk to your healthcare provider about any concerns you have regarding your period before having the IUD placed.
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 are the side effects?
- Weight gain
- Mood changes
- Ovarian cysts
- Breast tenderness
Who shouldn't use the hormonal IUD?
- Women with recent pelvic inflammatory disease (unless they have had a pregnancy since their last PID episode)
- Women with an untreated pelvic infection
- Women with breast, cervical or uterine cancer
- Women with undiagnosed and abnormal vaginal bleeding
- Women with liver tumors
- Women at high risk of STDs, unless they use condoms with all their sex partners
HIV positive women should check with their doctor if they can use hormonal IUDs. Because there's a slight risk of infections with IUDs, other birth control methods might be better.
Other non-hormonal option?
If you do not want to get use a hormonal IUD, you can use Copper IUD/Multi load or Copper T. Read more about it here in detail.