It is a long-term reversible type of contraception and is considered the most effective reversible birth control on the market. This means that it will be effective in stopping pregnancy for as long as five years or more ( depending on the brand). However, you can use this method for a short duration too (1-2 years) to prevent pregnancy. You can safely use this method for as many years as you want; and get it removed by a gynaecologist, even after 6 months or a year or when you plan a pregnancy.
There are two types of IUDs, a copper IUD and hormonal IUD.
Pros
- Very good at preventing pregnancy
- Can be used for years at a time and also for short 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 ( hormonal IUD)
Cons
- Can sometimes slip out of the uterus (expulsion) or, in rare cases puncture the uterus (perforation)
- It doesn’t protect against STDs
- If insertion is done in the presence of sexually transmitted infection, there is a small risk of getting PID within three weeks after 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
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. If you feel something amiss, go to your healthcare provider.
However, the WHO no longer recommends checking the strings because there is a risk that women may accidentally pull the strings and dislodge the IUD.
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 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 as long as a provider can be certain you are not 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: Pregnancy is suspected, or spotting lasting longer than the first two 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.
Pregnancy prevention effectiveness:
The failure rates for the hormonal IUD is 0.5% in perfect use and 0.7% in typical use.
How to check your strings?
- Wash your hands.
- Find a comfortable, private place to sit or squat - like in a bathroom or your headroom.
- Insert a finger ( index finger/middle finger) into your vagina until you feel the strings coming out of your cervix.
- If you do not feel the strings, do not panic. It may mean that the strings have drawn back into the cervical canal or uterus. Just book an appointment with your doctor for a check-up.
Update: The WHO no longer recommends checking the strings because there is a risk that women may accidentally pull the strings and dislodge the IUD.