Source: "Essentials of Contraceptive Technology" - Chapter 12
What is IUD?
An intrauterine device (IUD) usually is a small, flexible plastic frame. It often has copper wire or copper sleeves on it. It is inserted into a woman’s uterus through her vagina. All IUDs have two strings, or threads, tied to them. The strings hang through the opening of the cervix into the vagina. The user can check that the IUD is still in place by touching the strings. A provider can remove the IUD by pulling gently on the strings with forceps.
Copper bearing IUD's are the most widely used type.
How it works?
IUDs work chiefly by preventing sperm and egg from meeting. The IUD makes it hard for sperm to move through the woman’s reproductive tract, and it reduces the ability of sperm to fertilize an egg. In few cases prevents egg from implanting in wall of uterus.
|ELOIRA||Extremely effective (99.8%)|
|COPPER IUD (Cu 250)||Extremely effective (99%)|
|COPPER IUD (Cu 375)||Extremely effective (99%)|
|COPPER IUD (TCu 380A)||Extremely effective (99%)|
|ORAL CONTRACEPTIVE PILLS||Very effective (92%)|
|INJECTABLE CONTRACEPTIVES||Very effective (97%)|
|ABSTINENCE||Extemely effective (100%)|
|FEMALE STERILIZATION||Extremely effective (99%)|
|LACTATIONAL AMENORRHEA METHOD||Extremely effective (98 - 99%)|
|VASECTOMY||Extremely effective (99%)|
|VAGINAL RING||Very effective (92%)|
|FEMALE CONDOM||Effective (79%)|
|MALE CONDOM||Effective (85%)|
|EMERGENCY CONTRACEPTION||Moderately effective (75 - 89%)|
|FERTILITY AWARENESS METHODS||Moderately effective (75%)|
|SPERMICIDE||Moderately effective (75%)|
|SPONGE||Moderately effective (68 - 84%)|
Who can use it?
In general, women CAN use IUDs safely and effectively.
IUDs can be used in any circumstances by women who:
- Smoke cigarettes
- Have just had an abortion or miscarriage (if no evidence of infection or risk of infection)
- Take antibiotics or anticonvulsants
- Are fat or thin
- Are breastfeeding.
Also, women with these conditions CAN use IUDs in any circumstances:
|Benign breast disease||Blood clotting problems||Diabetes|
|Breast cancer||Varicose veins||Liver or gallbladder disease|
|Headaches||Heart disease (disease involving heart valves may require treatment with antibiotics before IUD insertion)||Schistosomiasis (without anemia)|
|High blood pressure||History of stroke||Thyroid disease|
|Irregular vaginal bleeding (after evaluation)||Malaria||Epilepsy|
|Nonpelvic tuberculosis||Past ectopic pregnancy||Past pelvic surgery|
- Very effective, reversible, long-term method.
- TCu-380A IUD, the most widely available.
- IUD, lasts at least 10 years.
- No hormonal side effects with copper-bearing or inert IUDs.
- Menstrual periods may be heavier and longer, especially at first.
- Inserted and removed from the uterus by a specially trained provider using infection-prevention techniques.
- Can be inserted after childbirth by provider with special training. No effect on breastfeeding.
- No interactions with any medicines.
- Not a good method for a woman at high risk of getting sexually transmitted diseases (STDs).
- Could lead to pelvic inflammatory disease.
|Woman’s situation||When to start|
|Having menstrual cycles||
Any time within the first 12 days after the start of menstrual bleeding, at the woman’s convenience.
Any other time during the menstrual cycle (not just during menstruation) if it is reasonably sure that the woman is not pregnant and has a healthy uterus. If a woman has been using a reliable contraceptive or has not been having sex, the best time to insert her IUD is when she asks for it.
During hospital stay after childbirth, if she has decided voluntarily in advance. The IUD is best inserted within 10 minutes after delivery of the placenta. Can be inserted any time within 48 hours after childbirth. (Special training
If not immediately after childbirth, as early as 4 weeks after childbirth for copper T IUD such as TCu-380A. At least 6 weeks after childbirth
|After miscarriage or abortion||
Immediately if no infection present.
If infection present, treat and help the client choose another effective method.
After 3 months, if no infection remains, reinfection is not likely, and she is not pregnant, the IUD can be inserted.
|When stopping another method||Immediately.|