The
Intrauterine Device (IUD)
An
IUD is a small piece of soft plastic with a thin copper wire wound around
it. It has two soft threads attached to the lower end that pass through
the opening at the neck of the womb (cervix) into the top of the vagina.
It comes in different shapes and sizes to suit different women. The most
commonly used IUD around the world and in Seychelles is the Tcu 380A
(Copper-T-380A).
How
does the IUD works?
The
main function of the IUD is to prevent sperm reaching the egg to fertilize
it. It may also prevent the egg from settling in the womb. It works as
soon as it is put in for 3-10yrs or more depending on the type inserted.
Your family planning nurse will tell you when to remove and change your
IUD.
How
effective is the IUD?
It
is a very effective reversible method. Studies show that for every 100
women using the Tcu 380A for 10 yrs, no more than one or two will get
pregnant. The IUD is effective as soon as it is inserted.
What
are the advantages of the IUD?
-
You
don’t have to think of contraception for as long as it is in place
-
It
provides long term contraception, lasting several years
-
It
does not interfere with sexual intercourse
What
are the disadvantages of the IUD?
-
Your
womb can push the IUD out, and it is important to check that you can
feel the IUD strings every month
-
The
IUD might perforate your womb, but this is very rare
-
If
you become pregnant while you are using the IUD, there is a chance
that the pregnancy could be outside the womb
-
The
IUD does not protect you from Sexually Transmitted Infections
-
The
IUD might increase your risk of infections of the reproductive organs
around the time of insertion
Can
anyone use the IUD?
Not
all women should use the IUD. A woman should not use an IUD if she has any
of the following:
-
Abnormal
or unexplained bleeding from the vagina
-
Recent
or repeated infection of the pelvic organs
-
Certain
medical conditions which result in increased susceptibility to
infection, eg. HIV, artificial heart valves
-
A
womb with a very small or distorted cavity, for example due to
fibroids
-
An
allergy to copper
-
History
of a pregnancy outside the womb, or any damage to the fallopian tubes
in women who still want children
In
the following conditions the IUD should only be used under a doctor’s
supervision:
-
When
the heart has been damaged by an infection, such as that which occurs
with rheumatic fever
-
Having
unsafe sexual intercourse with more than one partner or a partner with more
than one partner
-
Low
fertility and want children later
-
Young
age and never had children
-
Severely
scarred uterus, eg. after more than two caesarean sections
-
Heavy
or painful periods
When
and how the IUD is inserted?
The
IUD is usually out in between the 3rd and 10th day
of your menstrual cycle. Before the IUD is inserted, certain simple tests
must be carried out to make sure the womb and cervix are healthy. You
should avoid sexual intercourse during and after your period until the IUD
is put in. An IUD should be put in by a doctor or a trained FP nurse. He
or she will examine you internally to find the position and size of the
womb before they fit in an IUD. Since the IUD is made of flexible soft
plastic, it is easy to slide it in the narrow plastic insertion tube which
is used to slide it through the passage in the neck of the womb and into
the womb itself. Once the IUD is in the womb, it is released from the tube
and it stays in the womb.
The
IUD insertion procedure can be a bit uncomfortable. You may get a
period-type pain and some bleeding for a few days after the IUD is fitted.
You can talk to your nurse or doctor about taking painkillers when the IUD
is inserted.
How
will I feel after the IUD is inserted?
You
may have cramp like period pains and backache immediately after the IUD is
put in and this may last up to 3 days. This can be relieved by taking
paracetamol tablets. It is advisable to abstain from intercourse for the
first 2-3 days, or as long that there is bleeding and cramping. If you
have pain in your lower abdomen, or pain during or after intercourse, with
high fever or a smelly discharge from your vagina, see your doctor or
family planning nurse as soon as possible. This is because you may have an
infection.
Will
an IUD affect my periods?
Your
periods will almost certainly be a bit heavier or longer than usual.
Spotting or bleeding may occur for the first few days and in between the
next 2 or 3 periods. See your nurse or doctor if this bleeding increases
in amount or persists. If you miss a period altogether, see your nurse or
doctor as soon as possible.
How
will I know the IUD is still in place?
An
IUD has two threads attached to the end that hang a little way down from
your womb into the top of your vagina. The doctor or nurse will teach you
how to feel for the threads to make sure the IUD is still in place. You
should do this weekly in the first month and then every month, usually
after each period.
It
is unlikely that an IUD will come out, but if you cannot feel the threads,
or if you feel you can feel the IUD itself, see your doctor or nurse
straight away. In the meantime, use an extra contraceptive method, such as
condoms. Rarely your partner may say he can feel the threads during sex.
If this happens, get your doctor or nurse to check the threads.
How
often do I need a check up?
You
will need to have a check up by a doctor or nurse 10 days after the IUD is
put in, then 6 weeks later, then 6 months later, and then once every year.
The nurse or doctor will tell you when to have your IUD changed. You will
also be given an appointment to have an ultrasound 6 weeks after insertion
to check the IUD is in the correct position in the uterus.
Can
I use tampons if I have an IUD inserted?
You
either use tampons or towels during your periods if you have an IUD, but
it is better that you wait at least a month after the IUD has been
inserted before using tampons.
What
if I want to have a baby or change to another method?
If
you want to have a baby, tell the nurse and she will remove the IUD. Do
not try to remove it yourself. If you want to change to another method,
start using a method, such as condoms, for seven days before the IUD is
taken out. Your usual fertility returns as soon as the IUD is taken out.
Where
can I get an IUD inserted?
You
can go to any health center to have an IUD inserted. The FP nurse will
explain what you need to do and when you can come to have an IUD inserted.
At
your family planning clinic:
Feel
free to ask your doctor or nurse for any advice or information on your
chosen method of contraception. It is important that you attend your
clinic regularly, keeping your appointments.
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