IUD

An intra-uterine device (IUD) or ‘coil’ is a device that is placed into the uterus to prevent pregnancy. IUD’s work by emitting copper. The copper changes the fallopian tubes and the fluid levels in the uterus, affecting the survival of sperm so that they die before they can achieve fertilisation. In some cases, fertilisation may still occur but the embryo is prevented from implanting so it is expelled via a normal period.

IUD’s are convenient because the couple don’t have to think about it prior to intercourse like they would have to with condoms, the cervical sponge or the ‘cap’ and they are long acting, lasting for five to 10 years from insertion. This provides a less invasive alternative to female sterilisation, with the added advantage that fertility will return once it is removed so the woman has the option to change her mind about her family size.

Most women have no problems with their IUD and enjoy the freedom it brings them. However, some women experience one or more side-effects:

• The copper IUD can cause heavy or painful periods or bleeding in between periods
• IUD’s may fall out – this is the main cause of unintended pregnancy while using this method of contraception. ThIs is most common in the first six weeks of using one and among women who have never had children.
• IUD’s can sometimes cause infection. If a woman experiences a foul smelling discharge, abdominal pain or fever, she should seek medical advice. IUD’s should not be used in women who have a history of pelvic inflammatory disease, recurrent vulvovaginal-candidiasis, or sepsis after childbirth.
• IUD’s can cause beign tumours to develop in the uterus. Women with a history of cervical or uterine cancer should not use the IUD.
• Around one in 1000 women will experience a uterine perforation (tear) after insertion of an IUD, commonly at the time it is inserted, but this may happen later. Uterine perforation is a medical emergency that requires surgery to correct it.

There is a different kind of IUD that can minimise some of the side-effects.

In those women for whom the copper IUD is not suitable, a change in contraceptive method may be advisable.

The Intra-Uterine System

The intra-uterine system (IUS) works similarly to the copper IUD but it releases the hormone progesterone – the hormone responsible for maintaining pregnancy and stopping the arrival of the menstrual period. When released by the IUS it may stop ovulation in some women. For the majority, it works by thickening the cervical mucus and preventing sperm from getting through. This method of contraception can stop menstruation entirely or it may make it lighter so it is more suitable for women who have experienced heavy bleeding and painful cramping after having a traditional copper IUD. This is important, since the main reason women give for having an IUD removed is excessive bleeding. However, the IUS doesn’t reduce the risk of infection or any of the other side-effects.

In that case, a review of the various contraceptive methods available would be advisable..