Birth Control Overview (cont.)
What is the effectiveness, and what are the side effects of an IUD(s) (intrauterine device)?
An intrauterine device (IUD) is a small T-shaped plastic device that is placed in the uterus to prevent pregnancy. A plastic string is attached to the end to ensure correct placement and for removal. (An IUD should only be inserted and removed by a medical professional.) Currently in the United States, 2 types of IUDs are available: copper and hormonal. Approximately 2% of women who use birth control in the United States currently use IUDs. The most recently introduced hormonal IUD is the levonorgestrel intrauterine system (LNG IUS or Mirena).
- Effectiveness: The IUD is one of the most effective classes of birth control available. According to the American College of Obstetricians and Gynecologists, only about 8 of 1,000 women who use the copper IUD will become pregnant in the first year of usage. According to Planned Parenthood, fewer than 3 women out of 100 who use the progestin IUD become pregnant during the first year of use. The success rate with the LNG IUS system is even greater. With continued use, even fewer pregnancies occur. A woman can increase her protection by checking the IUD string regularly, and by talking with her doctor immediately if she notices a problem.
- Pros: A woman using an IUD is always protected with nothing to remember. IUDs start working immediately, and they can be removed at any time. IUDs are relatively inexpensive over time. The risk of side effects is low. IUDs can be inserted 6 weeks after the delivery of a baby or following a spontaneous or induced abortion. Women who use a copper IUD after childbirth can breastfeed safely. An IUD is usually not felt by a woman or her partner. Women who cannot use birth control pills because of
cigarette smoking or conditions such as uncontrolled hypertension may be able to use an IUD. Most women experience less menstrual blood loss and pain with hormonal IUD usage. The copper IUD can remain in place up to 10 years. The LNG IUS is approved for use to prevent pregnancy for up to 5 years in the United States and up to 7 years in Europe and Asia.
- Cons: A trained professional must both insert and remove an IUD. Serious complications from IUD usage are rare. IUDs are spontaneously expelled during the first year of use in about 5% of women who use them. This is most likely to happen during the menstrual period. During menstruation women using IUDs should check their pads or tampons for expulsion. They should also attempt to feel the IUD string in the vagina on a regular basis. If an IUD is expelled unnoticed, a woman may easily become pregnant. If pregnancy occurs while an IUD is still in place, the risk of miscarriage is 50% greater. This risk is decreased to 25% if the IUD is extracted as soon as possible. If the IUD is not removed, a serious infection may result. An IUD will protect against normal intrauterine as well as ectopic pregnancies. However, if a woman conceives with an IUD in place, she is more likely to have an ectopic than a woman who conceived without an IUD. Women using IUDs who suspect they may be pregnant should contact their clinicians immediately to make certain that the pregnancy is within the uterus, as an ectopic pregnancy is a very serious complication.
- Side effects and serious adverse events: An IUD may perforate the wall of the uterus when it is inserted. This occurs in 1-3 of 1,000 insertions. Cramping and backache may occur in the first few hours after an IUD is placed. Bleeding may occur for several weeks after insertion. Some women have increased menstrual cramps and bleeding while using the copper IUD, but these symptoms are usually decreased in those using the hormonal IUD. Pelvic inflammatory disease is also possible with IUD use if a woman is not in a monogamous relationship and has an increased risk of STD transmission. It should be noted that IUDs do not in and of themselves cause pelvic infection.
- STD protection: IUDs do not protect against STDs. STDs can be more serious in women who have IUDs, and the chance of getting an STD may be higher in women who use IUDs during the first 4 months after they are placed. IUDs are best suited for women in relationships in which both partners are monogamous.
Medically Reviewed by a Doctor on 8/26/2016
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