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Birth Control Intrauterine Devices (IUDs) (cont.)

What Are the Disadvantages of IUDs?

A doctor must insert and remove an IUD. Serious complications from IUD use are rare.

IUDs come out during the first year of use in about 5% of women who use them. This is most likely to happen during the menstrual period and in women who have previously given birth. Women using IUDs may wish to feel regularly to make sure the string is in place. 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%. This risk is decreased by 25% if the IUD is taken out as soon as possible. If the IUD is not removed, a risk of serious infection to the woman exists.

Ectopic pregnancies in IUD users are half as likely as in women using no birth control. Ectopic pregnancies are less likely to occur with hormonal IUDs. Women using IUDs who suspect they may be pregnant should contact their health-care professional immediately.

An IUD may puncture 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 a couple of weeks after an IUD is placed. Some women have increased menstrual pain and heavy periods while using the copper IUD, but these symptoms are decreased in those using the hormonal IUD. Pelvic inflammatory disease is also possible with IUD use, especially if a woman is not in a monogamous relationship and has an increased risk of transmission of a sexually transmitted disease (STD), though hormonal IUDs appear to protect against pelvic inflammatory disease.

IUDs do not protect against STDs. STDs can be worse 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 for women in relationships in which both partners are monogamous.

Who Should Not Use an IUD?

  • Women who are pregnant or who have abnormal bleeding or cervical cancer or uterine cancer should not use IUDs.
  • Women who have pelvic inflammatory disease, gonorrhea, or Chlamydia or a recent history of these infections should not use an IUD. Women with other current reproductive organ infections should not use an IUD until their infection is resolved and their doctor says that an IUD can be used safely.
  • If a woman has abnormalities of the cervix, uterus, or ovaries that would make insertion dangerous, an IUD is not appropriate.
  • Women who are allergic to copper or who have Wilson disease (a rare disease in which copper accumulates in body tissues) should not use the copper IUD.
Medically Reviewed by a Doctor on 2/25/2016

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