The Benefits and Risks of an IUD
What is an intrauterine device or IUD?
An intrauterine device or IUD is a tiny, T-shaped birth control device. It is basically a plastic device, which is wrapped in copper. It also contains certain hormones. An IUD is inserted into the uterus by a doctor. There is a plastic string tied to the end of the IUD and it hangs down through the cervix into the vagina. To ensure that the IUD is in place, one can feel for this string through the vagina.
To remove the IUD from the uterus, the doctor can do so with the help of the string. The IUD is one of the most common and popular birth control measures. Once it has been inserted safely and properly in place, there is no second thought on the maintenance of the IUD. It has been considered as one of the effective methods when it comes to preventing pregnancies for as long as 3-10 years along with preserving fertility. However, for the longevity of the IUD, it depends on which type of IUD inserted. There are basically two types of IUD available:
- Hormonal IUD - This type of IUD helps to release a form of progestin hormone known as levonorgestrel. The hormonal IUD is known to be slightly better and effective in terms of preventing pregnancies than copper IUDs. Hormonal IUDs can prevent pregnancies for a period of 3-5 years, mostly depending on which type of IUD has been used.
- Copper IUD - This is the most commonly used IUD, wherein there is a copper wire wound around the stem of the T-shaped device. Copper IUDs are known to prevent pregnancies for as long as 10 years and is considered to be a highly effective form of contraception.
However, 1 out of 100 cases of women has reported of getting pregnant in the first year of IUD (hormonal or copper) insertion. Pregnancies can still happen when the IUD is expelled or pushed aside.
Benefits of Using IUDs
1. Effective enough
IUDs are said to be more effective when compared to other methods of contraception. According to studies, IUDs are 99 percent effective against pregnancies. IUDs work well as birth control implants and sterilization. There is no way to mess it up because it stays inside the uterus and you can always check to feel its presence unlike tablets or pills, which may be mistakenly forgotten or condoms that can be incorrectly used.
2. Convenience
Once the IUD is inserted, you no longer have to think about it. It effectively works until you decide to remove it or when it expires. Moreover, you won't do anything before sex to prevent getting pregnant. When using IUDs, you're usually protected up to 12 years, depending on the type of IUD used.
3. Doesn't affect fertility
IUDs are basically a temporary form of avoiding unwanted pregnancies. If you plan to get pregnant, then you can take it off anytime. IUDs do not affect fertility. Moreover, it does not make the process of getting pregnant harder. There can be a possibility that as soon as you remove the IUD, you can get pregnant after having sex.
4. Better periods
The use of hormonal IUDs can help periods to become lighter. It also reduces menstrual cramps during or before periods. In certain cases, some women just stop getting periods. Hormonal IUDs can help women who suffer from severe cramps, heavy bleeding during periods, and anemia.
5. Copper IUDs don't have hormones
Women who cannot use hormonal IUDs due to certain medical conditions can use copper IUDs instead. Copper IUDs are a non-hormonal birth control method.
Few of the other advantages of using IUDs is the cost-effectiveness, the ease of using IUDs, lower risk of having ectopic pregnancies, along with uninterrupted foreplay or sex.
What are the risks of an IUD?
1. Possibility of infection
There is a certain risk of getting PID or pelvic inflammatory disease with the use of IUDs. The risk of getting PID is low after the first 20 days of IUD insertion. Pelvic inflammatory disease is usually caused by sexually transmitted infections and the risk of getting PID increases if your partner has multiple sex partners.
Pelvic infections are usually caused by bacteria that enter the uterus during the insertion. Most of the time, the infection develops within three weeks of inserting the IUD. After the first three weeks of insertion, there are fewer chances of getting the infection. However, if you develop an infection after a period of three weeks, then it is most likely due to STD exposure from your partner.
2. Uterine perforation
Although perforation is rare, it is sometimes inevitable during an IUD insertion. According to statistics, 1 in 1,000 women will experience uterine perforation. In such cases, the IUD must be immediately removed.
3. Expulsion
In certain cases, there can be chances that the IUD can partially or completely slip off from the uterus. This, however, is most likely to happen during the first few months of use. There are chances that it can happen during periods as well. When the IUD is expelled, women can get pregnant.
4. Pregnancy
In rare instances when IUDs are incorrectly inserted, pregnancy can happen. As soon as pregnancy is confirmed, IUDs must be immediately removed. If you get pregnant with an IUD present, your doctor will recommend the removal of your IUD to prevent miscarriage or preterm labor. Note that IUDs do not cause birth defects.
5. Menstrual issues
When using copper IUDs, women may experience increased menstrual cramps or bleeding. They also tend to experience spotting in between periods. The use of hormonal IUDs may reduce such issues.
Who should avoid IUDs?
Most of the time, women do not have any problems with IUDs. However, if you have certain medical conditions, then there is an increased risk of developing complications when using an IUD. Risks include:
- Sexually transmitted diseases (STDs) at the time of insertion
- Had two or more sexually transmitted infections in the past two years
- Serious blood clotting in the lungs or deep veins
- Anemia or diabetes
- Had a pelvic inflammatory disease in the past year
- Had or currently have ovarian cancer
- Blood clotting problems
- Taking corticosteroids such as prednisone
- Bacterial vaginosis
- A history of tubal infection
- A retroverted (tilted or tipped) uterus
- A history of impaired fertility
Before proceeding with the IUD insertion, inform the doctor if you:
- Think that you are pregnant
- Have an STD or PID
- Have an untreated uterine or cervical cancer
- Unusual vaginal bleeding
- Had a pelvic infection after childbirth or abortion within three months
- Have a copper allergy, a bleeding disorder, or Wilson’s disease
- Have breast cancer
IUD Side Effects
Along with a host of advantages from using IUDs, there are also certain side effects that should be considered before going for it. The side effects of IUDs go away gradually within 3-6 months once the body gets used to the device. Few of the IUD side effects are:
- Spotting between periods
- Mild to moderate pain
- Delayed or irregular periods
- Heavy bleeding with worsening menstrual cramps
- Backaches or stomach cramping for a few days
An IUD does not protect you from any sexually transmitted diseases. IUDs are only used to prevent unwanted pregnancies. Condoms may help reduce the chances of transmitting STDs. Hence, it is still safe to use condoms even though you have an IUD.
The use of hormonal IUDs can lead to certain side effects, which are quite similar to the effects of most oral contraceptives. Such side effects would include breast tenderness, mood changes, acne, and severe headaches. If these side effects do happen, they mostly go away in the first few months.
Consult your doctor for proper management of the side effects.
Safety Considerations
Seek immediate medical attention if you experience any of the following conditions:
- If the length of the IUD string feels shorter or longer than usual
- If you feel that you are pregnant
- If you can feel that the hard bottom plastic of the IUD is coming out through the cervix
- Pain or bleeding during sex
- An onset of terrible cramps leading to discomfort in the lower belly or stomach
- Unusual vaginal discharge
- Sudden fever with chills
- Difficulty breathing
- Heavy vaginal bleeding
