Intra uterine device

Intrauterine Device (IUD)

An Intrauterine Device (IUD) is a form of long-term birth control that is inserted into the uterus to prevent pregnancy. It is one of the most effective forms of reversible birth control with a one-year failure rate around 0.2-0.8%. The IUD is a small, often T-shaped device that can come in hormonal or non-hormonal (copper) forms.

Types of IUDs

There are two main types of IUDs: copper-based IUDs and hormonal IUDs.

Copper IUD

The Copper IUD, such as the Paragard IUD in the United States, does not contain hormones. It works by releasing copper into the uterus, which acts as a spermicide, killing sperm before they can fertilize an egg. Copper IUDs can be effective for up to 10 years.

Hormonal IUD

Hormonal IUDs, such as Mirena, Skyla, Liletta, and Kyleena, release a small amount of progestin, a hormone similar to progesterone, into the uterus. This thickens the cervical mucus to prevent sperm from reaching or fertilizing an egg. Hormonal IUDs also thin the lining of the uterus, which can prevent implantation of a fertilized egg. Depending on the brand, hormonal IUDs are effective for 3 to 7 years.

Mechanism of Action

The primary mechanism by which IUDs prevent pregnancy is by inhibiting sperm from fertilizing an egg. Copper acts as a spermicide, while hormonal IUDs increase the thickness of the cervical mucus. Additionally, hormonal IUDs may prevent ovulation in some users.

Insertion and Removal

IUD insertion is a procedure that should be performed by a healthcare professional. It involves measuring the depth of the uterus and then placing the IUD through the cervical canal into the uterine cavity. The process can be uncomfortable, and some women may experience pain and cramping during and after the procedure. Removal of an IUD involves gently pulling on the device's strings by a healthcare provider, which collapses its arms and allows it to slide out.

Benefits and Risks

Benefits

IUDs offer several benefits, including long-term protection against pregnancy, reversibility, and minimal maintenance. Hormonal IUDs can also provide the added benefit of reducing menstrual bleeding and cramps.

Risks

Potential risks include expulsion, where the IUD partially or completely falls out of the uterus, and perforation of the uterus, although this is rare. There is also a small risk of infection following insertion. Women with hormonal IUDs may experience hormonal side effects such as mood changes, acne, and headaches.

Conclusion

IUDs are a highly effective and reversible form of birth control suitable for many women. However, the choice between a copper or hormonal IUD and the decision to use an IUD at all should be made in consultation with a healthcare provider, considering individual health needs and lifestyle.