Healthy Woman - Blog

IUD 411

Dr. Julie Leizer is back with her series on contraception. This month, she talks about intrauterine devices, aka IUDs.

The intrauterine device (IUD) is one of the most effective forms of birth control. It is a small, T-shaped plastic device that is inserted and left inside the uterus to prevent pregnancy. The IUD can be used by women of all ages, including teenagers and those who have never had children. There are 2 types of IUDs available for insertion: the hormonal IUD (Mirena) and the copper IUD (Paraguard). The IUD mostly works by preventing fertilization, but it also interferes with implantation. Fertility is not affected by the use of the IUD. Return to fertility after removal of the IUD is similar to the rates after discontinuation of other forms of contraception, such as birth control pills.

The Mirena is an IUD that contains the hormone progestin. It slowly releases this hormone over 5 years. The Mirena IUD has more than just contraceptive benefits. It can also help women who have heavy periods. In fact, about 47% of women will have no period after three years of Mirena use. Even if your cycle doesn’t go away completely, the majority of women will still at least experience shorter and lighter cycles. The Mirena IUD should be placed within seven days of your menstrual cycle, but can be placed at any time during your cycle. The Mirena can be placed immediately post partum, but there is a higher risk of expulsion or uterine perforation when it is placed at this time. It is safer to wait until at least 6 weeks post partum. The 5 year failure rate of the Mirena IUD is 0.7 pegnancies/100 women. However, if you do become pregnant while using the IUD make sure to consult your healthcare provider immediately because there is a higher risk of ectopic pregnancy, meaning that the pregnancy implants outside of the uterus, usually in the fallopian tubes.

Potential side effects of the Mirena IUD are irregular bleeding, especially for the first three to six months. Patients may rarely develop an infection of the pelvis, called Pelvic Inflammatory Disease. If you are prone to acne, the Mirena IUD can make it worse. There is a small chance that the IUD can migrate out of the uterus and into the abdominal or pelvic cavity. If this is the case, you might need a laparoscopic surgery to have the IUD removed.

The copper IUD (Paraguard) works the same way as the Mirena, but it is made of copper, doesn’t contain hormones, and is meant to stay in place for up to 10 years. The Paraguard can also be placed at any time of the cycle. The failure rate of the Paraguard is 0.6-0.8/100 women. As with the Mirena, although pregnancy is rare if you do become pregnant you may be at increased risk of having an ectopic pregnancy.

The main side effect of the Paraguard is heavier and longer menstrual cycles. However, the Paraguard IUD can be associated with a decreased incidence of endometrial cancer.

Remember that IUDs do not prevent against sexually transmitted infections and should not be placed if you are at high risk of developing or currently have a pelvic infection. They should also not be used if you have unexplained vaginal bleeding.

IUD are extremely effective methods of birth control. They should be considered in anyone who desires long term birth control but doesn’t want anything permanent. Once it is in place, you do not have to do anything else to prevent pregnancy. It does not interfere with sex or daily activities. You can use a tampon with it. It is easily reversible, and if you wish to become pregnant, simply have the IUD removed. The insertion of an IUD is a simple office procedure, so if you are interested in this type of birth control discuss it with your doctor and you can decide if it is the proper type of birth control for you.

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