Intra Uterine Device (IUD)

How does it work?
Because the copper IUD is toxic to sperm, it prevents fertilisation of the egg. The IUD also stops any fertilised egg from implanting in the uterus.

Does it work?
Effectiveness is greater than 99 percent.

Who should use an IUD?

• Women who have finished having children and want a long-term reversible form of contraception.
• Women who cannot or do not wish to take the Pill.
• Women who are at long-term risk of contracting sexually transmissible infections (STIs) should NOT have an IUD fitted.

Before insertion

• Have a Pap smear and swabs to rule out any pelvic infections
• Ensure that you are not pregnant (so either have the IUD inserted immediately after your period or use another reliable contraception until it can be fitted).

How is an IUD fitted?
In the clinic you will need to lie down on your back or on your side, as if you were about to have a Pap smear test. The doctor or nurse will place a speculum into your vagina and will clean your cervix with antiseptic. The length of your uterus is measured, and the IUD is placed inside through the cervix or opening to the uterus and the strings are cut to a length of three or four cm.

You will wait at the clinic for about 15 minutes to ensure that you feel no unnecessary discomfort or pain. It is best not to drive home after this procedure (or have a hectic day planned afterwards) as some women have the feelings of period pains after having an IUD fitted, and these feelings can take several hours to improve. The procedure itself can cause some bleeding, and some women have the IUD placed at the time of their period - this is in fact the best time to have it placed.

As the risk of infection with an IUD is highest in the first three weeks after insertion, it is recommended that you allow nothing into your vagina until two days after any bleeding has occurred. This means no tampons, no fingers and no penis.

What are the advantages?

• Does not interfere with sexual intercourse
• Cost-effective
• More suitable for women who have had children

What are the disadvantages/side effects?

• Needs to be inserted by an experienced doctor or nurse
• Does not provide protection against STIs
• An increase in bleeding, painful periods and vaginal discharge
• The IUD may expel itself from the uterus, usually during a period. The woman may not be aware that this has happened and should always check that the string is in place after her period is finished.
• There is a small risk of infection in the three weeks following insertion.
• Because pelvic infections can lead to infertility, it is important that a woman with an IUD be particularly careful about protecting herself from sexually transmissible infections
• The IUD may perforate the wall of the uterus. This is a very rare occurrence which may happen when the IUD is being inserted.
• Although rare, when an IUD fails and the woman becomes pregnant, the device must be removed as soon as possible. An IUD in a pregnant woman increases the risk of miscarriage
• There is also the risk of an ectopic pregnancy (where the fertilised egg implants in the fallopian tubes) when the IUD fails (again, rarely)

What if I feel that something is wrong?
Contact your doctor when:

• The string feels like it is shorter or longer than normal as the IUD may have shifted. It is important to check the length of string after each period
• You experience persistent low back or abdominal pain, particularly when associated with a fever
• You have an unusual discharge or bleeding or there is pain with intercourse
• Either you or your partner have had another sexual experience which increases your exposure to a sexually transmissible infection
• Six weeks have elapsed after insertion, and then every 12 months.