An intrauterine device (IUD) is a small piece of equipment inserted into the uterus for birth control. The copper Paragard and progestin-releasing Mirena are the most common types. IUDs are highly effective, but do not protect against STDs and can cause discomfort and other side effects. They are suitable for women in committed relationships and can be removed quickly if pregnancy is desired.
An intrauterine device (IUD) refers to one or two different small pieces of equipment that are inserted into the uterus by a doctor for birth control purposes. Most commonly, an IUD is a tiny T-shaped piece of copper. It is one of the most effective methods of contraception, for those who tolerate it, and prevents pregnancy by stimulating mucus production in the cervix and uterus, which forms a barrier to the passage of sperm. A similar newer product is a small device that secretes progestogen. This can be differentiated from the IUD by name and called an intrauterine system or intrauterine contraception (IUC).
Different types of IUDs have been around for decades. Some early types were not effective, and in the 1970s in particular the Dalkon Shield resulted in a very large number of lawsuits because it caused a significant risk of developing pelvic inflammatory disease (PID). The number of Dalkon Shield lawsuits has made many people suspicious of the intrauterine device, but current types pose no similar risk. The two most common types available are the copper Paragard® and the progestin-releasing Mirena®.
Insertion of an intrauterine device must be performed by a doctor. Some of the insertion process, especially the “sounding” or measuring of the uterus, is very uncomfortable. The discomfort passes quickly, although some women experience cramping or breakthrough bleeding. Doctors often recommend the use of the IUD in both forms for women who have experienced pregnancy. There is an increased chance of the device being expelled in women who have not.
Both forms of intrauterine device have high efficacy ratings, comparable to or even better than the birth control pill of some types, approximately 97-99.5% effective. They do not protect against STDs and are therefore more suitable for women in committed relationships. There are problems associated with IUDs, which can vary depending on the type.
Copper IUDs can cause a significant increase in cycle volume and length, and breakthrough bleeding. IUDs can cause ovarian cysts, especially in the first few months after insertion. There is a slight risk of developing PID, a chance that the device will be expelled, or a small chance that the IUD will puncture the uterus. An IUC could also cause PID, be expelled, or be punctured. A minimal chance of pregnancy occurs with both types of IUD, and there is a higher chance of an ectopic pregnancy.
Hormonal intrauterine device is associated with a decrease in menstrual bleeding. Progestin may not be used by everyone and is not recommended for smokers over the age of 35 or for people at risk of a heart attack or stroke. A common complaint about Mirena® is that it can cause mood swings. In addition, progestin has been shown to reduce sexual interest. IUD placement of both types tends to be expensive, and not all insurance companies cover these costs.
The benefits of this form of birth control include its overall ease of use. Once in place, women only need to check the cords, which hang in the vagina, once a month to verify that birth control is working. Most women tolerate the intrauterine device quite well, and if they change plans and want to get pregnant, the device can be removed quickly. Another benefit is the length of time this birth control can be used, up to 10 years for copper IUDs.
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