Intrauterine Contraception (IUD)
An intrauterine device
(IUD) is a small device which is placed into the uterine
cavity. There
are two highly effective intrauterine contraceptives available in the United States: the Copper T IUD and the LNG-IUS.
IUDs are safe, relatively inexpensive, and provide extremely effective long-term
contraception. Complete information about this contraceptive is available through
your clinician or the package insert accompanying the IUD. Recent analysis shows that use of IUDs carries no increased risk of reproductive tract infections.
In the horizontal arms of the Copper T 380A IUD
there is some copper. The IUD slowly gives off copper into the uterine cavity.
This does several
things. Most importantly, it stops sperm from making their way up through the
uterus. Among typical couples who initiate use of this IUD,
just less than 1% will experience an accidental pregnancy in the first
year.
What are the
advantages of the Copper T IUD?
- The
Copper T IUD is the second most effective reversible
method, rivaling surgical sterilization in preventing pregnancy.
- The IUD is effective
for at least 10 years.
- Only
2 of 100 women using a Copper T for 10 years
will become pregnant.
- Prevents
ectopic pregnancies.
- Far
more readily reversible than tubal sterilization
or vasectomy.
- Protects against endometrial cancer.
- Very
low cost over time. Convenient. Safe. Private.
What are the
disadvantages?
- No protection against sexually transmitted infections. Use condoms if there is any risk.
- There
may be cramping, pain or spotting after insertion.
- The
number of bleeding days is slightly higher than normal
and you could have somewhat increased menstrual cramping.
If your bleeding pattern is bothersome to you, contact
your clinician. There are medications which may make
you have a more acceptable pattern of bleeding.
- High
initial cost of insertion.
- Must
be inserted by a doctor, nurse practitioner, nurse
midwife or physician's assistant.
- A small
percentage of women are allergic to copper.
What is the LNG-IUS?
The LNG-IUS contains some levonorgestrel in its
vertical arm. This hormone is a progestin much like the
progesterone a woman's
ovaries produce each monthly cycle. Each week the LNG-IUS
gives off about the same amount of levonorgestrel as a
woman gets when she takes
one or two of the minipills called Ovrette. The levonorgestrel
causes the cervical mucus to become thicker so sperm cannot
get to the egg.
Among typical couples who initiate use of the LNG-IUS, just
one in 1,000 women will experience an accidental pregnancy
in the first year.
What are the advantages of the LNG-IUS?
- The
LNG-IUS is the most effective reversible method, rivaling surgical sterilization in preventing pregnancy.
- It prevents ectopic pregnancies and pelvic
inflammatory disease, decreases menstrual cramping
and dramatically decreases menstrual blood loss (up
to a 97 percent reduction in menstrual blood loss in
one study).
- It may be left in place for up to
seven years.
- It is safe, inexpensive over time, and provides extremely
effective long-term contraception from a single decision.
- One
of the costs of any contraceptive is the cost to you
should your contraceptive fail. Given the extremely
low failure rate of the LNG-IUS, a person using
this method is far less likely to have either the emotional
and financial expenses associated with an unintended
pregnancy.
- Prevents ectopic pregnancies.
What are the
disadvantages?
- It
often changes the menstrual cycle. A woman has more
bleeding days than normal for the first few months
and less than normal after six to eight months. If a woman
finds that her bleeding pattern is bothersome, she
should contact a clinician. Some medications may improve
the pattern of bleeding.
- This
method provides no protection against sexually transmitted
infections. Use condoms improve protection against
sexually transmitted infections.
- It
has a high initial cost of insertion.
Where can
I go to get intrauterine contraception?
You
can get intrauterine contraception from your clinician, health department,
or family planning clinic. But not all clinicians insert
intrauterine contraception. You might want to check on this in advance. Most
clinics insert intrauterine contraception when a woman is on her period or within
7 days of the start of the period.
Adapted from Hatcher RA et al. Contraceptive Technology. 18th rev. edition. New York, NY: Ardent Media, 2004.
Additional Information >> Contraceptive Choices
Chart Comparing the Effectiveness of Various Methods :: Contraceptive
Myths & Facts :: Local Clinics & Hotlines
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