Awareness about Intra-uterine contraceptive devices (IUCDs)

Intra-uterine contraceptive device (IUCD) literally means a device which is placed inside the uterus to prevent pregnancy. It is commonly known as a ring or coil by the layman. It is basically a small T shaped plastic device with a string which is inserted into the uterus by medical professionals. There are two types of IUCDs, one which contains copper and other which releases hormones. It is a long-term method of birth control having a reversible type of contraception (birth control). IUCDs cause changes in the uterus and prevent an egg from fertilization or stop the implantation process.

Here are some major types of IUCDs which are approved by FDA (Food and drug authority) of USA.

Copper containing IUCDs

The copper containing IUCD comes under the brand name Paragard. In which a copper wire is coiled around the plastic T shaped device. It is used for birth control and for emergency contraception. The device can be placed in the uterus which can last for 10 years. It can be used in women of any age. And on the removal of this device, fertility returns quickly.

How It Works

The copper produces inflammatory reactions within the uterus that are harmful to the sperm. Hence it prevents the fertilization process.

For emergency contraception, it can be used within 5 days of unprotected intercourse. It is the most effective form of emergency contraception available. It is more effective than emergency contraceptive pills. It prevents fertilization and implantation process. And the additional advantage is that it can be used for birth control for 10-12 years after insertion.

Side effects

The major side effects are;

• Heavy bleeding
• Discomfort
• A long period(menstruation)
• Back ache
• Cramps

Advantages

• Do not contain hormones
• Used up to 10 years
• 99% effective
• Used as an emergency contraceptive
• Starts working almost immediately
• On removal, fertility returns i.e. they are reversible type of birth control

Hormone containing IUCDs

Hormone releasing IUCDs are used for birth control, to control heavy bleeding and to prevent the thickening of uterus walls in patients who are on estrogen replacement therapy.

Mirena is the most famous hormone releasing IUCD. Skyla is another type of it. They both contain the same hormone in them but Skyla is small in size as compared to Mirena. Skyla can be placed in the uterus for 3 years and Mirena has a life of 5 years.

Read Also: 6 Causes Of Premature Birth Every Mother Should Know

How it works

They slowly release hormone each day in the body. They contain progestin hormone naming Levonorgestrel. That is present in birth control pills also.

They prevent the pregnancy in these ways:

• The female body ovulates less often.
• It thickens the cervical mucus which blocks the sperm passage into the uterus
• Thinning the lining of the uterus
• Prevent sperm to bind with egg and attaching with the uterus

Other than these two types of hormone releasing IUCDs, Liletta and Kyleena are the newest ones. Litletta is approved by FDA in February 2015 and kyleena is approved in September 2015. That’s why less research has done on these two types.

Side Effects

The major side effects of this type of IUDs are

• Acne
• Breast tenderness
• Ovarian cysts
• Less or no periods
• Headache
• Depressed mood
• Pain in abdomen or pelvic area
• Weight gain

Advantages

• They are helpful for short term contraception for 3 to 5 years.
• They do not increase the menstrual bleeding.
• They are used to control heavy menstrual bleeding in women who have menstrual bleeding issues.
• Mirena improves endometriosis and prevents endometrial hyperplasia (thickening of uterus walls) and reduces women’s risk of endometrial cancer.

Insertion and removal of IUCDs

Insertion of IUCD is done in doctor’s office. The doctor uses special inserter to put the IUCD in the uterus through the vaginal opening. The process takes less than five minutes.

Removal of the IUCD is also done by the professional doctors. The doctor looks for your IUCD string and uses forceps to grasp the string and slowly pull it out. The flexible arms of the IUCD fold up as the IUCD slides through the opening of the cervix.

Drawbacks of IUCDs

All the types of IUCDs are almost equally effective for contraception i.e. over 99%. Unfortunately, no method of contraception is 100% safe. One of the most problematic drawbacks of IUCDs is the placement related complications. In this situation, the IUCD moves from its place and attaches or go through the wall of the uterus. Hence cause other problems. Sometimes the device comes out also. But they are very rare situations.

The string of the IUCD which is present in the cervix should be checked every month or after few months according to your doctor’s instructions.

Risk associated with IUCDs

Ectopic pregnancy (pregnancy in tubes or other sites instead of the uterus) is the main risk factor associated with IUCDs.

You can not get an IUCD if…

• You have any Sexually transmitting disease (STD) or any pelvic infection
• You have cervical cancer
• You have cancer of uterus
• You have abnormal vaginal bleeding
• You think you might be pregnant
• You have liver disease

You cannot have Paragard if you have a copper allergy, Wilson’s disease or bleeding disorder in which your blood doesn’t clot easily. And hormonal IUCDs are not for women who have had breast cancer.

Some important facts you should know about IUCDs

• The insertion and removal of IUCD are not very painful. Rather it causes cramping for a few hours to a few days. Sometimes insertion of IUCD makes you dizzy also.but for some women it may be a painful process.
• You may get heavy period or your menstrual period disappear completely
• They are more effective than contraceptive pills
• They are most common method of contraception used by the female doctors
• They do not stop ovulation. Even in hormonal IUCD, the hormone is released in the uterus and very less amount is absorbed into the blood stream. But in some women, the hormonal IUCD can affect the ovulation process in the start.
• You can still get pregnant later because it’s a reversible method of contraception
• Your partner cannot feel it during intercourse
• They cannot prevent sexually transmitted diseases (STD), so it is advisable to use a condom when you have any doubt of STD or any other infection.
• They should be inserted or removed by the professional medical practitioners only
• A very rare situation is; your uterus size and shape prevents the insertion of IUCD.
• You can have both types of IUCDs while breast feeding.
• In 1970s, a type of IUCDs was in the market which caused infections and had very poor results. But one’s today are incredibly safe.
• Make sure you are seeing the best doctor who is well experienced and has hygienic conditions in his/her clinic while inserting or removing the device.

For choosing the best method of contraception, you should always consult the best gynecologist in Lahore, Karachi and other main cities of Pakistan from where you belong. Only they can decide which type of IUCD is suitable for you according to your age, health, and lifestyle.