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What is an IUD?
Intrauterine devices (IUDs) are T-shaped plastic devices that are inserted into the uterus. They are used mainly for birth control but some IUDs are also used to decrease the amount of bleeding and discomfort women have during their periods. There are 2 types of IUDs, one contains a hormone and one contains copper. Both are very effective at preventing pregnancy and can be used for 3, 5 or 10 years at a time. They can be removed at any time by a doctor. It’s possible to get pregnant very soon after the IUD is removed. Speak to your doctor about which kind of IUD is is best for you.
What are the benefits of an IUD?
- IUDs are very effective. The hormonal IUD prevents 99.8% of pregnancies and the copper IUD prevents 99.2% of pregnancies.
- IUDs are ‘low maintenance’. With an IUD you won’t have to remember to take a pill every day or come for an injection every 3 months.
- IUDs can decrease bleeding and cramping during periods. The hormonal IUD also helps to decrease the amount of bleeding and cramping women have with their periods. Many women using a hormonal IUD stop having periods altogether while it is in place.
Different IUDs are effective for different periods of time. Make sure you know how long your IUD is effective for.
- 3 years: Jaydess®, copper
- 5 years: Mirena®, copper
- 10 years: copper
Are there any risks?
These are rare. Possible risks include:
- Making a small hole in the uterus when the IUD is being put in (0.1%, or a 1 in 1000 chance of this happening);
- Infection shortly after insertion;
- IUD falling out (5%, or 5 in 100 IUD insertions).
The chance of pregnancy with an IUD is very small. If you do get pregnant with an IUD in place, it is possible that the pregnancy is in the tube, not the uterus (ectopic pregnancy). If you get pregnant while your IUD is in place, contact your health care provider right away.
Are there any side effects?
The most common side effect of an IUD is irregular bleeding, especially in the first 3 months after it has been inserted. This usually gets better with time. Some women who use the hormonal IUD may notice mild hormonal side effects like headaches or breast tenderness. This often improves by the 3-month mark. Women who use the copper IUD may find that their periods become heavier or have more cramps. An anti-inflammatory medication, like ibuprofen (Advil®, Motrin®) can be helpful if this happens.
The IUD does not protect against HIV or other sexually transmitted infections. Keep using condoms to protect yourself from these infections.
Getting ready for the IUD insertion
- If you are sexually active, you need to use a reliable form of birth control until the IUD is inserted. The IUD can be placed at any time during your menstrual cycle, as long as there is no chance that you are pregnant.
- If you have no allergies, take 800mg of ibuprofen (Advil® or Motrin®) at least 2 hours before your appointment. If you cannot take ibuprofen, take 1000mg of acetaminophen (Tylenol®). Make sure you have eaten and have had enough fluids to drink.
- If your doctor has given you a medication called ‘misoprostol’, please place these tablets in your vagina on the morning of your appointment.
What will happen during my appointment?
Your appointment will take about 15 minutes. We will do a pregnancy test before inserting the IUD (if you are sexually active).
Your doctor will:
- Do an internal exam. This includes a speculum exam to check the size and position of the uterus.
- Insert the IUD with a special applicator that fits through the cervix and into the uterus. The IUD itself is small enough to fit in the palm of your hand (even though the box looks big!).
Most women have some cramping when the IUD is being inserted and may have some cramping afterward. Some women feel dizzy after insertion. If this happens, you’ll need to lie down for a few minutes.
What should I expect after IUD insertion?
The IUD has one or two small strings that come through the cervix and into the vagina. This is so that the IUD can be removed later and they should not bother either you or your partner.
After the IUD is inserted:
- You may notice irregular bleeding or spotting for the first 3 months. You may also experience some cramping for a few days after the insertion.
- Avoid intercourse or tampon use for the first 7 days after insertion. If you do have sex in the first week after the IUD is put in, please use a condom. Use condoms even when you have an IUD in place, to protect yourself from sexually transmitted infections.
If you have a hormonal IUD: your periods will become lighter with time and may disappear completely.
If you have a copper IUD: your periods may become a bit heavier or more painful. If this happens, you can use ibuprofen (Advil® or Motrin®) as long as there is no medical reason that you should not.
What follow up is needed?
You should see your doctor 1 to 2 months after having the IUD inserted. This gives us the chance to:
- Check that the IUD is in the right position;
- Make sure you’re happy with the IUD;
- Answer any questions you may have.
Call your doctor or go to the emergency department if you notice:
- Severe abdominal or pelvic pain;
- An unusual vaginal discharge;
- Pain or discomfort during sex;
- Signs of pregnancy or a positive pregnancy test;
- The IUD has fallen out or you can feel it in the cervix or vagina.
Patients from CHEO clinic: 613-737-7600 extension 3589
Patients from St. Mary’s & Youville Centre clinics: 613-737-8552
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