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revised Friday October 12 2007

Intrauterine Device (IUD)

What is it?

An IUD is a small plastic and copper device that fits inside the uterus. The most commonly used one is T-shaped. The IUD has thin plastic strings attached to it, which hang through the cervix into the vagina. The strings are approximately 2.5-5 centimeters long. All IUDs must be inserted and removed by a doctor. IUDs medicated with the hormone progesterone are also available.

The IUD is 94-97% effective. However, the IUD may slip out of the uterus and this is a major reason for failure (2-10% of IUD users found that the IUD had slipped out of their uterus within the 1st year of use).

How does it work?

The exact way it works is not completely understood. The IUD may work by slowing the sperm as they move toward the egg, thus preventing fertilization. The IUD may also alter the lining of the uterus so that the fertilized egg does not attach to the uterine wall. The IUD can remain in the uterus on average from 1-5 years.

Who should not use an IUD?

Women with the following should not use an IUD:

  • pelvic inflammatory disease (PID) or recent PID (within last 3 months)
  • recent (within last 3 months) or recurrent sexually transmitted infections
  • pregnancy or suspected pregnancy
  • undiagnosed or irregular uterine bleeding
  • abnormal pap or possibility of uterine cancer
  • anemia or bleeding disorders
  • HIV or AIDS

What are the side effects and complications?

  • longer and heavier periods with more cramps (this may decrease with time)
  • expulsion or displacement (moving) of the IUD
  • spotting or bleeding between periods
  • a slightly increased risk of PID during the first 3 weeks after IUD insertion. The chance of PID increases if you or your partner has other partners.
  • perforation of the uterus at the time of insertion (rare)
  • slight increased risk of a tubal pregnancy

Before having an IUD inserted:

  • get tested for sexually transmitted infections
  • ask the doctor about taking an over-the-counter medication such as ibuprofen 1/2 half hour before having the IUD inserted to lessen any discomfort

Instructions following insertion:

  • no sexual intercourse or use of tampons for 3 days after insertion of IUD
  • be aware of missed periods or extreme bleeding
  • eat iron rich food
  • do not try to remove the IUD yourself
  • learn and pay attention to the signs of infection
  • check the strings

Checking for IUD strings:

The IUD strings should be checked:

  • once a week during the 1st month after insertion
  • after every menstrual period
  • after noticing any problems (see below)

If the IUD has been displaced, you may notice:

  • unusual vaginal discharge
  • cramping or pain
  • spotting between periods or after intercourse
  • painful sex for male or female (can feel the IUD in the vagina)
  • strings are either missing, shorter or longer

A missed period may be the first sign of pregnancy because the IUD has been displaced or come out.

Signs of infection:

  • abnormal spotting or bleeding
  • pain with intercourse
  • unusual discharge or odour
  • fever, dizziness, and chills

If you notice any of the above signs, see your doctor.

For more information, call 905-799-7700 and ask for Sexual Health Information.

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Revised: Friday October 12 2007

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