IUD's

The fifth birth control method that we will look today is the IUD (Intrauterine Device) or IUC (Intrauterine Contraception). It is quit different from other methods that we have talked about because the IUD is placed inside the uterus. Before we get started I want to make clear that there are two different types of devices. According to Choosing a Birth Control Method, published in 2009, the two methods available are

1.The Copper T 380A (brand name ParaGard®) which contains no hormones and is effective for 10 years.

2.The Levonorgestrel intrauterine system (brand name Mirena®) which contain progestin and is effective for 5 years.

Jan Ray, a RN Board Certified Women's Health Nurse Practitioner and Advanced Practice Nurse Prescriber talks about how the IUD works once it is inserted. “Once the IUD is inserted it makes the cervical mucus very thick which does not allow the sperm to penetrate, changes the uterine lining, and changes tubal motility, and inhibits ovulation.”

So you are probably wondering how does it get inserted and is it uncomfortable. As with the Implanon, the medical provider must be trained. Ray says, “Speculum is put in the vagina, the cervix is cleansed with a antimicrobial soap, tenaculum (hooklike pointed instrument with a slender shank for grasping) is put on the cervix to keep it from moving, uterus is sounded (sized) to determine how big it is, the inserter is then passed and the IUD is put in place in the uterine cavity, inserter is removed, speculum is removed and we are done”. This seems like a complicated process but however with the proper training it is not.



As with all birth control methods there are the positive and the negatives. Rays says that a potential complication of placing the IUD is perforation of the uterus. Another problems but not a complications may be that the uterine cavity is too small or the cervical os (opening) is too small to allow the inserter to be passed. She also said that there are usually no problems with taking it out, unless the strings that hang from the IUD are not visible.

So enough negative, let’s look at the positive. Ray says, “IUD is a long acting reversible method. Don’t have to do anything after it is inserted except to check the strings once a month. How easy it that. Also, it is also very effective!”
When choosing a method or making any medical decision education is important. Ray says, “Paragard may cause heavier periods and more cramps. Mirena periods usually disappear which for some women this is grand for others they may be uncomfortable without a period so good counseling is extremely important.” Furthermore, some providers may not put IUD’s in women who have not been pregnant even though current recommendations are that it can be inserted in women who have not been pregnant.

So when deciding on a birth control method, be sure you have done your research. Know all about it and make sure your doctor answers all the questions you have.