Intrauterine device (IUD)

An intrauterine device (IUD) is a small contraceptive device placed inside the uterus, also known as a contraceptive ring or device. Initially designed in a circular shape, it is now typically in the shape of a "T." It is inserted into the uterus by a doctor to prevent a fertilized egg from implanting, thereby achieving contraception. Additionally, newer medicated IUDs not only serve as contraceptives but also treat gynecological issues such as heavy menstrual bleeding, endometriosis, and endometrial hyperplasia, thereby reducing the risk of these conditions developing into cancer.

If a woman wishes to conceive after the IUD is removed, her fertility can quickly return. Research indicates that the pregnancy rates for women who have previously used an IUD are not significantly different from those who have never used one.

Classification and Uses of IUDs

IUDs can be classified into medicated IUDs and regular IUDs:

Medicated IUDs (e.g., Mirena®)

• Contains a type of progesterone hormone that prevents pregnancy by thickening cervical mucus, inhibiting sperm movement, and thinning the endometrium. In addition to its contraceptive function, it also treats heavy menstrual bleeding, endometriosis, and endometrial hyperplasia. After insertion, menstrual cycles may become irregular, and flow typically decreases over several months. After 9 to 12 months, due to the thinning of the endometrium under the influence of progesterone, some women may even stop menstruating, but this does not harm their health.
• If used for contraception, Mirena® can be effective for up to 8 years; if used for treatment, it can be worn for 5 years.

Copper IUDs

• Copper IUDs are typically made of plastic with copper wire wrapped around them. The IUD slowly releases copper ions, which affect sperm activity, reducing the chances of fertilization, while the altered uterine environment is also unfavorable for embryo implantation. Depending on the model, the contraceptive effectiveness can last from 5 to 10 years.
   

Both types of IUDs have a thin string attached at the bottom for women or doctors to check the IUD's position and for removal.

Preparations for IUD Insertion and How It Is Done

An IUD must be placed in a woman’s uterus by a doctor. Before insertion, the doctor will review the woman's medical history and conduct a pelvic examination to assess whether an IUD is suitable and to choose the appropriate type based on individual circumstances.

The process of inserting an IUD is straightforward and does not require anesthesia; it can be completed by a doctor in a clinic. Generally, there is no severe discomfort during the procedure, although mild pain may occur in the lower abdomen. Light vaginal bleeding may also occur in the days following insertion, which is normal.

After IUD insertion, regular follow-up appointments are necessary. If a woman needs to replace the IUD or wishes to conceive, the doctor will use instruments to pull the IUD out via the string.

Important Considerations Before IUD Insertion

1. Before using an IUD, it is essential to confirm that you are not pregnant, as using it during pregnancy may lead to a miscarriage.
2. If the medicated IUD is not inserted within the first seven days of the menstrual cycle, sexual intercourse must be avoided or condoms must be used during the first week after insertion to reduce the risk of accidental pregnancy.
3. There is a possibility that the IUD may be expelled during menstruation, especially during the period. Therefore, women can check monthly to see if the IUD's string is still present. If they cannot feel the string, they should contact a doctor as soon as possible; in this case, they must also avoid sexual intercourse or use additional contraceptive measures (such as condoms).
4. Women should attend regular follow-up appointments and pelvic examinations to ensure the IUD is not displaced or expelled.
5. The IUD is a very reliable contraceptive method, with a failure rate of less than 1%. However, if accidental pregnancy occurs while using an IUD, medical attention should be sought promptly to rule out the possibility of an ectopic pregnancy.

Who Should Not Use an IUD?

Most women can use an IUD, but doctors will conduct relevant evaluations and checks before insertion. Women should consult a doctor if they have:

• Heavy menstrual bleeding, severe menstrual cramps, or abnormal vaginal bleeding
• Allergic reactions to copper
• Abnormalities in the reproductive organ structure (e.g., uterus didelphys, uterine septum)
• A history of gynecological diseases (e.g., uterine inflammation, pelvic inflammatory disease, tumors, ectopic pregnancy, sexually transmitted infections)
• Multiple sexual partners (increased risk of pelvic inflammatory disease)
• Heart problems (e.g., valvular heart disease)

Frequently Asked Questions

Q: Can an IUD be inserted at any time?
A: Essentially, as long as it is confirmed that the woman is not pregnant, an IUD can be inserted by a doctor. Women should abstain from sexual intercourse from the start of their period until the IUD is inserted to ensure they are not pregnant.

Q: Will using an IUD lead to infertility in the future?
A: Studies show that the rates of subsequent pregnancy after IUD removal are not significantly different from those of women who have never used an IUD. The IUD is a long-term contraceptive method, but its effects are reversible. When a woman wishes to conceive, the IUD can be removed by a doctor, allowing her to attempt pregnancy. If you want to know if you are suitable for an IUD, you can contact us via WhatsApp to schedule a consultation. Our reproductive medicine specialists will assess your health and provide the most suitable options for you.