What It Is

The IUD, or intrauterine device, is a small, T-shaped device that is inserted into the uterus by a clinician to prevent pregnancy. Currently there are two types of IUDs, the ParaGard and the Mirena.  The ParaGard IUD contains copper wiring and has no hormones.  The Mirena IUD contains a low dose of the hormone progestin, which is commonly found in birth control pills.  Both types of IUDs are extremely effective in preventing pregnancy.  The IUD is over 99% effective, which is the same level of effectiveness as tubal ligation or having your "tubes tied".  IUDs can remain in place from five to ten years depending on which type of IUD is used.  The Mirena is effective for up to five years, and the ParaGard is effective for up to ten years.  Currently Tapestry Healthis inserting only the ParaGard IUD.

How It Works

The ParaGard IUD works mainly by preventing  sperm from reaching and fertilizing an egg.

Advantages

• Has a very high rate of effectiveness
• Does not interfere with the act of sex
• Provides continuous contraception for ten years
• Its effect is immediately reversible once the IUD is removed.
• It is cost effective.

Disadvantages

• Needs be inserted by a clinician.
• Requires a pelvic exam.
• Can possibly cause heavier and more painful periouds

Who Should Not Use the IUD

Your should not use the IUD if you:

• Are pregnant, or thinking that you might be pregnant
• Currently have or have had in the past three months: pelvic inflammatory disease, or a sexually transmitted infection such has Chlamydia or Gonorrhea
• Have any condition that alters the size of the uterine cavity (fibroids, edometrial polyps, cervical stenosis, bicornuate uterus, small uterus < 6 cm)
• Postpartum or post abortion endometritis within the last three months
• Cervical or endometrial cancer
• Undiagnosed vaginal bleeding
• Allergy or sensitivity to copper

Possible Side Effects

The Paragard IUD may cause heavier menstrual bleeding and/or longer periods.  The IUD may also cause an an increase in menstrual cramps. Some women may experience spotting early on after the insertion. Over-the-counter pain relievers, such as acetominophen or ibuprofen, can help. If over-the-counter pain relief does not help, call your clinician.

Health Risks

While rare, the serious health risks associated with the ParaGard IUD include perforation of the uterus during insertion, expulsion of the IUD, and pregnancy while the IUD is in place.  Perforation can occur during the insertion if the IUD goes through the wall of the uterus.  There is a small risk that the IUD will come out of the uterus (expulsion) especially during the first month after the IUD is inserted.  While pregnancy with an IUD in place is very rare, if you do become pregnant, you are at risk for a miscarriage and must have the IUD removed immediately.

How to Use the IUD

The IUD must be inserted by a clinician and can only be removed by a clinician.  Never try to remove an IUD yourself, and do not let your partner pull on the string. 

You should learn how to check for the string of the IUD before leaving the insertion site.  Then you should check to feel the string before each time you have sex and after your period.

Here's how:

• Wash your hands.
• Put your finger deep into your vagina. Feel for your cervix. It feels like the tip of your nose. This may be done in any position that you find comfortable, some suggestions are; squatting position, lying down with your knees raised or standing with one foot on a chair or toilet seat.
• You may not be able to find the string immediately and it may be difficult to find.
• It is possible that you won't feel the string at all. If you cannot find the string or if it is very short or very long, or if you feel plastic, call your health care provider to be checked.
• If any of the above occurs, use a back up method until you see your health care provider since it is possible that the IUD is being expelled into your uterus.

See your clinician after your first menstrual period following the insertion of the IUD.  Make sure that your visit is no later than six weeks after insertion.  This visit will allow the clinician to make sure that the IUD is in the correct position.  

When to See a Clinician

If you are using an IUD, you should see a clinician if you experience any of the following problems:

• A missed period.
• Unexplained or abnormal vaginal bleeding or discharge.
• A delayed period followed by scanty or irregular bleeding.
• Pelvic or lower abdominal pain
• Unexplained fever or chills.
• Exposure to sexually transmitted infections (STIs).
• Genital sores or lesions.
• Severe or prolonged menstrual bleeding.
• String disappearance
• Pain with intercourse.

How to Protect Against STIs and HIV/AIDS

The only way to guard against getting sexually transmitted infections (STIs) is not to have sex or to have sex only with partners who have been tested and are free of infection. If you do have sex, you should use a latex barrier, such as a male condom, a female condom, or a dental dam, every time. Condoms provide protection against STIs, including HIV, the virus that causes AIDS. Tapestry Health clinicians recommend using such barriers even in combination with other methods of birth control. Latex condoms are preferred to lambskin condoms for the prevention of STIs.

If you have any questions about IUD, talk to your clinician.