Contraception is an important element of birth control. The IUD is a popular and one of the most effective forms of contraception. It is a long-term and reversible method. The IUD is inserted into the uterine cavity by a doctor. There are copper IUDs that are effective for up to 10 years and hormonal IUDs that need to be replaced after 3-5 years.
How does the IUD (intrauterine device) work?
The mechanism of the IUD basically prevents conception. After the insertion of the IUD, the uterus reacts to the presence of a foreign body by forming a local inflammatory reaction.
The copper IUD gradually releases copper ions that disrupt the movement of spermatozoa and cause increased contractions in the uterus, accelerating the transport and expulsion of the egg. The hormonal insert, instead of copper ions, gradually releases the hormone levonorgestrel, which thickens the cervix, preventing spermatozoa from passing through the cervical canal. Changes occurring in the endometrium (reduction of estrogen and progesterone receptors, low sensitivity to circulating estradiol) prevent fertilisation or possible embryo implantation.
Intrauterine device – effectiveness
The effectiveness of contraception is determined by the Perle index. This was the number of pregnancies per 100 women using this method of contraception. In this case, there is a small risk of error with the method. The IUD (both copper and hormonal) is more than 99% effective. The Perl index for a copper IUD is 0.16-1.26 and for a hormonal IUD 0.09-0.33.
It is contraindicated to wear it when:
- pregnant,
- unexplained vaginal bleeding,
- cancer (of the breast, endometrium, cervix or ovaries),
- uterine anatomical defects,
- uterine myoma,
- inflammation of the pelvic organs and genital tract,
- immune system disorders.
There are also contraindications to inserting a certain type of IUD. A copper IUD should not be inserted if the patient has heavy menstruation, anaemia, endometriosis or an allergy to copper. A hormonal IUD is not used for acute liver disease and hormone-dependent cancer.
IUDs – side effects
The most common side effects in the first few days after IUD insertion are menstrual pain and intermenstrual bleeding.
There is an increased risk of infection for several weeks after insertion. This occurs in 1 in 300 women and requires treatment with antibiotics.
An even rarer side effect is uterine perforation, which can occur in 1 in 500 women with an IUD inserted. In this case, an operation to remove the insert is necessary.
After the insertion of the hormonal IUD, the menstruation pattern changes during the first 3-6 months, there may be frequent menstruation and bleeding. Six months after insertion, 95% of women will have their periods shorter than usual or will not have them at all. Because of the hormone content, at the beginning. You may experience breast soreness, headaches and mood swings when using the pad. These changes almost always go away with time.
With copper IUDs, this period may be longer than usual for several months after insertion.
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