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IUD (IntraUterine Device)

IUDs are small devices made of plastic that contain copper or a natural hormone. A clinician will suggest which is the right type for each woman before it is inserted into her uterus. The ParaGard (Copper T IUD) can be left in place for 10 years. The Progestasert must be replaced every year. The IUD does not change the hormone levels throughout the body.

IUDs usually work by preventing fertilization of an egg. They seem to do it by affecting the way the sperm or eggs move. They can also affect the lining of the uterus in ways that prevent implantation.

Of 100 women who use IUDs, two or fewer will become pregnant during the first year of typical use. You can increase your protection by checking for the IUD string regularly (at the end of each menstrual cycle and after each vaginal intercourse). IUDs are the most popular form of reversible birth control in the world. More than 85 million women use them.

Insertion is often done during menstruation. It may be somewhat painful, like severe menstrual cramps. Sometimes it is only slightly uncomfortable. The cramping usually is brief and eases with a little rest and medication for pain relief. Antibiotics may be given to reduce the chance of infection when the IUD is inserted.

A string on the IUD hangs down through the cervix into the vagina. You should feel for the string now and then, especially after menstruation, to make sure the IUD is in place. If it is not, you should use another form of birth control and call your clinician for advice. You should have a checkup within three months after insertion. You should always have annual checkups.

There is a small chance that the IUD may fall out. You may not know it, and pregnancy could result. Pregnancy with an IUD in place is rare. Removal of the IUD lessens the chance of serious infections during pregnancy that can be life threatening in rare cases. Removal also reduces chances of miscarriage or premature delivery in the rare case when an IUD fails, there is a greater chance that the pregnancy will be in the tube. Ectopic pregnancies are life threatening. They usually are eliminated medically or removed with surgery. Infection, with or without symptoms, may increase the risk of tubal pregnancy, cause sterility, or, very rarely, require removal of the uterus or ovaries. An untreated infection may require surgery or lead to infertility or ectopic pregnancy.

Rarely, the IUD may puncture the wall of the uterus. This usually is associated with insertion. In such cases, surgery may be required to remove the IUD.


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