Intrauterine Devices (IUD)
This is a Long Acting Reversible Contraception (LARC). LARC methods do not rely on you remembering to use them.
Used to be called a coil.
An IUD is a small plastic and copper device that is put into your womb by a trained doctor or nurse. It can stay in for 3 – 10 years, depending on the type used. There are different IUDs to suit different women.
IUDs are 99% effective for the newer and more commonly used types. Less than 1 woman in 100 will get pregnant in a year.
IUDs are effective as soon as they are put in, and fertility returns as soon as they are removed.
IUDs work in several different ways. The main way is to stop sperm reaching an egg. It does this by:
- Preventing sperm from surviving in the womb.
- Making it difficult for sperm to penetrate through cervical mucus.
- It may also work by stopping a fertilised egg from implanting in the womb.
Advantages
- Effective for 3 to 10 years, you do not have to think about contraception for as long as it is in place.
- It doesn’t interrupt sex.
- Your normal fertility returns as soon as the IUD is taken out.
Disadvantages
- Your periods may be heavier, longer or more painful. This may improve after a few months.
- There is a very small chance of getting an infection during the first 20 days after an IUD is put in.
- You may be advised to have a check for any possible existing infection before an IUD is fitted in order to reduce the chances of an infection after IUD insertion.
IUDs are very effective at stopping pregnancy but they will give you no protection against sexually transmitted infection (STI). If you get an STI when the IUD is in place this could lead to a pelvic infection at any time.
There is a very small risk that the IUD can be pushed out of the womb (expelled) or it can move (displacement). This is more likely to happen soon after it has been put in and you may not know it has happened. This is why your nurse or doctor will teach you how to check your IUD threads every month. This is rare, and will not be brought on by anything that you have done, so continue your own routine e.g. gym, sport and exercise as normal.
It is not common, but there is the risk that an IUD might go through (perforate) your womb when it is put in. This risk is low when fitted by an experienced doctor or nurse.
If you do become pregnant while you are using an IUD, there is a small increased risk of having an ectopic pregnancy. This is when the pregnancy develops outside your womb. Although, this is not common, it is dangerous. The risk of ectopic pregnancy is less in women using an IUD than in a women using no contraception at all.
Can anyone use an IUD?
Most women who want to use an IUD can do so, including women who have never been pregnant and women who are HIV positive. Your doctor or nurse will need to ask about medical history to check if an IUD is suitable for you, some of the conditions which may mean you should not use an IUD are:
- If you think that you might already be pregnant
- If you or your partner are at risk of getting a STI
- If you have an untreated STI or pelvic infection
- If you have problems with your womb or cervix
- If you have any unexplained bleeding from your vagina (in between your periods)
- If you have an artificial or diseased heart valve – this would require specialist advice.
Where can I get an IUD?
You can go to the CaSH service or your own GP. Some GP’s will fit IUDs but not all. All treatment is confidential and free.
How is an IUD put in?
An IUD can be put in at any time in your menstrual cycle if it is certain you are not pregnant.
Fitting an IUD takes about 15 – 20 minutes. Some women find it uncomfortable and may wish to take a painkiller, your doctor or nurse will talk to you about that beforehand. You may get a period-type pain and some light bleeding for a few days after the IUD is fitted, painkillers can help with this.
Is it safe to use tampons if I have an IUD fitted?
Yes, you can use either tampons or towels during your periods.
How often do I need to see a doctor or nurse?
You should have your IUD checked three to six weeks after it is put in. The IUD can stay in for 3 to 10 years depending on the device used, during which time if you have any problems you can go and see your doctor or nurse at any time.
When can an IUD be put in?
An IUD is usually put in four weeks after a vaginal or caesarean birth and can be used while you are breastfeeding.
An IUD can be put in immediately after a termination of pregnancy or miscarriage if you were pregnant for less than 24 weeks.
If you have a medical termination of pregnancy (using pills) an IUD should be fitted in the first two days following, otherwise you will need to wait four weeks.
When can it be removed?
A trained doctor or nurse can take out the IUD at any time. If you are going to have another IUD put in, and you don’t want to become pregnant, use extra contraception, such as condoms, for seven days before IUD removal.
The IUD will give you no protection against sexually transmitted infections, we therefore recommend the use of condoms as well.