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An IUD, or intrauterine device, is a long-acting form of birth control. At the time of publication, two IUDs are FDA-approved for use in the United States; one contains copper and the other emits low levels of the hormone progestin. An IUD sits inside the uterus and prevents pregnancy by preventing a fertilized egg from attaching to the wall of the uterus. If a fertilized egg cannot attach and grow, it is unable to develop into a fetus. Hormone IUDs also increase the thickness of the cervical mucus, making it difficult for sperm cells to reach an egg.
INSERTION
You need to visit your health care provider to have an IUD placed. Your doctor will ask about your medical and sexual history, perform a pelvic examination and may order laboratory tests to make sure you do not have an infection. An IUD is usually inserted during or immediately following your menstrual period because the opening to your uterus, the cervix, is more open at this time of the month compared to other times. You may experience cramping and low back pain for a few hours after the device is placed. IUDs have a thin, plastic thread attached, which comes through the cervix and rests in your vagina. Check to feel that the "tail" is still present after every menstrual period, confirming the presence of IUD in your uterus. Your health care provider will want to see you approximately a month your IUD is inserted to be it is in the proper place. The placement of the IUD is also confirmed at your yearly examinations.
REMOVAL
When you wish to discontinue use of an IUD, it must be removed by a health care provider. Removal is usually easiest during your menstrual period, but the device can be removed anytime. Never try to remove an IUD yourself; you may cause permanent damage to your reproductive organs. Copper IUDs can remain in place for up to 10 years; hormone IUDs must be replaced every five years.
IS AN IUD FOR YOU?
Most women can use an IUD, including women who have not had children. There are certain situations, however, that may preclude you from using an IUD. The size or shape of your uterus may prevent you from using an IUD, although this is rare. You should not get an IUD if you have a unexplained vaginal bleeding, a pelvic infection, untreated cervical or uterine cancer or are pregnant. Your health care provider will talk with you about the potential complications of an IUD.
BENEFITS
Once an IUD is placed, it requires almost no maintenance. You only have to remember to check for the tail after every period. The IUD is effective immediately upon insertion. Because the device offers continuous contraceptive protection, you may find your sex life is more spontaneous with an IUD. You can use an IUD while breast-feeding, and your fertility returns soon after the device is removed if you want to get pregnant. The copper IUD can be used for emergency contraception.
DISADVANTAGES
You may experience heavier, longer periods and more cramps with a copper IUD. Spotting between periods occurs in some women with both types of IUDs, especially during the first three to six months of use. There is a small chance of developing a pelvic infection when the device is inserted. Rarely, an IUD slips out of the uterus, leaving you without contraceptive protection. This most often occurs in young women who have not had a child. An IUD does not protect you against sexually transmitted infections, such as HIV, gonorrhea, chlamydia, genital warts, herpes and syphilis.
EFFECTIVENESS
Fewer than one out of 100 women with an IUD get pregnant during a year of use, according to Planned Parenthood. In June 2011, the American Congress of Obstetrics and Gynecology issued a practice bulletin stating, "... intrauterine devices (IUDs) and implants are the most effective forms of reversible contraception available and are safe for use by almost all reproductive-age women..."
