What is it?
An IUD is a small plastic and copper device that fits inside the uterus. The most commonly used one is T-shaped. Some IUDs are medicated with the hormone progesterone. The IUD has thin plastic strings attached to it, which hang through the cervix into the vagina. The strings are approximately 1-2 inches long. All IUDs must be inserted and removed by a doctor.

The IUD is 94-97% effective. However, the IUD may slip out of the uterus and this is a major reason for failure. Two to ten percent of IUD users found that the IUD had slipped out of their uterus within the 1st year of use.

How does it work?
The exact way it works is not completely understood. The IUD may work by slowing the sperm as they move toward the egg, thus preventing fertilization. The IUD may also alter the lining of the uterus so that the fertilized egg does not attach to the uterine wall. The IUD can remain in the uterus on average from 1-5 years.

Who should not use an IUD?
Women experiencing the following should not use an IUD:

• Pelvic Inflammatory Disease (PID) or recent PID (within last 3 months)
• Recent (within last 3 months) or recurrent sexually transmitted infections
• Pregnancy or suspected pregnancy
• Undiagnosed or irregular uterine bleeding
• Abnormal pap or possibility of uterine cancer
• Anemia or bleeding disorders.
• AIDS or HIV positive

What are the possible side effects and complications?

• Longer and heavier periods with more cramps (this may decrease with time)
• Expulsion or partial dislodging of the IUD.
• Increased risk of infection, Pelvic Inflammatory Disease (P.I.D.) and possible transmission of HIV (more likely with multiple partners).
• Spotting or bleeding between periods.
• A slightly increased risk of PID during the 1st 3 weeks after IUD insertion (The chance of PID increases if you or your partner have other partners)
• Perforation of the uterus at the time of insertion (rare).

Before having an IUD inserted, get tested for sexually transmitted infections.

Instructions following insertion

• No sexual intercourse or use of tampons for 3 days after insertion of IUD
• Be aware of missed periods or extreme bleeding with periods.
• Eat iron rich food.
• Do not try to remove the IUD yourself.
• Learn and pay attention to signs of infection.
• Check the strings

Early IUD danger signs
The IUD strings should be checked:

• once a week during the 1st month after insertion
• after each menstrual period
• after noticing any problems (see below)
• If the IUD has fallen out, you may notice:
• unusual vaginal discharge
• cramping or pain
• spotting between periods
• spotting after intercourse
• painful sex for male or female (can feel the plastic of IUD in the vagina)
• strings are either missing, shorter or longer
• A missed period may be the 1st sign of a "silent" expulsion.

Signs of infection:

• abnormal spotting or bleeding
• pain with intercourse
• unusual discharge or odour
• fever, dizziness, and chills

If you notice any of the above signs see your doctor.

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