iud insertion in north vancouver graphic

IUD Birth Control: Knowing Your Options in BC

By Dr. Naz Baradaran

An Intra-Uterine Contraceptive Device (IUCD), or commonly known as IUD, is a long-acting reversible birth control method. It is the highest effective reversible method that lasts for years and does not affect fertility. Insertion and removal of an IUD does require a doctor’s visit. However, once a doctor inserts the device, you may forget that it’s there.

What is an IUD?

An IUD is a birth control device that is often a small, T-shaped plastic device that contains either hormone or is wrapped with a copper coil. Hormonal UD (which are correctly called (IUS) contain a hormone called progestin. Most people use an IUD for long-term pregnancy prevention.

However, an IUD can also provide effective emergency contraception (copper IUD). Some people also use hormonal IUDs to control severe period symptoms such as cramping and excessive bleeding.

How Does an IUD Work?

All IUDs work by keeping sperm from reaching an egg. They do this in a few different ways. A copper IUD is toxic for sperm and eggs. It changes the biochemistry around the uterus so in the unlikely case that an egg becomes fertilized anyway, it prevents the fertilized egg from attaching to the uterine wall.

Hormonal IUDs like Kyleena and Mirena keep sperm and eggs apart in two ways. Firstly, they thicken the mucus of the cervix. That mucus traps the sperm and prevents it from entering the uterus. Secondly

How Effective are IUDs?

IUDs of all types are more than 99% effective at preventing pregnancy. This makes it more effective than either condoms or birth control pills. Furthermore, because it’s a long-term birth control method, users don’t have to worry about forgetting or misusing it. Unlike female sterilization or vasectomy it is fully reversible.

What Kinds of IUDs are Available?

Several different IUDs are available throughout the Canadian provinces. Your doctor or physician can help you to decide which is best for you.

Hormonal IUDs

There are currently two types of hormonal IUDs available, and they are Mirena and Kyleena. As of yet, there are no generic IUDS. These are plastic devices that contain a progestin hormone called Levonorgestrel. Both devices continuously release small amounts of this hormone into the uterus.

Both Kyleena and Mirena can prevent pregnancy for up to five years and they are covered under almost all extended health benefits.

Non-Hormonal IUDs

Non-hormonal IUDs is a T-shaped copper devices. A copper IUD works through a combination of actions as explained above.

A copper IUD can prevent pregnancy for between three and ten years and they work as an emergency contraception if inserted within 7 days of intercourse.

What are the Advantages of an IUD?

The IUD has a long list of advantages and benefits, including:

  • Easy to use: just insert and forget about it
  • More than 99 percent effective
  • Lasts for many years
  • Completely reversible and does not affect fertility
  • Can make your periods easier, lighter and less painful
  • Decrease risk of endometrial cancer
  • Can be used as emergency contraception

What are the Disadvantages of an IUD?

There are far fewer disadvantages of IUDs. Still, you should be aware that IUDs:

  • Don’t protect against STIs
  • Copper IUD may potentially cause more cramping and bleeding if that is your baseline

Are There Any Risks Associated with IUDs?

There are risks associated with every form of birth control. However, serious complications relating to IUDs are rare. The most common ones are pregnancy and insertion-related issues.

Pregnancy

No birth control method is 100 percent effective, though the IUD comes close. However, on rare occasions the IUD may slip out of place or come out completely. If full expulsion happens, you may become pregnant. If your IUD slips out, you will need to have it re-inserted in a doctor’s office.

If you do become pregnant with an IUD in place, it’s essential to have it removed as soon as possible.

Insertion-Related Problems

If bacteria enter the uterus during the insertion of your IUD, it could cause an infection. This infection needs to be treated immediately. There is a very small chance that the IUD could push through the wall of the uterus during insertion. It doesn’t hurt, but it may require a procedure to remove the IUD.

Who Might Benefit From an IUD?

Because it’s easily reversible, the IUD is an excellent option for people who want to prevent pregnancy now but may want to become pregnant in the future.

It’s also an excellent choice for people who want to prevent pregnancy in the long term.

The Canadian Pediatric Society specifically recommends long-acting reversible contraception methods like IUD as the first line contraception for sexually active teenagers.

Who Should Not Use an IUD?

If you meet any of the following criteria, you may not be able to use an IUD. Still, your physician can help you clarify which birth control methods may be safe for you. But, in general, you should avoid IUDs if you:

  • Think you might be pregnant
  • Have STIs at the moment. Past history of STI does not prevent you from having IUD
  • Have an acute pelvic infection
  • Known distorted uterine cavity
  • Have Wilson’s Disease or are allergic to copper: for Copper IUD only
  • Suffer from current cervical cancer, uterine cancer, breast cancer
  • Unexplained abnormal vaginal bleeding

If you’re allergic to copper, your doctor may suggest a hormonal IUD. Still, other health conditions may preclude the use of a hormonal IUD.

How Does IUD Insertion Work?

First, the doctor will check the size and position of your uterus. They’ll likely use a lubricated speculum to check your cervix and will do a swab to check for infection.

Before inserting the IUD, the doctor may use a local freezing to dull the pain. You may still feel a pinch followed by a sharp cramp when the doctor inserts the device. Taking ibuprofen an hour before your appointment can reduce this pain. The whole procedure normally takes less than five minutes.

How Does IUD Removal Work?

Although a doctor must remove an IUD, it’s generally a fast, easy, and painless procedure. In very rare cases that the IUD is stuck to your uterine wall, however, removal may require further procedure. Your physician will work with you to manage or eliminate pain before performing the procedure.

For More Information

For more information about the IUD and whether it’s right for you, contact a reputable medical professional or reach out to your medical care provider. It’s important to always follow safety guidelines and recommendations, and to learn as much as you can about your birth control options.

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