Intrauterine Devices

What is an Intrauterine Contraceptive Device (IUCD)?

An Intrauterine Contraceptive Device (IUCD) is a small, plastic, copper or hormone containing device, which is placed inside the uterus to prevent pregnancy. It comes in different types, sizes and shapes to suite different women. Depending upon your choice of contraception period, it can be inserted for 3-5-10 years.

What are the different types of IUCDs?

IUCDs are broadly classified as:

  • 1. Nonhormonal - containing copper.
  • 2. Hormonal - contain levonorgestrel.

Action & Efficacy - Intrauterine Contraceptive Device

How is an IUCD inserted?

  • The doctor or nurse will examine you internally to check the position and size of the uterus before they put in an IUCD. Sometimes, they will check for any possibility of an existing infection. This can be done before or at the time of fitting IUCD.
  • You may also be given antibiotics at the same time during IUCD insertion. Fitting an IUCD takes about 10-15 minutes. Once an IUCD is inserted it could be uncomfortable or painful for some women, and you might want to use a local anaesthetic. Your doctor or nurse should talk to you about this beforehand.
  • You may experience a period-type pain and light bleeding for a few days after the IUCD is fitted. Pain relieving drugs can help to reduce the pain.

How does an IUCD work?

  • An IUCD prevents pregnancy by making it difficult for the sperms to survive inside the uterus or to reach the egg in the fallopian tube. It may also work by stopping a fertilized egg from getting implanted inside the uterus. However it does not cause an abortion.

Usage & Benefits - Intrauterine Contraceptive Device

When can an IUCD be removed?

  • A trained doctor or a nurse can take IUCD out at any time by pulling gently on the threads. Sperms can live for upto seven days inside your body and could cause a pregnancy once the IUCD is removed.
  • If you are not going to have another IUCD inserted, and you do not want to became pregnant, use additional contraception, such as condoms, for seven days before the IUCD is taken out. This is to stop sperms getting into your uterus.
  • Your fertility returns to normal as soon as the IUCD is taken out.

What are the advantages of an IUCD?

  • More than 99% effective in preventing pregnancy
  • Cost effective method
  • Easy to use
  • Safe to use while breast feeding
  • Can be removed whenever you have problems or want to stop using it. Fertility returns with the first ovulation cycle following the IUCD removal
  • Can be inserted after a normal vaginal delivery, a cesarean section, or afirst trimester abortion

What are the limitations of an IUCD?

  • You need an internal examination to check whether IUCD is suitable so that it can be fitted
  • Only a health professional can insert/remove the IUCD
  • Your periods may be heavier and longer
  • Does not protect against STDs
  • Could be spontaneously expelled out of the uterus

What precautions should be taken?

  • Prior to insertion, physical examination should be done which including a pelvic examination, cervical smear, and if possible, appropriate tests for diagnosing sexually transmitted diseases.
  • After insertion IUCD users should be re-examined shortly after the first period and after immediate post-abortion or post-partum insertion monthly during the first three months. Thereafter, appropriate examination should be carried out at regular intervals i.e every six months.
  • If IUCD threads cannot be felt in a woman who has not noticed expulsion, examination is necessary to exclude perforation or unnoticed expulsion. Ultrasound or X-ray may be used to locate the device.