IUD (cont.)
What are the advantages of an intrauterine device (IUD)?
The advantages of the IUD include the fact that it is highly effective in
preventing conception, is reversible, and starts working almost immediately. A
woman with an IUD does not need to use other birth control methods before she
has sexual intercourse, and once the IUD is removed, there is a quick return to
fertility. The levonorgestrel-releasing IUD (99% effectiveness) is replaced
every five years. The copper IUD is also 99% effective and only needs to be
replaced every 10 years.
What are the side effects of an intrauterine device (IUD)?
Side effects of the IUD are limited primarily to the uterus. These include:
It is also possible for the IUD to pass through
(perforate) the uterine wall and enter the abdominal cavity, where it must be
retrieved surgically. Perforation of or trauma to the uterus by
the IUD occurs in 1/1,000 insertions. Warning signs of possible complications
from an IUD include abdominal pain, heavy bleeding, abnormal spotting or
bleeding, and a smelly vaginal discharge. If a woman experiences any of these signs, she should contact
her health care professional.
What are the risks and complications of intrauterine devices (IUDs)?
An IUD may not be appropriate for women who have heavy
menstrual bleeding, had previous pelvic infections, have more than one sexual
partner, or plan on getting pregnant. This is because IUDs do not protect
against sexually transmitted infections (STDs) and should not be in place if a woman
intends to become pregnant.
If women become pregnant with their IUDs in place,
40-50% of the pregnancies end in miscarriage.
Women who use non-progesterone types of
IUDs are 50% less likely to have an ectopic pregnancy compared to women using no
contraception. When a woman using an IUD does become pregnant, the pregnancy is
more likely to be ectopic, but still ectopic pregnancy in a user of an IUD is a
rare occurrence.
Serious complications due to infection associated with an IUD
may prevent a woman from being able to become pregnant in the future.
Also, with
the progesterone-releasing IUD (levonorgestrel IUD), a reduction in menstrual
flow and a decrease in painful menstrual cramping are often observed with
continued use. This is because the progesterone hormone can cause thinning of
the lining of the uterus. These menstrual changes are not dangerous in any way
and do not mean that the contraceptive action of the IUD is diminished.
The IUD provides no protection against
sexually transmitted diseases (STDs).
Previous contributing authors:
Barbara K. Hecht,
Ph.D. and Carolyn Janet Crandall, MD, FACP
Last Editorial Review: 2/2/2009
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