How are intrauterine devices fitted?

Inserting an intrauterine device (IUD) is a simple procedure that takes a few minutes. An IUD is a small, T-shaped device made from plastic or copper that is placed in a woman's womb to prevent pregnancy. An IUD is a reversible contraceptive that can provide contraceptive protection for up to 10 years.
- Before an IUD is fitted, a doctor or nurse may examine the vagina.
- The doctor or nurse may test patients for any existing infections, such as sexually transmitted infections (STIs) and may give antibiotics if needed.
- Having an IUD fitted can be uncomfortable. Hence, the doctor or nurse may give local anesthesia to patients to numb the pain.
- Having a coil fitted takes less than 10 minutes in the doctor’s clinic.
- A type of instrument called speculum is lubricated and inserted into the vagina, and the coil is inserted through the cervix (neck of the womb).
- It can feel slightly uncomfortable and can cause some period-like pains afterward. However, painkillers can ease the cramps. Patients may also bleed for a few days after having an IUD fitted.
- Once an IUD has been fitted, it may need to be checked by a doctor after three to six weeks to make sure everything is fine.
How does an IUD work?
An intrauterine device (IUD) works by stopping a man's sperm from meeting an egg or it may also stop a fertilized egg from implanting in the uterus. The IUD sits in the womb and does not move from there. There are threads attached to the IUD that hang down into the vagina that assist with removal (which should not be pulled). The IUD starts working as soon as it is put in and stops working as soon as it is taken out. The advantages include
- It can be inserted easily by a trained doctor.
- It is effective immediately and it protects against pregnancy for 5 or 10 years, depending on the type.
- It is easy to use (nothing to remember after insertion).
- It can be easily removed.
- It's possible to get pregnant as soon as the IUD is removed.
- It works as soon as it's put in.
- There are no hormonal side effects such as acne, headaches or breast tenderness.
- Fertility returns immediately after it’s removed.
- It does not interrupt sex.
- The woman’s partner will not know about it.
- It's safe to use an IUD if a woman is breastfeeding.
- It's not affected by other medicines.
- The IUD is 99% effective, if used correctly, during the course of 5 years, Less than 1% women using the IUD may become pregnant.
What are disadvantages and risks of IUD?
Although these side effects are uncommon, an intrauterine device (IUD) has disadvantages that include
- Periods may become heavier, longer or more painful, although this may improve after a few months.
- It does not protect against sexually transmitted infections (STIs), so condoms are still recommended during intercourse.
- Rarely, an IUD can lead to pelvic infection if not treated.
- Most women who stop using an IUD do so because of vaginal bleeding and pain, although these side effects are uncommon.
Risks
- Damage to the womb: In rare cases, an IUD can make a hole in the womb when it's put in. This may be painful, but often, there are no symptoms. A woman who experiences extreme pain should notify the doctor immediately and may sometimes require a surgery to remove it.
- Ectopic pregnancy: If an IUD fails and the patient becomes pregnant, there's also a small increased risk of ectopic pregnancy. Ectopic pregnancy is the medical condition in which implantation of an embryo occurs outside the uterine cavity, most commonly in the fallopian tube.
- Rejection: Rarely, an IUD can be rejected (expelled) by the womb, or it can move (displacement). If this happens, it's usually soon after it's been fitted.
- Infections: Thrush and pelvic infections are sometimes associated with IUD fitting.
What are the different choices of IUD?
The common choices include
Copper coil (intrauterine device, IUD)
- The copper coil does not have any hormones and works by preventing fertilization or implantation of the fertilized egg.
- The copper coil is effective immediately after insertion and can be inserted at any time in the menstrual cycle if it is reasonably certain that the patient is not pregnant.
- The copper coil is one of the first choices for an emergency contraception method.
Hormonal coil
- The patient may be asked to abstain from sex for 7days prior to and after the IUD is fitted. The woman may be asked to continue with her current contraception until 7 days after the IUD has been fitted.
- The main way this works is by thinning the lining of the womb and creating a thicker mucosal plug in the lower part of the womb to prevent sperm movement.

QUESTION
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