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Hart Family Medical (LOGO)

IUD FAQ

What is an IUD (Intrauterine Contraceptive Device)?

The IUD or intrauterine device is a form of birth control that is available to woman of any reproductive age seeking reversible, forgettable, long-term, safe and effective contraception. It is a small soft T-shaped device with a nylon string attached. A healthcare provider slides it into your uterus (womb). There are two types of IUD – copper and hormonal (Levenogestrel, a synthetic progesterone) which work in different ways to prevent pregnancy.

How does an IUD work?

An IUD helps to prevent the egg and sperm from meeting by slowing down the sperms ability to swim and meet the egg cell. An IUD may also stop a fertilized egg from growing inside the uterus. The progesterone IUD's make the cervical mucus really thick so that sperms and germs cannot penetrate into the uterus. 

How do I know that it is working?

With the hormone IUD's your periods should be lighter or even go away completely. With the copper ones you should have regular periods so the only way to know if it is in there is to check for your strings regularly. If you or your partner cannot feel them, please come back and see us. We sometimes have to do an ultrasound or X ray to find it in the womb if the strings have pulled up into your cervix.  

What are the Pros of using an IUD?

• Safe in breastfeeding

• An IUD provides long-term contraceptive protective for three to ten years which makes it the cheapest form of birth control available. 

• You cannot forget it, skip it or mess it up. As long as it is in position in the uterus it works. 

• It is also convenient, as you do not have to remember to take pills or apply patches or rings regularly.

• When you are ready to become pregnant, your healthcare provider can easily remove the IUD by pulling on the strings with no long-term effects on your fertility or future pregnancies.

• Because the IUD cannot be seen or felt, it’s private and it’s your choice to share information about the IUD if you choose.

• You are protected from pregnancy as soon as the IUD has been inserted, if you inserted it during your period. You are able to go swimming, wear tampons or have intercourse 24 hours after the  insertion.

• No estrogen in any of them reduces the risk of having blood clots in your blood vessels and lungs almost completely. 

• The Mirena makes about 60 % of woman's periods go away completely and at least reduces the flow and cramps in most women. So, it is an excellent treatment for endometrial polyps or iron deficiency anemia due to heavy blood flow. The statistics for the Kyleena is 40% of women experience no bleeding. 

• The Mirena prevents your inner lining of your uterus from becoming thickened. So, it is good to protect people with too much estrogen in their systems like -Polycystic ovaries/PCOS, obesity or hormone replacement therapy/HRT from endometrial thickening, polyps and uterine cancers.

• Does not cause hormone related facial pigmentation like cloasma or melasma.

· Very reliable birth control for woman who are not allowed to get pregnant due to medical reasons like being on Accutane treatment for acne.


What are the Cons of using an IUD?

  • It doesn't protect against sexually transmitted diseases. 
  • The copper IUD's may cause irregular bleeding or heavier, longer and more painful periods. Usually this improves within a few months after insertion. If it persists or continues between periods, please see your healthcare provider. 
  • There is a slightly increased risk of infection within the first month of insertion. Please let the inserting office know if you have any signs of infection including fevers, offensive discharge or increased pelvic pain. Because of design flaws in IUDS produced in the 1970s, there was significant concern about pelvic inflammatory disease. This is no longer an issue and LARC's have a very low rate of infection. 
  • Insertion can be uncomfortable: For some it is an easy insertion, for others it may be painful. Your healthcare provider can provide options to help decrease pain. 
  • It does not treat acne, prevent PMS or reduce painful ovarian cysts or ovulation pains. If you have trouble with these things then the oral pill, ring or patch would be a better option for you. 
  • Rarely (less than 1 % of people) the IUD can perforate your uterus wall or attach itself to your uterine wall and will have to be removed by a gynecologist as a minor surgical procedure. 
  • Rarely (less than one percent) of times it can fall out. This happens more often if we insert it too soon after having a baby (we usually wait till 3 months after giving birth or having a C/section) Some women may experience spotting for 3 to 6 months after insertion and this may be daily, and there may be some cramping for the first few weeks that may not go away.
  • In some women the IUD may fall out spontaneously, this could lead to an unplanned pregnancy. 
  • The strings may migrate up into the cervical canal which means that when it comes time for the IUD to be removed she may need surgery to do so. 

Will I or my partner feel the IUD?

No, the plastic, the copper or the strings should not be felt or seen outside of the vagina. Some woman can feel their strings when they look for them to make sure they haven’t fallen out accidentally, but if you cannot feel it, don't worry about it, if we’ve checked it at your 4-6 week visit and it is still inside, then you don't have to worry about it. Just enjoy the freedom. Checking is best done after each period especially if you use tampons or a diva cup. Feel with fingers around your cervix, there should be something with a different texture there. Your partner should not be feeling any sharp parts. 



IMPORTANT FACTS TO KNOW:

  • Yearly string checks with your healthcare provider is advisable to ensure that it is still in the correct position. 
  • When the recommended time for the IUD has expired it is suggested to have it replaced or removed.
  • When the IUD perforates the uterus and migrates into the abdominal cavity it has to be surgically removed and there is a risk for potential damage to the bowel, bladder, blood vessels and  nerves.
  • The risk of becoming pregnant is very low, less than 1% however if you are to become pregnant  you are at risk for an ectopic pregnancy and you should immediately present to your health care provider for evaluation. 

What does the process entail?

1. You book an appointment with one of the doctors to discuss the type of IUD that would be the best for you, and we choose one with you, give you a prescription and discuss the procedure and pain control with you. If you are under 18 it may be good to bring your mom or guardian with you to discuss consent.


2. You pick the device up at the pharmacy of your choice (the box stores like Costco is usually the cheapest). 


3. Then you book your appointment during your period (towards the tail end is often the best) and take 600 mg of Ibuprofen 30 mins before your appointment. 


4. The whole insertion will usually take about 30 minutes. Most woman are ok to drive themselves home afterwards, although some get faint and dizzy so then we suggest you rest a bit before driving. It is a good idea to bring a support person with you to hold your hand, but this is not essential. We often do STI swabs at the same time and can even do you PAP smear if you are due.


5. We ask that you see us again in 4-6 weeks after the insertion, so we can trouble shoot any problems and help you feel for the strings. 


6. After that you continue to see your healthcare provider yearly for a IUD check and continue with your PAP smears on your screening protocol every 1 to 3 years. 


7. When you are done with the IUD the removal is a very simple and relatively painless procedure. There are no sharp instruments needed like with the insertion. You are fertile again within 8 hours of the IUD being removed, so be sure to be ready!

 

8. Most woman choose to reinsert the next IUD at the same time of removal so there is no interruption in contraception. 

GOOD WEBSITES: FOR LINKS

http://www.sexualityandu.ca Canadian one.

http://www.willowclinic.ca - BC clinic lots of options/explanations

https://www.plannedparenthood.org/learn/birth-control/iud -  American one

https://bedsider.org - really hip one for teens and cool people

httos://healthlinkbc/health-topics/tw9516