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Which IUDs are the best? Benefits, risks, and side effects

Khaldoun Sharif. Oxford Handbook of Obstetrics and Gynaecology. Sally Collins. Textbook of Influenza. Robert G. Modern Colposcopy Textbook and Atlas. American Society for Colposcopy and Cervical Pathology. In , a healthcare professional can place a copper IUD during a non-surgical procedure.

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The healthcare specialist places the copper IUD inside the uterus through the vaginal canal. At that time, women may experience some discomfort in the form of cramping or pinching. There is also an increased risk for pelvic inflammatory disease , or PID, a type of infection in the uterus. Sometimes, IUDs are difficult to remove, as they become embedded in the uterus and require surgical removal. In cases where the copper IUD fails to prevent a pregnancy , there is a five percent chance that the pregnancy will be ectopic, or occurring outside of the uterus.

However, researchers have improved the design over time to increase efficacy and the duration of effectiveness. The effectiveness of a copper IUD is largely dependent upon the rate of dissolving of copper ions into the uterine environment. As the copper dissolves over time, the IUD becomes less effective as less copper is available. The device had coiled copper wire around the vertical shaft of the T-shaped device that dissolved over time, causing the IUD to become less and less effective.

The new design increased the amount of time for which a copper IUD could remain effective. The Copper T has additional copper collars or cylinders that coat both arms of the T and thicker wire with more copper wrapped around the vertical shaft.

Due to the increased amount of copper in the device, the Copper T remains effective for a minimum of six years. That change in design increased the duration of effectiveness of the copper IUDs from six years to between ten and fifteen years.

Since the s, higher doses of copper and a higher proportion of exposed copper have prolonged the effectiveness of copper IUDs. ParaGard is the brand name for that IUD. Other countries have approved more types of copper IUDs in different shapes and sizes. The most widely used contraception for women worldwide is the contraceptive pill. However, the efficacy of the pill and many other birth control methods is dependent upon the user taking it correctly and consistently, which researchers call perfect use.

Perfect use is rare, and as a result, nearly fifty percent of unintended pregnancies are due to contraceptive failure.

Intrauterine device

While IUDs and the contraceptive pill have similar rates of protection from pregnancy with perfect use, the failure rate is twenty times as high in women who use the pill compared to women who use a long acting method like the IUD. A copper IUD is a long-term reversible birth control , a method that maintains fertility while still allowing women to prevent pregnancies. A copper IUD can last for years without needing replacement, but it is not permanent. Once an IUD is removed, fertility often returns immediately. Sterilization through tubal ligation and the use of copper IUDs are considered equally as effective in preventing pregnancy , making copper IUDs a cost-effective alternative to sterilization procedures.

In , 5. Your health care provider will evaluate your overall health and do a pelvic exam before inserting Mirena. You may be screened for STIs. If you have Mirena inserted more than seven days after the start of your period, be sure to use backup contraception for one week. Taking a nonsteroidal anti-inflammatory medication, such as ibuprofen Advil, Motrin IB, others , one to two hours before the procedure can help reduce cramping.

Mirena is a hormonal intrauterine device IUD that's inserted into the uterus by a health care provider. Your health care provider will insert a speculum into your vagina and clean your vagina and cervix with an antiseptic solution. Special instruments might be used to gently align your cervical canal and uterine cavity and to measure the depth of your uterine cavity. Next, your health care provider will fold Mirena's horizontal arms and place the device inside an applicator tube.

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The tube is inserted into your cervical canal, and Mirena is carefully placed in your uterus. When the applicator tube is removed, Mirena will remain in place. Your health care provider will trim Mirena's strings so that they don't protrude too far into the vagina, and may record the length of the strings. During Mirena insertion, you may experience cramping, dizziness, fainting or a slower than normal heart rate.

Once a month, check to feel that Mirena's strings are protruding from your cervix. Be careful not to pull on the strings. About a month after Mirena is inserted, your health care provider may re-examine you to make sure Mirena hasn't moved and to check for signs and symptoms of infection. It's also important to contact your health care provider immediately if you think Mirena is no longer in place.

Your provider will check the location of Mirena and, if it's displaced, remove it if necessary. Mirena can remain in place for up to five years. To remove Mirena, your health care provider will likely use forceps to grasp the device's strings and gently pull. The device's arms will fold upward as it's withdrawn from the uterus.