What Is an IUD (Intrauterine Device) Birth Control: Types & Effectiveness

IUDs or Intra Uterine Devices are contraceptive devices that help in birth control, where the device is fitted inside the uterus by a medical health practitioner. The device prevents sperm from reaching the ovary and the fertilised egg from being implanted in the uterus. 

It is considered to be one of the best measures of birth control, offering 99% effectiveness. Read to learn how IUDs help in birth control, IUD types and more.

IUD or Intra Uterine Devices or an Intra Uterine Contraceptive Device (IUCD) refers to a small-sized device placed inside a woman’s uterus to prevent unintended pregnancy. It is almost the size of a quarter, T-shaped and serves as the best option for reversible birth control.  There are two types of IUDs – the copper IUD and the hormonal IUD. 

The IUDs help in birth control and protect against pregnancy for over 5-10 years. However, they do not protect against Sexually Transmissible Diseases (STDs), and one must always opt for additional contraceptives like barrier methods or condoms to keep STDs at bay.

IUCDs can prevent unwanted pregnancy for an extended period, ranging from 5 to 10 years. For this reason, they are referred to as Long-Acting-Reversible Contraception (LARC). Users can choose IUDs from different brands based on their working mechanisms.  

There are 2 types of IUCDs that differ primarily based on their working mechanisms. These are hormonal IUDs and non-hormonal IUDs. These two types and their benefits are discussed in the underlying sections.

1. Hormonal IUDs

Hormonal IUDs are coated with progestin, a synthetic form of the progesterone hormone. They provide 99% effectiveness in birth control. Another advantage of this type of IUD is that it can be removed later if required. 

The hormone progestin causes a thickening of the mucosal layer near the neck of the uterus. This thick mucosal layer prevents the entry of sperm cells into the cervical canal and further up to the uterus. Thus, it helps to avert fertilisation between sperm and ova. Additionally, progestin also causes the inner lining of a woman’s uterus to thin. It prevents the formation of thick inner walls of the uterus, thereby intercepting implantation and pregnancy.

Benefits

Hormonal IUCDs provide the following benefits to the users:

• Effectiveness – A hormonal IUCD provides 99% effectiveness to its users, with only 1 out of 100 users having the chance of getting pregnant after using it. A clinical research study on the effectiveness of IUDs, released in 2015, suggested that hormonal IUDs are even more effective than their non-hormonal counterparts.
• Lowered Risk of Cancer – Hormones present in IUDs help to reduce cancer in the ovaries and uterine cancer.
• Regularity in Periods – Hormonal IUDs regulate the flow of reproductive hormones and reduce irregular periods over a period of time.

It may take a hormonal IUD a period of 7 days to become completely functional, and it is one of the most economical methods of contraception. However, this type of IUD may increase cramps during one’s periods, and it does not protect against Sexually Transmitted Diseases or STDs.

2. Non-hormonal IUDs

Non-hormonal IUDs or copper IUDs do not contain any hormones. They contain copper coil, and the copper in them destroys the sperm cells, thereby preventing them from fertilising the ova or egg cell. Thus, it prevents pregnancy.

Copper also stimulates an immune response in the body which prevents the development of healthy ova and destroys egg cells which do. In India, Pregna is a reliable brand of copper T IUDs helping to relieve pregnancy for a period of 5 to 10 years. Once removed, the IUD offers restored fertility within a short time of one week.

Benefits

A few major benefits of non-hormonal IUDs are explained below.

• No Involvement of Hormones – Hormonal IUDs can have severe altercations for people under steroid medicines or associated ailments. Thus, non-hormonal IUDs help in such cases. Copper IUDs are safe for all, inclusive of those who face an inability to use hormonal IUDs.
• Long Lasting Effect – Copper Ts’ have a long-lasting effect for preventing pregnancy and can function for a period of 5 years to 10 years.

Emergency Contraception – Non-hormonal copper IUDs have immediate effect. Thus IUDs help in birth control by functioning immediately as an emergency measure.

The function of an Intra Uterine Device (IUD) is quite similar to that of the Intra Uterine System (IUS). All hormonal IUDs release a small amount of  progestin into the uterus, causing metabolic changes in the body of a woman.  

These metabolic changes include increased secretion of mucus in the uterus, which results in the formation of a thick mucosal wall at the mouth of the cervix. This helps to prevent the entry of sperm into the womb.

Another metabolic change is the prevention of ovulation or development of a healthy egg cell. This prevents fertilisation. Also, IUDs cause the inner uterine walls to become thinner. The thick walls of the uterus help in implantation of the fertilised egg, which later develops into the foetus.

All these changes in the body of a woman deter fertilisation and ovulation and make it difficult for sperm to survive. This, in turn, prevents unintended pregnancy. IUDs can be fitted anytime during a woman’s menstrual cycle and have no age-specific criteria. However, a doctor’s consultation is mandatory prior to deciding whether an IUD is a right choice for you.

IUDs are 99% effective in preventing unintended pregnancy, and this means that out of 100 women using an IUD, only 1 will face pregnancy. The high effectiveness of it comes with the fact that its use or application does not require routine surveillance. One may, however, forget to take a birth control pill timely or may use a barrier contraceptive in the wrong way. 

Once inserted, IUDs help to protect a user from unintended pregnancy for a period of 3 years to as long as 12 years. One can simply keep track of the date of insertion and expiry date. When used as an emergency contraceptive, IUDs prove to be very effective, as the copper ones start to provide protection from the day of insertion.

However, one should note that IUDs do not protect against Sexually Transmitted Infections (STIs) or Sexually Transmitted Diseases (STDs). Using an additional protective measure like a condom alongside an IUCD is thereby a more reliable measure.

IUDs need to be inserted by skilled nurse practitioners or doctors. The user needs to visit a healthcare clinic or a doctor’s office for the same. IUDs need to be fitted in the uterus, and a few protocols must be followed by the user to ensure that the device stays in place.

There is no specific time in a woman’s menstrual cycle for IUD insertion, and the device can be fitted anytime. However, before insertion, a doctor will always suggest a pregnancy check to ensure that there’s no pre-formed foetus implantation in the uterus.

A woman can opt for an IUD insertion anytime within one’s cycle, ensuring that she is not pregnant. The device starts to protect the user from pregnancy straight away. Here are the steps that will follow:

Step 1: First, the user plans a visit to a clinic or doctor’s chamber. A nurse or associated healthcare practitioner will check body stats, position of uterus, previous reproductive health issues (if any) and the uterine size before proceeding with the insertion. 

Step 2: The user will also be tested for any previous infections in the cervix and uterus. A medical practitioner will also test for Sexually Transmitted Infections (STIs), and the necessary medications, antibiotics and precautionary measures will be taken.

Step 3: The doctor’s appointment takes a minimum of 30 minutes. The procedure of fitting an IUD does not take more than 5 minutes.

Step 4: The user will be asked to lie down on one’s back in a comfortable posture. Next, the vaginal opening will be held open as the device will be inserted via the cervix and fitted into the womb by the doctor.

Step 5: The process of fitting an IUD and its insertion into the cervical channel may be uncomfortable and painful for some people. It is best that one discusses this with the doctor before insertion and takes the help of a local anaesthetic to reduce the discomfort. 

Step 6: One needs to inform the practitioner of any pain or discomfort faced while it is being fitted into the uterus and can ask the doctor to stop the process at any time before proceeding further, as per one’s comfort.

Step 7: Users’ can take painkillers to help with the pain if they need to after fitting an IUD. Pain occurs mostly like cramps during one’s period. One may also experience mild bleeding after insertion and should inform a doctor of any bodily changes.

Step 8: After the entire process is completed, it is best to do a routine follow-up 3-6 weeks after it with the concerned healthcare practitioner. During this time, one needs to report any medical issue faced post insertion, if previous issues have stopped or if one wants to get the device removed.

IUD contraceptives comprise 2 threads which hand down from the uterus to the beginning of one’s cervical canal. The medical practitioner will inform the user of the same and teach them how to check if the device is fitted into place by feeling for the threads. 

A new user must routinely check if the IUD remains in place during the first month and after one’s monthly menstrual bleeding. It is highly unlikely for the device to fall out, but if one cannot feel the threads or feels there is a change in its usual position, one should contact a medical practitioner immediately.

One should be aware of the fact that if an IUD has been displaced, then it won’t protect from pregnancy, and for such instances, one should always use an additional contraceptive like a condom. It is best to use emergency contraception during intercourse, even after fitting an IUD. Furthermore, one’s partner should not feel the device during intercourse; and if so, one should seek immediate medical support.

The side effects of using an IUD are provided below:

• After the insertion, users often experience discomfort in the form of period cramps and bleeding for a few days, after which these effects settle down.
• IUDs, though properly inserted and fitted, may, at times, get displaced. First-time users must maintain all caution and care as suggested by the healthcare practitioners for 3-6 months post insertion.
• After getting an IUD, the menstrual cycle and the dates of period bleeding will change. This can cause spotting issues in the initial 3-6 months period post insertion. 
• A user, after IUD insertion, may experience certain other side effects, namely, headache, mood swings, tenderness in breasts and skin changes. These eventually reduce and settle over time. IUD is not associated with obesity or weight gain.

[Note: For hormonal IUDs, after the 6 months of insertion, most women experience no bleeding or mild menstrual bleeding, and none of this is damaging to a woman’s body. In the case of copper IUDs, users may experience heavier bleeding. This normalises 3-6 months post insertion.]

IUDs are considered highly safe for most individuals and body types.  However, depending on specific individual scenarios and health issues, an IUD may not be considered a safer option for some individuals. 

One can consider the following section as a guide to check how safe an IUD is for oneself.

1. Eligibility

• First, one should delve into the factors which need to be considered before getting an IUD.
• A person should not get an IUD if there is a prevalent pelvic infection or STIs.
• If one is allergic to copper, then getting a copper IUD won’t be ideal for the user.
• One should not get an IUD if one is pregnant.
• Furthermore, if one has untreated cervical cancer or uterine cancer, an IUD insertion is not the best choice of contraception.
• Also, if one has undergone an abortion over the last 3 months, it is not a safe choice to get an IUD.

2. Risks

• One should be aware of the risks associated with getting an IUD. An IUD, after insertion, may slip off and, if so, needs to be removed by a practitioner. 
• Also, one should not use a menstrual cup alongside an IUD, as it may cause the device to be displaced. 
• Ectopic pregnancy is a situation where a fertilised egg gets implanted anywhere in the fallopian tube and not the uterus. Ectopic pregnancy is common if one uses an IUD and the fertilised egg needs to be surgically removed.
• It is possible to contract an infection (bacterial) during the procedure of IUD insertion. If this infection is left in an untreated stage, then it may dampen the chances of getting pregnant later on.
• If the process of IUD insertion is very painful, one may later need it to be removed via surgical means. But this is a rare scenario and often not common among women.

3. Recognise Warning Signs

One should always keep a watch on one’s health metrics post IUD insertion and contact medical assistance at the earliest hour. The following are some warning signs one must check out routinely.

• Check the length of IUD strings. If either one feels longer or shortened, then one should contact medical help.
• If you start to feel something hard near the neck of your cervix, it may be the hard plastic from which your IUD is made. This is a sign that the IUD may have been displaced.
• Check for painful cramps and soreness in the stomach or lower abdomen.
• Check if you experience heavier menstrual bleeding.
• Check if you get sudden chills, troubled breathing or fever, it may be due to an IUD infection. Contact your doctor immediately.
• Check whether you experience bleeding or pain at the time of intercourse.
• Check if the vaginal discharge and its colour, texture or thickness have altered.
• Check whether your body is showing signs of pregnancy.

It is safe to use an IUD while one is breastfeeding, as the presence of an IUD neither affects the milk production nor does it have any impact on the newborn baby.

Before opting for an IUD, a user should not only be aware of its benefits but must also look into its possible disadvantages and side effects to get a complete picture. IUDs though highly versatile and require minimum maintenance, do have some side effects. These advantages, side effects and disadvantages are discussed in the underlying section.

IUD effectiveness comes to 99% in terms of preventing pregnancy and unintended childbirth. They do not require constant monitoring on the part of the user and provide protection for years. One can get an IUD fitted and stay protected from the very first day with minimal maintenance.

Here the top benefits of IUDs are discussed in detail.

1. Highly Effective

IUDs provide 99% effectiveness when it comes to preventing pregnancy.  Unlike pills and condoms, where a new user can face difficulties in dosage or using mechanisms, there is minimal user involvement in case of an IUD. This results in high efficiency in preventing unwanted pregnancies.

2. Convenient

Once inserted, a user does not have to worry about matters like how to use it, which is common in terms of condoms or barrier methods. Similarly, in terms of pills, one needs to maintain a strict vigil over the timings and take the pill routinely on time. There is no such hassle in case of an IUD. It is very easy to use and maintain.

3. Reversible Fertility

If one wishes to become pregnant at any time in the future, then getting the IUD removed will do the job. Once removed, a woman’s fertility is regained back within a week to a few weeks. IUDs do not affect a woman’s fertility and are hence considered reversible contraceptives.

4. Improved Menstrual Cycle

The hormonal IUDs can help to balance the levels of reproductive hormones and can reduce painful cramps and heavy periodic bleeding.

5. Non-Hormonal Measure

Copper IUDs do not have any hormones and are a better option for individuals who are already on hormonal medications or who prefer non-hormonal methods of birth control.

6. Emergency Contraceptive

IUDs are considered highly effective emergency contraception measures. If an IUD is inserted within 5 days or 120 hours of unprotected intercourse, it can still prove to be 99% effective in preventing pregnancy.

7. Long Lasting

The most convenient side of using an IUD is that it is long lasting and can provide protection for as long as 6 years to 12 years, based on specific brands. This is the reason why they are also referred to as “Long-Acting-Reversible-Contraception” or LARC.

Apart from the advantages, a few disadvantages of IUDs are discussed below.

• Some frequent complaints faced after usage are menorrhagia, polymenorrhagia and dysmenorrhea.  
• IUDs do not protect against STDs or STIs.
• Women may run a slight risk of contracting a uterine infection after IUD insertion within the first 2 weeks post insertion. This needs to be treated under medical supervision.
• IUDs may be expelled during periods and bleeding, so one needs to check its placement and contact help if necessary.
• Some women (0.1%) may suffer from uterine perforation followed by pain in the lower abdomen.
• The risk of ectopic pregnancies remains, though getting pregnant with an IUD inserted is a rare occurrence.

Myth 1: IUDs are painful

Truth: The process of insertion may be painful or uncomfortable, but it takes only 5 minutes to complete it. Furthermore, once inserted, the initial cramps often subside within a few weeks. After that, a user may not be able to feel an IUD at all.

Myth 2: IUDs cause infertility

Truth:  An IUD is an irreversible contraceptive, and if removed, a woman can regain her fertility within a week or a month. Thus, they are termed LARC or “Long-Acting-Reversible-Contraception”. 

This article discusses how IUDs help in birth control. IUDs are very effective even as an emergency contraceptive. Furthermore, they offer long lasting action of 6 years or even more and are reversible in nature. Additionally, the risks and IUD side effects have also been discussed to provide a comprehensive idea.