Intrauterine Device
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What is an intrauterine device?


What is an intrauterine device? 

An intrauterine device (commonly known as IUD) is a small T-shaped device used as a means of birth control through insertion into a woman’s uterus. Having an intrauterine device implanted means that changes will occur in the uterus that will make it difficult for fertilization and implantation of an egg to take place. IUDs have proven to be over 99% effective in preventing pregnancy. 

While IUDs are highly effective, it is not, along with other birth control methods, except abstinence, considered to be 100% effective.

Types of intrauterine device 

There are 2 types of intrauterine device:

  • Hormonal intrauterine device: This is made of plastic and fortified with progesterone hormone, which it releases upon being implanted.
  • Non hormonal intrauterine device: This is made of and plastic, and fortified with copper.

Insertion of intrauterine device 

  • The procedure for the insertion of an intrauterine device, IUD, is similar to that of getting a Pap smear. 
  • The patient places their feet in stirrups, and a speculum is placed in the vagina to hold it open. 
  • The IUD is placed in a small tube and inserted into the vagina. The tube is passed through the cervix to get to the uterus. At the uterus, the IUD is pushed out of the tube and the tube is pulled out. 
  • The strings attached to the IUD is hanged 1-2 inches into the vagina.
  • The procedure may be discomforting, with cramps and bleeding, but these tend to go away in a few days. 

Removal of intrauterine device 

For the removal of the intrauterine device, the patient places her feet in stirrups and with the aid of forceps, the IUD is slowly pulled out. This may be accompanied by some cramping and bleeding but should go away in 1-2 days.

The removal of the intrauterine device only takes a few minutes.

Intrauterine device mechanism of action

The mechanism of action of the intrauterine devices is not fully understood. However, it is thought they prevent conception by causing brief localized inflammation, which begins about 24 hours after insertion. The inflammatory reaction caused inside the uterus then attracts white blood cells, which in response produce substances that are toxic or poisonous to sperm. 

  • For the Hormonal intrauterine device, which are progesterone-releasing; they cause a subtle change in the lining of the uterus which impairs the implantation of eggs in the uterine wall. Hormonal intrauterine device also alters the cervical mucus by thickening the mucus at the entrance of the uterus. This, in turn, inhibits sperm from passing through the cervix.
  • For Non-hormonal intrauterine devices, which are fortified with copper; the copper-contained in a non-hormonal intrauterine device is toxic to sperm, and makes it harder for sperm to reach and fertilize an egg. Non hormonal intrauterine device also changes the lining of the uterus to prevent fertilised egg(s), from attaching and developing in the uterus.

Who can use an intrauterine device?

Most women can use an intrauterine device. IUD may, however, not be suitable for those who:

  • Are pregnant.
  • Have an untreated STI, or an untreated pelvic infection. 
  • Have problems with their womb or cervix.
  • Experience unexplained vaginal bleeding between periods or after sex.
  • Are suffering from cancer of the cervix or uterus.
  • Have liver disease. 
  • Have breast cancer, or are at a high risk of it.

Benefits of intrauterine devices

  • It offers 5 or 10 years protection against pregnancy, depending on the type though.
  • Starts working immediately it is implanted.
  • Most women can use an intrauterine device.
  • No hormonal side effects; like acne, headaches or breast tenderness.
  • Does not interrupt sex.
  • It’s safe to use for breastfeeding mothers.
  • There’s a possibility of getting pregnant as soon as it is removed.
  • It’s not affected by other medications.
  • There’s no evidence that it increases the risk of cervical cancer, ovarian cancer or cancer of the uterus.
  • It has proven to be highly effective; with 98 to 99 percent success rate.
  • It does not cause weight gain.
  • It does not affect mood or sex drive


What are the probable complications of an intrauterine device? 

  • Periods may become heavier, longer or more painful. This, though, will likely improve after a few months.
  • It doesn’t offer protection against STIs.
  • Vaginal bleeding and pain.
  • Menorrhagia is a frequent complaint from users of intrauterine devices. So are dysmenorrhea and polymenorrhea. These are some of the major reasons for IUD discontinuation amongst others.
  • 1% risk of acquiring a uterine infection during an IUD insertion within 20 days of the procedure. 
  • The pelvic inflammatory disease may occur if STIs are contracted.
  • High risk of ectopic pregnancy if conception occurs with an intrauterine device in situ.
  • Perforation of the uterine wall. 
  • The device may become embedded in the muscle wall of the uterus.

Does the intrauterine device hurts or causes any discomfort? 

It is common and expected to feel some discomfort with the insertion of an intrauterine device. About two-thirds of persons report feeling mild to moderate discomfort during insertion of intrauterine devices. The discomfort is, however, short-lived, and less than 20% of people require treatment.

Is an intrauterine device safe to use? 

In spite of its troubled past, the modern intrauterine device has become very effective and safe to use, with very rare severe complications.

How effective is an intrauterine device?

If correctly used, the chances of getting pregnant with an intrauterine device are less than 1%.

Will the use of an intrauterine device change my period?

For hormonal intrauterine devices, there are fewer cramps and irregular spotting for the first few months. In the long run, most women experience light periods or have no period at all. 

The non-hormonal intrauterine device may make periods heavier than normal and worsen cramping.

What are the warning signs and symptoms of possible complications from an intrauterine device?

Warning signs of possible complications of the intrauterine device may be;

  • Abdominal pain.
  • Heavy bleeding.
  • Abnormal spotting or bleeding.
  • Smelly vaginal discharge.

Is the use of an intrauterine device risky?

There is a risk of infection with intrauterine device use, especially during insertion. 

In very rare situations, an intrauterine device may penetrate the uterine wall. 

If pregnancy occurs while on an intrauterine device, there is an increased risk to the pregnancy.

Can an intrauterine device fall out? 

This is likely to happen if:

  • You’ve yet to have children.
  • You’re less than 20 years old.
  • There are fibroids in your uterus.
  • Your uterus has an unusual size or shape.
  • Intrauterine devices are also more likely to come out during the period.

What if I want to have kids?

If you want to get pregnant and have kids, just have the intrauterine device removed. As soon as this is done, your menstrual cycle should return to normal.

How long does an intrauterine device last?

The non-hormonal intrauterine devices can remain in place for up to 10 years, while the hormonal intrauterine devices can only remain in place for 3 or 5 years.

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