IUD Health Article

Definition

An IUD is an intrauterine device made of plastic and/or copper that is inserted into the womb (uterus) by way of the vaginal canal. One type releases a hormone (progesterone), and is replaced each year. The second type is made of copper and can be left in place for five years. The most common shape in current use is a plastic "T" which is wrapped with copper wire.

Purpose

IUDs are used to prevent pregnancy and are considered to be 95–98% effective. It should be noted that IUDs offer no protection against the acquired immunodeficiency syndrome (AIDS) virus or other sexually transmitted diseases (STDs).

Precautions

IUDs are placed in the uterus by physicians. Prior to placement the doctor will take a medical history, do a physical examination, and take a Pap test. Women who have had tubal pregnancies, an abnormal Pap smear, or abnormal vaginal bleeding are generally disqualified from using this form of contraception. Also, women who have STDs, an allergy to copper, severe pain with periods (menstruation), sex with multiple partners, or who are currently pregnant are not eligible for an IUD. There are no age restrictions.

Description

There is continuing controversy over exactly how IUDs prevent pregnancy. Some researchers think pregnancy is controlled by preventing conception (fertilization), while others believe that the devices prevent embryo attachment to the uterine wall (implantation).

IUDs that release a hormone may prevent pregnancy in several ways. Since one hormonal response is a thickening of the mucus at the entrance to the uterus, it is more difficult for the sperm to gain entry. This prevents the sperm from reaching an ovum. At the same time, the lining of the uterus becomes thinner, making it more difficult for a fertilized egg to implant itself in the uterus. The copper device slowly releases copper, which is believed to weaken and perhaps kill sperm. An alternate explanation is that these objects "sweep" the uterus, dislodging any fertilized egg that attempts to implant itself. In addition, both devices tend to cause a mild inflammatory reaction in the lining of the uterus, which also has an adverse impact on implantation.