"The IUD is the world's most widely used method of reversible birth control for women."

There are two types of IUD's currently on the market for use in this country. The copper IUD, also called Paragard, is FDA-approved for 10 years of use, which makes it convenient and inexpensive if used for the full 10 years. The hormonal IUD, or Progestasert, contains the hormone progesterone. It must be replaced every year by your healthcare provider. Both IUDs are excellent at preventing pregnancy, but both can lead to heavier, crampier periods, although this is more likely with the Paragard (copper) IUD. Both are normally given only to women in long-term, mutually monogamous relationships, simply because these women are not likely to acquire STD's. There are various reason for choosing one over the other, but it is something you will need to discuss with your physician.

IUD's in the past were identified with horrible consequences such as infections that literally left some women sterile, as well as other major problems. However, today they are safe and effective with little chance of infection. The greatest risk for any infection would occur at insertion and removal. If you are infection free when it is inserted, and remain in a safe relationship (sexually),. you should not have any problems.

There is some discrepancy in how they work depending on the source, but they may prevent pregnancy by affecting the sperm, eggs, and the lining of the uterus, where implantation of the fertilized egg would occur. The IUD appears to operate in one of the following two ways:

By interfering with migration of sperm from the vagina to the fallopian tube.
By accelerating egg transport through the fallopian tube, thus impeding fertilization.

It is also believed that "while an IUD will indeed prevent the implantation of a fertilized egg, its primary method of action is preventing fertilization in the first place. The copper IUD causes an inflammatory response in the uterine cavity. This prompts an influx of white blood cells that attack sperm. The white blood cells release chemicals that interfere with tubal motility, sperm motility and the sperm activation required before fertilization."

Who Can Use IUDs ?
An IUD may be right for you if:

You want a very effective, long-term, reversible method of birth control.

You have not had pelvic inflammatory disease, gonorrhea, or chlamydia within the past 12 months.

You are not at risk for contracting a sexually transmitted infection

You are breastfeeding.

You cannot use hormonal methods like the Pill because of cigarette smoking or certain conditions like hypertension.

You should not use the IUD if you might be pregnant or if you have:
A sexually transmitted bacterial infection like gonorrhea or chlamydia
had postpartum endometriosis or an infected abortion in the past three months
untreated acute cervicitis or vaginitis, including bacterial vaginosis, until infection is controlled
Abnormal vaginal bleeding
Cancer of the cervix or uterus
Conditions associated with increased susceptibility to infections with micro-organisms, including leukemia, AIDS, and I.V. drug use
certain anatomical abnormalities of the cervix, uterus, or ovaries that would make insertion difficult or dangerous
Abnormal Pap test results or cancer of the uterus or cervix
A bacterial infection—such as actinomycosis—of the reproductive tract
A previously inserted IUD that has not been removed
A uterus that is shorter or smaller than the IUD
No access to medical care if problems develop

IUDs are prescribed by licensed health care professionals. Because some women have physical or medical conditions that may rule out IUD use, it is important to have a pelvic examination and a complete medical history taken. The physical examination will let the clinician know if your cervix, vagina, and internal organs are normal. It is also important to make sure you have no pelvic infection. Simple tests will show if you have a sexually transmitted bacterial infection like gonorrhea or chlamydia, a vaginal infection, early cancer, or any other condition that needs to be treated. A blood sample may also be taken to make sure you are not anemic.

Before insertion, discuss any question you have with your clinician. Learn how to watch for possible side effects or other problems. Be sure to read the package insert that comes with the IUD before you decide to have one inserted.

Your clinician will also provide you with a consent form containing detailed information about the risks and benefits of the IUD you are considering. You need to read, understand, and sign this form before your clinician inserts the IUD.

Warnings that Something Is Wrong with Your IUD:
Tell your clinician immediately if you are not able to find and feel the string; if you think you might be pregnant; or if you have:

Severe cramping or increasing pain in the lower abdomen that may be associated with
Feeling faint
Pain or bleeding during sex
Unexplained fever and/or chills
Increased or bad-smelling discharge
A missed, late, or unusually light period
Unexplained vaginal bleeding after the usual adjustment phase.
If you can't feel the IUD string, your uterus might have pushed out the IUD without your knowing it. It's also possible, although rare, that the IUD may have worked through your uterus into your abdomen. This could result in an internal injury. In either case, medical attention is required.

If you feel the hard plastic bottom of the "T" of the IUD against the cervix, it is not in the correct position and is not protecting you against pregnancy. Tell your clinician immediately.

Infection and the IUD:
Like the Pill, the IUD does not offer protection against sexually transmitted infections (STIs). An STI can permanently damage the reproductive system. If you think you have been exposed to an STI, see your clinician for an examination as soon as possible. Treatment may be necessary. The longer you wait, the greater the risk of developing a serious pelvic infection. Pelvic inflammatory disease may result in loss of fertility, ectopic pregnancy, or surgical removal of the fallopian tubes or uterus.

Possible Problems and Side Effects While Using IUDs:
IUD use offers much less risk to a woman's life and health than pregnancy. However, there are some risks associated with any method of birth control. Serious problems connected with the use of the IUD are rare, but they do happen once in a while. Knowing what could happen is your safeguard. The sooner you report any problems to your clinician, the better your chances of avoiding serious complications.

Heavy Menstrual Flow:
Spotting between periods is common with IUD use. The Copper T IUD may cause a 50 to 75 percent increase in menstrual flow. The Progestasert, on the other hand, frequently decreases the amount of bleeding -- but it has been known to prolong bleeding and increase the incidence of spotting.

Menstrual Cramps:
Copper T IUDs can increase menstrual cramping. The Progestasert may decrease painful periods.

Expulsion:
From 1.2 to 7.1 percent of IUDs are partially or completely expelled from the uterus in the first year, especially in the first few months after insertion. If the expulsion is "silent" and the woman does not notice it, she can easily become pregnant. One out of five expulsions goes unnoticed. One-third of the pregnancies that occur during IUD use are due to "silent expulsions." Expulsion is more likely among younger women and women who have never had a baby. Strenuous physical activity, however, does not affect the position of the IUD.

Uterine Puncture
In one to three out of 1,000 insertions, the uterus is accidentally punctured. This is usually discovered and corrected right away. If not, the IUD can "migrate" through the perforation into other parts of the pelvic area. Although "perforation" sounds painful, it usually isn't. Some women discover it has happened only after becoming pregnant. If an IUD "migrates," surgery may be required to remove the IUD. The removal is usually performed with a laparoscope through a tiny incision below the navel.

Infection
Even though the inserter is sterilized before use, it can push bacteria that are naturally found in the vagina into the uterus. Women using IUDs are more likely to develop a pelvic infection during the four months following insertion. After that time, if a woman and her partner have sex only with each other, there is no greater risk of infection than for women not using birth control.

A mild infection usually clears up with antibiotics without having the IUD removed. Once in a while, more serious infection occurs, and the IUD may need to be removed. In rare cases, infection may cause sterility or the need to remove the reproductive organs. Left untreated, such an infection might become fatal.

Infertility:
Because untreated infections associated with IUDs may make it difficult or impossible to become pregnant, IUDs are generally not recommended for:

·Young women who haven't had any children

Women who want more children

Women who have had trouble conceiving in the past.

However, some women without children choose to use the IUD anyway, because it is so highly effective.

Pregnancy
Most pregnancies happen to IUD users when their IUDs fall out without their knowing it.

Source: ACOG; Planned Parenthood

Disclaimer:
Clitical does not promote one method of birth control over another. This is merely an informational section with guidelines you should consider before choosing the best possible birth control for you and your partner to follow. It is important to see your physician when using some birth control methods and when any problems arise with any of the discussed methods that can be found below.