IUD 08

Naomie & Julia, Sandy & Stephanie

What does IUD mean?

IUD is the abbreviation for Intra Uterine Device, which is a birth control instrument inserted within the uterus, containing active elements, such as copper or hormones. It is a flexible T-shaped plastic device with a string attached to its end.

you could give here a more precise definition--Pierre.brawand 17 janvier 2009 à 20:22 (MET)

What are the roles of IUDs?

The role of an IUD is to avoid sperm cells encountering an ovum. The basic IUD modifies neither the uterine cycle nor the ovarian cycle. The menstruations are not induced by IUDs. If a woman has irregular cycles, the IUD won't regularize them, unlike the pill.

I would recommend that you either develop this topic or suppress it. You could possibly transfer some information from this topic to others (e.g. 'How IUDs work'). I am afraid that, as it is, it looks rather strange and out of context. - Julia 21 janvier 2009 à 20:26 (MET)

How does it work?

No one is completely sure about the exact way IUDs prevent pregnancy. However, it is commonly believed that it can have the three following effects:

• Affecting sperm movements and preventing its survival in the uterus by making the environment more hostile. This ensures that sperm cellls will not be able to go through to the egg and fertilize it.
• Changing the lining of the fallopian tubes, which prevents ovulation - hence, there is no egg to fertilize.
• Inhibiting the thickening of the endometrium and thus leaving no space where a fertilized egg could implant.

What types of IUDs are there?

The two exisiting IUD types are copper IUDs and hormonal IUDs. Hormonal IUDs are statistically slightly more efficient than copper IUDs.

Copper IUDs

A copper wire is wrapped around the stem of such devices. Copper particles released by such an IUD influence the uterus and fallopian tubes, making them produce a sperm-killing liquid containing white blood cells, copper ions, enzymes, and prostaglandins.
The most widely known copper IUD is called Paragard.

Hormonal IUDs

These devices usually contain progestin, a hormone with effects similar to those of progesterone. It prevents the endometrium from becoming too thick and makes the mucus in the cervix more sticky, so that the sperm cannot get through to the uterus.
The most frequently used hormonal IUD is the levonorgestrel (LNg) IUD, commonly known as Mirena; levonorgestrel is a form of progestin.
Julia 17 janvier 2009 à 11:09 (MET)

you should consider here showing a figure with an Annex. I'll show you how to proceed...--Pierre.brawand 17 janvier 2009 à 20:24 (MET)

Emergency IUDs

An other type of IUD is used in case of emergency contraceptive method. It is called Copper T IUD. This IUD can be inserted up to 5 days after unprotected sex and will prevent the implantation of the possible fertilized egg in the endomentrium. It can also be left inside the uterus and be used as a normal contraceptive method for several years.

Cf 'When would a woman use an IUD as a contraceptive method?' Please, either transfer the information to that topic or erase the last part of my article, completing yours.Julia 22 janvier 2009 à 20:25 (MET)

Does an IUD protect from STDs (= sexually transmitted diseases)?

No, so condoms are highly recommended even while using an IUD. In fact, if girls, who use IUD methods, have many partners and don't use condoms, the risk of getting STDs is greater and these diseases can develop into a pelvic infection.

How is an IUD inserted and when?

Before inserting an IUD, a woman has to undergo a clinical check, where the position and the size of the uterus are checked, as well as the possible presence of an infection. The insertion itself seldom takes more than 20 minutes. The cervix is cleansed with an antiseptic and held in place by a tenaculum, then the IUD, folded inside a long insertion tube, is introduced into the uterus and slowly released from its container by withdrawing the latter. The IUD thus unfolds into its usual "T" shape. The string of the device protrudes from the cervix, allowing a verification of the IUD's presence, as well as its removal, if needed. An anaesthetic may be used during the operation to relieve possible pain.
Although an IUD can theoretically be inserted at any time during the menstrual cycle, it is recommended to install it during the phase of menstrual bleeding in order to be sure the woman is not pregnant and to make the insertion procedure more comfortable. If the IUD is inserted during a different phase, one should take a hormonal contraceptive (for example, the pill - information at Pill_08) until the next menstruation. An IUD can also be installed immediately after childbirth or after an abortion (cf Abortion_08) made during the first trimester of pregnancy.
Julia 17 janvier 2009 à 11:09 (MET)

Once inserted, how should one check the IUD?

After each period, the woman should check whether the IUD has not been expulsed by verifying the presence of the string in her uterus. In additian, yearly checkups are required.

When would a woman use an IUD as a contraceptive method?

IUDs are recommended to women who are in a stable monogamous relationship and want a long-term contraception without much effort. Polygamous relations on either the woman's or on her partner's side increase the risks of getting a STD, from which the IUD is unable to deliver a protection - that is why the relationship has to be stable. The IUD will be easier accepted by the organism of a parous woman (i.e. a woman who has already given birth), because there is less risks that the IUD is expelled from the uterus. An IUD is frequently used by women who cannot use other means of birth control, for example, if they are allergic to estrogen or are breastfeeding; however, a breastfeeding women must realize that if she uses a hormonal IUD, the secreted hormone will be contained in the breast milk. Smokers who are over 35 years old also ought to avoid hormonal means of birth control.

A copper IUD can also be used as a means of emergency contraception within a week after an unprotected intercourse (for more info Emergency_contraception_08).
It either stops the sperm cells from fertilizing the egg, or prevents the implantement of an egg that has already been fertilized. It is extremely effective: in fact, out of 1000 women who use a copper IUD for emergency contraception, only one will become pregnant - which means a 99.9% efficiency. This rate is considerably higher than that of an emergency contraceptive pill.

Julia 27 janvier 2009 à 16:30 (MET)

Good. Maybe explain why IUD is recommended for women with a stable relation,etc...--Pierre.brawand 17 janvier 2009 à 20:25 (MET)

In which cases should a woman not use an IUD?

The use of an IUD, in general, is not recommended for a woman who:

• Knows or suspects she is pregnant
• Has a STD or has had one within the past 3 months
• Has a recent or current pelvic inflammatory disease (PID) - an infection of the uterus, cervix, fallopian tubes or ovaries, caused by some STDs
• Has lesions in the genital tract
• Has unexplained uterine bleeding
• Has a structural abnormalty of the uterus
• Does not intend to use condoms to protect herself from STDs

More particularly, a copper IUD should not be used if the woman:

• Has bleeding disorders or is taking anticoagulants
• Is allergic to copper
• Has Wilson's disease, a genetic defect causing an accumulation of copper in a person's liver or brain

In these three cases the woman can still use a hormonal IUD.

There are different opinions as to the case when a woman has had an ectopic pregnancy ( i.e. when a fertilized egg attaches itself outside the uterus - see Pregnancy Childbirth 08): some sources say IUDs can be used quite safely, while others state that these devices should be avoided.

Julia 27 janvier 2009 à 16:40 (MET)

What are the advantages of IUDs?

The IUDs prevent contraception for a quite long period of time, which varies in function of the type of IUD.

The copper-containing IUD:

• effective for ten years after insertion
• the costs of IUDs are about $250, so if it is used for a long-term period, it becomes very cheap
• it is highly effective, 99.5 %, the risks of getting pregnant is less than 1%, which is very low
• after insertion, we do not have to pay much attention to the IUD, we just have to do gynaecologic controls as usual

The hormonal IUD: as this IUD contains hormones, women have about the same advantages as using a pill, which means less painful menstruations, lighter periods than the other IUDs, does not require much attention of the women

References

the links below might help... especially the first one in French...!--Pierre.brawand 17 janvier 2009 à 20:21 (MET)

1. http://www.snv.jussieu.fr/vie/dossiers/levoru486/images/modes_contraception.swf
2. http://www.fpa.org.uk/information/leaflets/documents_and_pdfs/detail.cfm?contentid=151
3. http://www.jr2.ox.ac.uk/bandolier/band35/b35-2.html
4. http://www.drspock.com/article/0,1510,5541,00.html

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