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Inter-uterine devices (IUD)
More than 99% effective.
A small t-shaped device inserted by the doctor that fits inside the uterus. A thread hangs from the uterus into the vagina so a woman can check that it is still in place and the partner cannot feel it.
Two types:
Copper - causes a reaction in the uterus which prevents implantation of a fertilized egg.
Mirena - releases a hormone that changes the lining of the uterus, making it difficult for the egg to grow.
An IUD is a good choice for those in a monogamous, mutually-committed relationship. It can be inserted anytime during the menstrual cycle, however should not be placed during menstruation to ensure the woman is not already pregnant. She should wait 6 weeks after the delivery of a baby in order to reduce the risk of it coming out.
Advantages:
- Inexpensive (Copper)
- The hormonal IUD (Mirena) may reduce cramping
- Long acting. Many doctors now believe it can remain in place for many years
- No daily routine required
- Non-hormonal (Copper)
- Effectiveness is not hindered by other common medications
- Can be used if you smoke
- Neither you nor your partner can feel it
- Possible lighter menstrual bleeding (Mirena)
Disadvantages:
- Cost (Mirena)
- Unpredictable bleeding and other side effects, particularly in the first few months
- May be difficult to insert in some women
- Increased risk of pelvic infection mainly associated with insertion (we recommend swabs first to rule out possibility of pelvic infection at time of insertion)
- Does not protect against sexually transmitted infections
- Period may be longer or heavier and increase cramping (Copper)
- Rarely an IUD may puncture the wall of the uterus
- Increased risk of benign ovarian cysts (Mirena)
Women with the following conditions should NOT use a Copper IUD:
- Currently pregnant
- Allergic to copper
- Large fibroids or uterine cancer
- Weakened immune system
- Heavy periods or severe cramps (does not apply to Mirena)
- Unusual undiagnosed bleeding from the vagina
- Have had recent or chronic pelvic infections or current vaginal or cervical infection
- Women at increased risk of sexually transmitted infections
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