The IUD, also known as an intrauterine device, is one of the most widely used contraceptives in the world, along with the pill and the condom. The 2.5 to 3.5 cm IUD is inserted into the woman’s uterus. While the first models of intrauterine devices were shaped like a spiral and thus gave them their name, today’s copper IUD is usually T-shaped, made of plastic and has a shaft wrapped with copper wire. Sometimes a gold plate is also incorporated, which makes the IUD easier to see on ultrasound. IUD contraception is considered very safe and can remain in the body for five years if well tolerated.
IUD: effect and function
How exactly the IUD works is not known in detail, experts assume several mechanisms that cause contraception:
- Copper ions released into the uterus have a toxic and inhibitory effect on sperm. Thus, they lose orientation ability, life span and mobility.
- The IUD is a foreign body and thus causes inflammation in the uterine lining, but this is harmless because it is not caused by viruses or bacteria. The inflammatory cells can directly break down sperm; at the same time, by altering the uterine lining, implantation is prevented. In an emergency, therefore, is sometimes used “the IUD after” (similar to the “morning-after pill”).
- The transport of egg and sperm is hindered by influenced function of the fallopian tubes.
- IUD: Insertion only by gynecologist
Insert spiral – remove spiral
Insertion of the IUD is always done in a gynecological office. For this purpose, a special sleeve is used, which facilitates the insertion through the cervix into the uterus. Since the cervix is slightly open during menstruation and pregnancy can usually be ruled out, the gynecologist will insert the IUD during the last days of the period. The IUD is accurately placed with the help of ultrasound; also in this way the position is checked at regular intervals. In addition, women can check the position of the IUD themselves by means of control cords, which can be felt in a similar way to the thread of a tampon. Although the insertion of the IUD does not take long, it usually causes a pulling sensation or pain. Young women in particular, whose uterus is still growing, find the insertion of the IUD unpleasant. It may be advisable to take a painkiller. In rare cases, injuries can occur during the insertion of the IUD.
IUD: side effects and safety
The copper IUD fell into disrepute shortly after its development, as a specific model led to severe inflammation due to design flaws. Modern IUDs also carry an increased risk of infection in the first few months after insertion. Young women in particular experience an increased incidence of pelvic inflammatory disease at the beginning. The risk is increased by frequent sexual intercourse with changing partners. Germs can rise more easily via the thread of the IUD, which in the worst case can even lead to infertility. The risk of the IUD being expelled is also higher in young women and girls and in women who have not yet given birth. In addition, there may be bleeding disorders such as spotting, bleeding between periods or a generally increased and also longer menstrual period. In this case, it may be advisable to have the position of the IUD checked. In addition, the IUD often causes increased discharge. The risk of ectopic pregnancy is also slightly increased with IUD contraception. If a woman becomes pregnant despite using an IUD, she must have it removed. In this case, there is a 20 percent risk of miscarriage, but the risk is even higher if the IUD is not removed.
IUD: contraception suitable for everyone?
IUD contraception is not suitable for everyone because of the disadvantages mentioned above. In general, the use of another contraceptive method is more recommended for the following groups of people:
- Young women and girls who have not yet had a child or whose uterus is still growing.
- Women with cycle and menstrual disorders.
- Blood clotting disorders and anemia
- Inflammation and (suspected) malignant diseases in the uterus and genital area.
In the following diseases, the insertion of the IUD should be used only after careful consideration of the risks with the doctor:
- Benign fibroids of the uterus
- Kidney diseases
- Diabetes mellitus
- Treatments that require the use of diminishing effect on the immune system.
On the other hand, the spiral is suitable for the following people:
- Women who already have children and have finished with family planning.
- Women who can not take hormonal contraceptives or do not want to give up a natural cycle.
- Women who do not want to worry about contraception for a period of several years
The advantages of the IUD are mainly that the user can not commit handling errors (the most common reason for pregnancy despite contraception) and can not be forgotten, such as the pill. Women who already have children can usually cope with the IUD.
IUD: cost and price
The cost of the IUD is borne by the patients themselves, except for women up to the age of 20 and women eligible for social assistance. The cost of the IUD ranges from 25 to 40 euros, depending on the model. The doctor also charges between 80 and 130 euros for the insertion of the IUD. The first ultrasound examination to check the position takes place four to six weeks after insertion of the IUD and is covered by the health insurance. Further check-ups, which are due every six months, must be paid for by the patient. As a rule, the IUD thus provides a less expensive form of contraception than the pill if it is used from a period of at least three years.
