There are a variety of contraceptive measures available to residents of Anguilla allowing them to prevent unwanted pregnancies and also assisting them to plan their reproductive lives. One of the most common long active reversible contractions available in Anguilla is the intrauterine device (IUD) also called the loop or coil.
What is an intrauterine device?
An intrauterine device (IUD or coil) is a small contraceptive device, often ‘T’-shaped, often containing either copper or levonorgestrel which is inserted into the uterus. The IUDs used in Anguilla are very safe and effective especially when inserted by a well-trained and qualified healthcare professional.
The device is inserted in the uterus (womb). The device has one or two threads on the end. These thin threads hang through the opening at the entrance of your uterus (cervix) into the top of your vagina.
There are different types and sizes of IUDs to suit different women. An IUD can stay in for 5–10 years depending on the type. If you are aged 40 or older when the IUD is fitted, it can be left in until the menopause. All intrauterine devices should only be fitted by a trained doctor or nurse. An IUD can be put in at any time in your menstrual cycle if it is certain that you are not pregnant. It will be effective immediately.
Can all women have an IUD?
Most women can use an IUD, including women who have never been pregnant.
Your doctor or nurse will need to ask you about your medical history to check if the IUD is suitable for you. You should give a detailed history and mention any illness or operations you have had as you may require specialist care when the IUD is fitted.
You should not have an IUD fitted if you think you are already pregnant or if you have an untreated sexually transmitted infection or pelvic infection. Avoid an IUD if you have problems with your uterus or cervix or have unexplained bleeding from your vagina (for example, between periods or after sex).
How does the IUD work?
The main way an IUD works is to stop sperm reaching an egg. It does this by preventing sperm from surviving in the cervix, uterus or fallopian tube.
It may also work by stopping a fertilised egg from implanting in the uterus.
How effective is the IUD?
How effective any contraceptive is depends on how old you are, how often you have sex and whether you follow the instructions.
If 100 sexually active women do not use any contraception, 80 to 90 will become pregnant in a year.
There are different types of IUDs. Newer IUDs contain more copper and are the most effective – over 99 percent effective. This means less than two women in 100 will get pregnant over five years.
When to see your doctor after having an IUD?
You should have your IUD checked 3–6 weeks after it is put in. Your doctor will then discuss with you when to have check-ups regarding your reproductive health.
Do contact your doctor or nurse if you have any problems, questions or want it removed. It is important to seek advice if you think you could be at risk of getting a sexually transmitted infection, as this can lead to a pelvic infection.
An IUD can stay in for 5–10 years depending on the type, or longer if you have it put in over the age of 40.
Some things you need to know about the IUD
In some women their periods may be heavier, longer or more painful. This may improve after a few months. This does not occur in the hormonal IUDs where your periods become lighter and shorter.
All women will need an internal examination to check if the IUD is suitable, and so it can be fitted.
The IUD does not protect you from sexually transmitted infections, so you may have to use condoms as well. The IUD does not increase your risk of infection but if you get an infection when an IUD is in place this could lead to a pelvic infection if it is not treated.
There is a very small chance of you getting an infection during the first 20 days after an IUD is put in. You may be advised to have a check with your doctor after it is inserted.
In a very few cases, the IUD can be pushed out by your uterus (expulsion) or it can move (displacement).This is not common. This is more likely to happen soon after it has been put in and you may not know it has happened. This is why your doctor or nurse will teach you how to check your IUD threads every month.
It is not common, but there is a risk that an IUD might go through (perforate) your uterus or cervix when it is put in. This may cause pain but often there are no symptoms. If it happens, the IUD may have to be removed by surgery. The risk of perforation is low when an IUD is fitted by an experienced doctor or nurse.
If you do become pregnant while you are using an IUD there is a small increased risk of you having an ectopic pregnancy. The risk of ectopic pregnancy is less in women using an IUD than in women using no contraception at all.
Removing an IUD
A trained doctor or nurse can take the IUD out at any time. This can be done as an out-patient procedure or in a doctor’s office.
If you are not going to have another IUD put in, and you do not want to become pregnant, use additional contraception such as condoms. Your fertility returns to normal as soon as the IUD is taken out.
If you want to try for a baby, start pre-pregnancy care such as taking folic acid and stopping smoking. You can ask your doctor or nurse for further advice.
Getting pregnant with an IUD
Very few women become pregnant while using an IUD.
If you are pregnant, contact your doctor or nurse to discuss your options as soon as you can. If you want to continue the pregnancy, removing the IUD can increase the risk of miscarriage.
If you do become pregnant there is a small increased risk of having an ectopic pregnancy. An ectopic pregnancy develops outside the uterus, usually in a fallopian tube. If you think you might be pregnant and/or have a sudden or unusual pain in your lower abdomen, seek medical advice as soon as possible. This might be the warning sign of an ectopic pregnancy.
Conclusion
The intrauterine device (IUD) is an effective method of contraception which is also known as ‘the coil’. It is inserted by a trained healthcare professional. Once fitted, it can stay in your uterus (womb) for up to ten years. Most women who use an IUD have no problems with it. If you are interested in this method of contraceptive talk to your healthcare provider today.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
