The intrauterine contraceptive device, also known as the coil or loop, is one form of contraception that is available in Anguilla. It is an effective method of long term contraception.There are various methods of contraceptives available in Anguilla, but women (and men) should know of the advantages and disadvantages of all the methods prior to making an informed choice of family planning.
What is an intrauterine contraceptive device?
An IUCD is a small device made from plastic and copper. It can be placed quite easily into the uterus (womb) by a trained doctor or nurse.
It works mainly by stopping the egg and sperm from meeting. The copper also has a spermicidal effect (kills sperm).
How effective is the intrauterine contraceptive device for contraception?
Modern IUCDs are very effective. Fewer than 2 women in 100 will become pregnant with five years of use of this method. Compare this with when no contraception is used. More than 80 in 100 sexually active women who do not use contraception become pregnant within one year. There are many different types of IUCDs. Most copper coils will work well for at least five years. Some types work for ten years.
What are the advantages of the intrauterine contraceptive device?
Unlike the oral contraceptive pill, you do not need to think about contraception everyday. It does not interfere with sex. It is not a hormonal method so it has no side-effects on the rest of the body. This means that it will not affect your mood, weight or libido. Having an IUCD does not increase your risk of having any type of cancer in the future. Other benefits include the following:
• Eliminates the need to interrupt sex for contraception or seek partner compliance
• Can remain in place for up to 10 years
• Can be removed at any time, followed by a quick return to fertility
• Decreases the risk of endometrial cancer and possibly cervical cancer
• Can be used while breast-feeding
What are the disadvantages of the intrauterine contraceptive device?
There are some situations where an IUCD is not recommended, such as undiagnosed, irregular vaginal bleeding and pelvic infection. Your doctor or nurse will make sure it is safe for you to use a coil, by asking questions about your health.
Although the majority women with an IUCD have no problems, the following may occasionally occur:
Heavy, painful periods
Some women find that their periods become heavier, longer or more painful with an IUCD. This tends to be in the first few months after insertion and then often settles. This means that the IUCD may not be suitable if you already have heavy or painful periods. There is a special IUCD called the intrauterine system (IUS) which is like an IUCD, but it also releases a progestogen hormone into the uterus. This is an effective treatment for heavy periods as well as a contraceptive.
Painful, heavy periods can still be treated in the same way as in women who do not have an IUCD.
Infection
There is a small risk of an infection of the uterus (pelvic infection). The main risk of infection is within the first 20 days after insertion. A check for infection of the vagina or cervix may be advised prior to insertion of the IUCD. You should not have an IUCD inserted if you have an infection which has not been treated.
Ectopic pregnancy
The chance of becoming pregnant is very small if you use an IUCD. However, if you do become pregnant, there is a slightly increased risk of having an ectopic pregnancy. This means the pregnancy is not in the uterus. This is rare, but serious. See a doctor urgently if you miss a period and develop lower abdominal pain. As the IUCD prevents most pregnancies, women who use it are at lower risk of having an ectopic pregnancy than are other sexually active women who are not using contraception.
Expulsion
Rarely the IUCD may come out without you noticing. This may happen during a period, most commonly in the first three months. It is a good idea to check. You can feel the threads of the coil after your period. If you cannot feel them, you should use extra precautions such as a condom, until your doctor has checked the coil is still there. The doctor may ask you questions to see whether you need emergency contraception.
How is the intrauterine contraceptive device fitted?
This is usually done towards the end of a period or shortly afterwards. However, it can be fitted at any time provided that you are certain you are not pregnant. You will need to have a vaginal examination.
Fitting an IUCD can sometimes be uncomfortable. Once the IUCD has been inserted, some women have crampy pains, like period pains, for a few hours afterwards. These can be eased by painkillers such as paracetamol or ibuprofen. Light vaginal bleeding may also occur for a short while.
Follow-up
The doctor will usually want to check that there are no problems a few weeks after fitting an IUCD. It is best done after your next period. After this, there is no need for any routine check until it is time to remove the IUCD. However, return to see your doctor or nurse at any time if you have any problems or queries. Most women have no problems, and the IUCD can remain in place for several years.
An IUCD can be removed at any time by a trained doctor or nurse. If you plan to have it removed, but do not want to get pregnant, then you should use other methods of contraception (such as condoms) for seven days before it is removed. This is because sperm can last up to seven days in the uterus and can fertilise an egg after the IUCD is removed. It is important that health providers recommending the removal of the IUCD, advise women on the need for other forms of contraception. Very often many women become pregnant shortly after removal of the coil.
You should consult a doctor if any of the following occurs:
• Prolonged abdominal pain after an IUCD is inserted.
• A delayed period or bleeding between periods.
• A delayed period and lower abdominal pain (which may be due to an ectopic pregnancy).
• Vaginal discharge with or without pain (which may indicate infection).
• If you suspect that the IUCD has come out or is coming out. It is usually possible to feel the threads of the IUCD inside the vagina to check it is in place. If you cannot feel the threads then use other contraceptive methods (such as condoms) until you have been checked by a doctor or nurse.
Conclusion
The intrauterine contraceptive device, also known as the loop or coil, is an effective method of long term contraception available in Anguilla. Like all forms of contraception, the individual should be aware of all the advantages and disadvantages of the IUCD prior to its insertion. Your gynaecologist, nurse or any member of the Anguilla Family Planning Association, will be able to provide important information on the IUCD.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
