IUD Insertion and Removal

IUD Insertion and Removal

Is an intrauterine device (IUD) that can be used to prevent long-term pregnancy (birth control). It may be called a “nonhormonal IUD option.

The IUD device is a T-shaped plastic structure that is inserted into the uterus. The copper coiled wire around the device produces an inflammatory reaction that is toxic to sperm and ovaries, preventing pregnancy.

IUD is the only copper IUD available in the United States. This device can prevent pregnancy for up to 10 years after insertion.

Why it is done
IUD offers an effective, long-term method of birth control. It can be used for premenopausal women of all ages, including adolescents.

These are some of the benefits of IUD:

• Eliminates the need to interrupt sexual activity for contraception
• Stays in place for up to 10 years
• Can be removed at any time
• Can be used during breastfeeding
• No risk of side effects, such as blood clots, related to hormonal contraceptive methods
• Can be used as emergency contraception if inserted within five days after unprotected intercourse

IUD is not suitable for everyone. The health professional may advise against the use of IUD in the following cases:

• You have uterine abnormalities, such as large fibroid, that interfere with the placement or retention of IUD
• Have a pelvic infection, such as pelvic inflammatory disease
• Have cancer of the uterus or cervix
• You have unexplained vaginal bleeding
• Are you allergic to any component of IUD
• Have a disorder that causes an excessive buildup of copper in the liver, brain, and other vital organs (Wilson’s disease)

Risks
Less than 1 percent of women using IUD will become pregnant in the first year of usual use.

If you become pregnant while using the IUD device, you are at high risk for ectopic pregnancy (when the fertilized egg implants outside the uterus, usually in a fallopian tube). But because the IUD device prevents most pregnancies, the overall risk of having an ectopic pregnancy is lower than for sexually active women who do not use any contraceptive method.

The IUD device does not offer protection against sexually transmitted infections.

Side effects associated with the IUD include the following:

• Bleeding between menstrual periods
• Cramps
• Severe menstrual pain and heavy bleeding
• There is also the possibility of expelling the IUD device from the uterus. If this happens, you may not feel it.

You may be more likely to expel it if:

• You have never been pregnant
• Have heavy or prolonged menstrual periods
• You have severe menstrual cramps
• You have previously expelled an IUD
• You are less than 25 years old
• Had an IUD inserted immediately after childbirth

How to Prepare
The IUD can be inserted at any time during a normal menstrual cycle. If you have just had a baby, your doctor may recommend that you wait about eight weeks after delivery to insert the IUD device.

Before inserting the IUD device, your health care provider will assess your overall health and perform a pelvic exam. You may need to have a pregnancy test to confirm that you are not pregnant and tests for sexually transmitted infections.

Taking a non-steroidal anti-inflammatory drug, such as ibuprofen (Advil, Motrin IB, or others) one to two hours before the procedure can help reduce pain.

What to Expect

Placement of IUD
The IUD device is usually placed in the health care provider’s office.

During the procedure
The health care provider will place a speculum in the vagina and clean the vagina and cervix with an antiseptic solution. A special instrument may be used to gently align the cervical canal and uterine cavity. In the next step, the health care provider will bend the horizontal arms of the IUD device and place it into an applicator tube.

The tube is inserted into the cervical canal and the IUD device is carefully placed into the uterus. When the applicator tube is removed, the IUD device will remain in place. Your health care provider will trim the threads from the IUD device so that they do not protrude too far into the vagina and can record the length of the threads.

During IUD insertion, you may have dizziness, fainting, nausea, low blood pressure, or a slower-than-normal heart rate. Your health care provider will probably suggest that you lie down for a few minutes to let these side effects go away. It is possible, though rare, for the IUD to pierce the uterine wall or cervix. If this complication occurs, the health care provider will discuss the appropriate treatment.

After the Procedure
About a month after insertion of the IUD device, your health care provider may reexamine you to make sure you have not moved and to check for signs and symptoms of infection.

While using the IUD system, contact your healthcare provider immediately if you have any of the following:

• Signs or Symptoms of Pregnancy
• Unusually heavy vaginal bleeding
• Unpleasant vaginal discharge
• Worsening of pelvic pain
• Severe abdominal pain or tenderness to touch
• Fever for no apparent reason
• Possible exposure to a sexually transmitted infection

It is also important that you contact your healthcare provider immediately if you believe the IUD device is not in place. Call your doctor if any of the following occurs:

• If you have breakthrough bleeding or bleeding after sex
• If sex is painful for you or your partner
• If the threads are gone or suddenly look longer
• If you can feel the device in the cervix or vagina

The health care provider will verify the location of the IUD system and may remove it if necessary.

Extraction
The IUD device is usually removed in the health care provider’s office. The professional may use tweezers to grasp the threads of the device and pull gently. The arms of the device will bend upward as they are removed from the uterus.

Mild bleeding and some pain are common during removal. Rarely, removal may be more complicated.