IUDS - intrauterine devices
There are three IUDs approved for use at this time. They are both small T-shaped devices inserted in the office. As a group they act by preventing implantation. They all have very high efficacy rates of preventing pregnancy, i.e. 1/300 :
None of them protect against sexually transmitted infections. If in the rare event a pregnancy occurs when an IUD is in place, it has a higher chance of being an ectopic, or tubal pregnancy.
A tubal pregnancy is a life threatening condition, and may be treated medically or surgically.
The two IUDs have some important differences:
Mirena - This device is imbued with a slow release progesterone which renders the lining of the uterus inhospitable for implantation of the fertilized egg. The Mirena is not believed to deliver a systemic dose of progesterone into the body. That is why systemic side-effects are not seen with this method. Its use is accompanied by spotty random bleeding, which, usually, over time, may go to no bleeding at all. This IUD lasts 5 years.
Skyla - This IUD is just like Mirena, imbued with a long acting progesterone, but lasts 3 years instead of 5. Additionally, it is smaller, to fit in a smaller uterus, such as those belonging to women who have not had children.
Paraguard - This IUD has no hormone and is made of copper. It lasts ten years. The Paraguard is associated with heavier crampier bleeding.
The procedure of IUD insertion:
Your IUD will be placed in the office, and a local anesthetic will be used if needed. It is reasonable to take some acetaminophen (Tylenol) or ibuprofen about a half hour beforehand since the procedure can make brief cramps.
The procedure will be reviewed with you and we will ask you to sign a consent. We will verify that you are not pregnant. We place a warm pack on your lower abdomen which greatly helps prevent cramps. The cervix will be cleaned, the uterus measured and the IUD inserted. Occasionally dilating of the cervix will be needed, and if so a local anesthetic will be applied. The string will be cut to a convenient length so you can reach it, but not so long that it will be in the way.
You will be asked back in for a one month follow up and are encouraged to call with any questions or concerns.
Click here for your Post IUD precautions and instructions sheet.