INSERTION OF INTRAUTERINE DEVICES
An intrauterine device (IUD) is a small device which is
inserted into the uterus as a contraceptive to prevent pregnancy or to treat a condition such as heavy menstrual bleeding or endometriosis.
Intrauterine devices are among the most effective forms of reversible birth control with very low failure rates ranging from 1-4% depending on which device is used. There are four types that can be inserted. Mirena and Kyleena are hormonal intrauterine systems or devices which release small amounts of the hormone progestin into your uterus. Copper T and Ballerine are copper containing non-hormonal devices, they prevent pregnancy by triggering an inflammatory reaction within the uterus. The insertion is a minor medical procedure that only takes a few minutes.
The procedure
No incisions are needed to place an IUD and thus this simple procedure can be done on an outpatient basis in Dr Guzha’s rooms. Once you have removed your clothing from the waist down, you will be asked to lie on your back. Dr Guzha will ensure you are comfortable during the entire procedure. With your legs open, she will do a pelvic exam and cleanse the vagina before inserting a speculum to open the vagina. Medication may be offered to help open or numb the cervix before the IUD is placed. The chosen IUD is then inserted into the uterus through the cervix /mouth of the womb. You may feel some pain and discomfort similar to cramps or period pains at this moment. While each woman’s experience is different, the pain experienced during placement of an IUD should only last for a minute or two. The entire procedure only takes a few minutes. After the procedure patients may experience mild lower back pain or cramping and may also have some mild vaginal bleeding. These symptoms are similar to menstruation and menstrual pain. This discomfort should resolve within the next few hours or day.
After the insertion
Some people feel dizzy during or right after the IUD is put in place. In rare cases, fainting occurs. It is advised to bring someone along with you to the insertion of your IUD to drive you home afterwards. You may want to rest for the remainder of the day should you experience some cramping and backache, but you should be fine to return to work or school immediately after the procedure. Heating pads and over-the-counter pain meds can help ease cramps in such cases. Doctor will prescribe some pain medication for you should you wish to use it.
Following insertion of an IUD, it is normal to notice some spotting. This may last for 3-6 months after the procedure. Hormonal IUDs such Mirena and the Kyleena may make your menstrual bleeding lighter and less crampy, and in some cases, stop your menstruation all together. Copper IUDs such as the Copper T and Ballerine on the other hand may make menstrual bleeding heavier and more painful initially but this mostly settles down. If your IUD is causing you pain, discomfort, or other side-effects do consult Dr Guzha.
Each IUD varies in how long its effects last and thus will need to be replaced at some point. The IUDs describe can be placed for 5 years and in certain instances even longer. Make sure to note when your IUD was placed so that you know when to have it replaced.
Complications and safety
Each IUD has a string attached. This string is about 2cm long and is there to allow your IUD to be removed. You shouldn’t notice it, but should you feel it, do not pull it as you may move your IUD out of place or dislodge it. Occasionally sexual partners report feeling the strings at intercourse, in that instance contact Dr Guzha and she will cut the strings shorter.
If you are not menstruating at the time your hormonal IUD placed you may need to use additional contraception for 7 days to prevent unwanted pregnancy. If a copper IUD is placed, the effects are more immediate.
In rare cases, an IUD can become expelled or dislodged on its own. If this occurs, you may become pregnant if you engage in unprotected sex. In such cases you should contact your gynaecologist immediately to have it reinserted. In even rarer cases it has been reported that IUDS have perforated the uterus and migrated into surrounding structures. This can mostly be prevented by correct placement followed by a placement sonar. Should this occur and the device can not be located in the uterus a surgical procedure may need to be done to locate it and remove it.