• Intrauterine Device Insertion

    (IUD Insertion; Insertion, Intrauterine Device; Insertion, IUD; Copper Intrauterine Device Insertion; Copper IUD Insertion; Insertion, Copper Intrauterine Device; Insertion, Copper IUD; Hormone-releasing Intrauterine Device Insertion; Hormone-releasing IUD Insertion; Insertion, Hormone-releasing Intrauterine Device; Insertion, Hormone-releasing IUD)

    Definition

    An intrauterine device (IUD) is a type of temporary birth control for women. It is inserted by a doctor.
    There are two types of IUDs:
    • Hormone-releasing—releases the hormone progestin. Can be left in the body for five years before it needs to be replaced.
    • Copper—releases copper ions. Can be left inside the body for 10 years.
    Intrauterine Device
    IMAGE
    Copyright © Nucleus Medical Media, Inc.
    Both devices are shaped like a letter “T” with a tiny string attached. Once the device is removed, most women can become pregnant again.

    Reasons for Procedure

    This procedure is done to prevent pregnancy. It does not protect against sexually transmitted diseases. The hormone-releasing IUD may also have other benefits, such as treating:

    Possible Complications

    Serious complications are rare, but no procedure is completely free of risk. Your doctor will review a list of possible complications, including:
    • Cramping
    • Abnormal bleeding and increased spotting for a few months
    • Irregular or no menstrual period (hormone-releasing IUD)
    • Heavier menstrual periods (copper IUD)
    • Pain when menstruating
    • IUD can slip out of the uterus or vagina
    • Infertility
    • Pelvic infection
    • Damage to the uterus or other pelvic organs
    Even with an IUD inserted, there is a chance that you can still get pregnant. If so, there is a possibility of an ectopic pregnancy. This happens when the fetus develops outside the uterus. Other possibilities include miscarriage, premature labor, or delivery.
    An IUD is not for every woman. Certain things would make a woman a poor candidate for IUD insertion, such as :
    • Pregnancy
    • Vaginal bleeding of unknown cause
    • Deformed uterus
    • History of ectopic pregnancy
    • History of pelvic infection after childbirth or an abortion in the last three months
    • History of pelvic inflammatory disease, unless there has been a normal pregnancy since then
    • Sexually transmitted disease or other infection in the pelvic area
    • Increased risk of pelvic infections
    • Cervical or uterine cancer
    • Liver disease or liver cancer (for the hormone-releasing IUD)
    • Breast cancer (for the hormone-releasing IUD)
    • Allergy to copper (for the copper IUD)
    • Wilson’s disease (for the copper IUD)
    Discuss these risks with your doctor before the IUD insertion.

    What to Expect

    Prior to Procedure

    Your doctor will ask you about your medical history. A physical exam will be done. Tests may include checking for pregnancy or infection.
    You may want to ask someone to give you a ride home after the procedure.

    Anesthesia

    Local anesthesia is used to keep you comfortable during the procedure.

    Description of the Procedure

    This procedure is usually done in an office or clinic setting with no need for an overnight stay.
    You will lie on an exam table and put your feet in foot holders. A speculum will be inserted into your vagina to allow access to the cervix. Your cervix and vagina will be cleansed with an antiseptic. Another tool called a tenaculum will be used to grasp the cervix and keep the uterus in place during the procedure. The doctor will insert a special tool to measure the depth of your uterus to make sure that it will fit the IUD.
    Then T-shaped IUD will be folded and inserted into a tube. The tube will be inserted into your uterus through the vagina. The tube will then be pulled back. The IUD will open into its T-shaped position inside your uterus. The tube and tenaculum will then be removed. The IUD's tiny strings will hang out of your cervix and into the far back of your vagina. The speculum will then be removed.
    Insertion of IUD Into Uterus
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    How Long Will It Take?

    Actual insertion takes about five minutes.

    Will It Hurt?

    You may feel cramping or mild discomfort while the IUD is being inserted. You may be given nonsteroidal anti-inflammatory medication such as ibuprofen an hour before the procedure.

    Post-procedure Care

    At the Care Center
    You may be given medication to ease any discomfort. Once you are ready, you will be able to leave.
    At Home
    Be sure to follow your doctor’s instructions. When you return home:
    • Resume regular activities as soon as you feel comfortable.
    • Check that the strings are present in the back of your vagina each month.
    • Do not drive unless your doctor has given you permission to do so.
    • Ask your doctor when you will be able return to work.
    Copper IUDs are effective immediately.
    Hormone-releasing IUDs are not always immediately effective. Talk to your doctor about alternate methods of birth control until the IUD takes effect.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Notice change in the length of the strings
    • Cannot feel the strings with your fingers
    • Feel the "T" part of the IUD passing through your cervix
    • Think you may be pregnant
    • Heavy periods or periods that last longer than usual
    • Missed, late, or unusually light period
    • You or your partner have or are exposed to a sexually transmitted disease
    • Severe cramps, pain, or tenderness in your abdomen
    • Pain or bleeding during sex
    • Unexplained fever or chills
    • Flu-like symptoms, like muscle aches or tiredness
    • Strange discharge from the vagina or sores on your genitals
    • Unexplained vaginal bleeding
    • Severe headaches
    • Signs of a heart attack or stroke

    RESOURCES

    The American College of Obstetricians and Gynecologists http://www.acog.org/

    Planned Parenthood http://www.plannedparenthood.org

    Women's Health.gov http://www.womenshealth.gov

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Endometrial hyperplasia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated November 20, 2012. Accessed March 11, 2013.

    IUD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated January 20, 2013. Accessed March 11, 2013.

    IUD. Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/iud-4245.htm. Accessed December 30, 2010.

    Johnson BA. Insertion and removal of intrauterine devices. Am Fam Physician. 2005 Jan 1;71(1):95-102.

    Mirena prescribing information. Mirena website. Available at http://berlex.bayerhealthcare.com/html/products/pi/Mirena%5FPI.pdf. Accessed January 10, 2011.

    The American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 110: Noncontraceptive Uses of Hormonal Contraception. Obstet Gynecol. 2010;115(1):206-218. Reaffirmed August 2012.

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