Birth control and you: The IUCD
THE IUCD (intrauterine contraceptive device) is a small flexible T-shaped device (about the size of a matchstick), which is inserted into the uterus to prevent pregnancy.
Obstetrician-gynaecologist Dr Anna-Kay Taylor Christmas says insertion is a quick and simple procedure that is done in an office or clinic allowing the woman to go home and continue normal activities immediately after.
“It is inserted through the vagina and cervix with the aid of a speculum to allow proper visualisation. It has a very thin string at the end that allows the woman and her health-care provider to check that the device is still in place,” she said.
Dr Taylor Christmas explained that the IUCD may contain hormones and last for three to five years, or may be non-hormonal and contain copper, which lasts for 10 years.
She said many women express fears and concerns about the effects of insertion and the IUCD itself, but these are unfounded.
“Patients have shared fears about cancer, bleeding and infection when being counselled about the device. However, when properly selected, the IUCD is an excellent contraceptive option with one of the lowest risks of pregnancy outside of tubal ligation,” she said.
Side effects include:
1. Irregular bleeding.
2. More severe infection if one is contracted after placement. Dr Taylor Christmas explained that the IUCD is not inserted if an active infection is suspected, and may not be a good choice for women who get frequent pelvic infections. The IUCD does not cause or increase the risk for infections.
3. Pain may be experienced. According to the ObGyn, this usually occurs in the time shortly after insertion and is usually similar to period cramps. She said it is typically relieved by pain tablets, either over the counter or prescribed by the doctor.
4. Damage to uterus wall. Dr Taylor Christmas said this rarely occurs, where the IUCD goes through the uterus during insertion. She said once it is properly in place, migration of the IUCD is rare, although it can happen if left in place for too long beyond the recommended time span.
5. It can fall out. Dr Taylor Christmas said the risk of this happening is greatest in the time shortly following insertion and in patients who have uterine abnormalities like fibroids. “There is a follow-up exam to confirm placement and patients are encouraged to check for the string at home also,” she said.
6. Ectopic pregnancy. “If pregnancy does occur with the IUCD in place, there is an increased risk of an ectopic pregnancy — pregnancy in the tubes. So a woman with an IUCD who suspects she is pregnant should see a doctor immediately,” Dr Taylor Christmas said.
Of note, she explained that the IUCD does not prevent STIs, so a condom is still needed for protection from infections. She added that the string is thin and it is rare for the woman’s partner to be bothered by it during intercourse.
“It is cut very short, resting in the top of the vagina, and is therefore not visible from the outside,” she said.
— Kimberley Hibbert
