Guardians of the womb
EVERY territory at some point in time needs some form of defence mechanism. For the womb that wishes to no longer bear fruit or needs a break from the season, an adequate front-line battalion is that of the intrauterine contraceptive device.
For decades, this device has been used in the prevention of pregnancy. To date, the main types of these devices are the copper T and the Mirena.
Both devices are long-term, and when removed, fertility is immediately restored. They are both effective and have a failure rate of 1/200 (that is, for every 200 women who use it, one will become pregnant). Both devices are ‘T’- shaped and can be inserted into the uterus through the vagina very easily in the doctor’s office. They possess two strings which are about the length of a fingertip which are present at the cervix (opening of the uterus). These strings are necessary for removal of the devices.
The copper T is a device which is composed of copper. Yes! The same copper that is used in our coins! This device is effective for 10 years. The copper is “anti-sperm”, and once sperm enter the uterus they are destroyed quickly and cannot reach the egg for fertilisation to occur. However, women who are allergic to copper should avoid this method of contraception.
The Mirena contains a hormone called levonorgestrel. It is effective for five years. The Mirena acts in three ways:
1. Thickening the cervix with mucus which adds an extra layer of protection by preventing sperm from entering.
2. Thins the lining of the endometrium preventing a pregnancy from being “planted” if it occurs.
3. Prevents the release of eggs.
The Mirena can also be used for women with heavy periods who are not known to have fibroids.
Both these devices have side effects, the most common being spotting. This spotting usually resolves in around three months. In rare occasions, the device may migrate or move through the top of the uterus and enter the abdomen. This is suspected if the string cannot be seen or felt. An ultrasound can confirm the presence of the device. If the device is in the abdomen, surgery will have to be done to remove it.
Though pregnancies can rarely occur, these devices are associated with ectopic pregnancies (pregnancies within the Fallopian tubes).
Though complications exist and are minimal, I would highly recommend any of these devices as guardians of the uterus.
Dr Daryl Daley is a consultant OBGYN at Gynae Associates, 23 Tangerine place, Kingston 10, and Shops 46-50, Portmore Town Centre, Portmore. He can be contacted at 929-5038/9 and 939-2859 or drdaryldaley@gmail.com.
