General Practice 2022

IUD (Intrauterine Device): what é, types and how it works

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IUD (Intrauterine Device): what é, types and how it works
IUD (Intrauterine Device): what é, types and how it works

The IUD, as it is popularly called the Intrauterine Device, is a contraceptive method made of flexible plastic molded into a "T" or "Y" shape that is inserted into the uterus to prevent pregnancy. This device can only be placed and removed by the gynecologist, and although it can be used at any time during the menstrual cycle, it should preferably be placed within the first 12 days of the cycle.

The IUD can consist of copper, a combination of silver and copper or hormones, having different advantages and disadvantages, although they are used to prevent pregnancy.

Although the hormonal IUD is related to a greater number of side effects compared to copper and silver IUDs, this type of contraceptive may be indicated for women who are undergoing treatment for endometriosis or myoma, for example, a since the hormone released by this IUD is beneficial in these situations.

Types of IUD

The IUD can be classified into some types according to its composition, the main ones being:

1. Copper IUD

The copper IUD is a type of non-hormonal device made of plastic, but coated with copper, which can be used for 10 years without loss of effectiveness. The contraceptive action of this type of IUD is due to the continuous release of copper ions in the uterus, which causes changes in the cervical and uterine mucus, as well as interfering with sperm motility.

As it is not associated with hormones, this type of IUD is usually well tolerated by women and is associated with fewer side effects. However, it is possible for a woman to experience increased menstrual flow and slightly more intense cramps. Learn more about the copper IUD.

2. Silver IUD

Like the copper IUD, the silver IUD is a type of non-hormonal intrauterine device.This type of IUD has a "Y" shape instead of a "T", with the stems made of silver and the base made of a mixture of a small amount of silver associated with copper, with the aim of reducing the fragmentation of copper in the body., although this is rare.

Due to its shape, the silver IUD is easier to insert and remove, making it more suitable for women with a smaller uterus. In addition, due to the lower amount of copper and the presence of silver, the silver IUD can be used for 5 years and may not result in increased menstrual flow or cramping.

3. Hormonal IUD

The hormonal IUD, also known as a Mirena IUD, is a type of device that contains hormones in its composition, such as levonorgestrel, which is released continuously from the moment it is inserted. This hormone promotes a decrease in the thickness of the inner layer of the uterus and an increase in the thickness of the cervical mucus, decreasing the chance of sperm reaching the egg and fertilization.

Although it is quite effective, as it is made up of hormones, the Mirena IUD is associated with several side effects, such as changes in the menstrual cycle, there may be lack of menstruation or spotting, increased cramps, headache, mood swings, decreased libido and bloating, for example. See more about the Mirena IUD.

Advantages and disadvantages of the IUD

Advantages Disadvantages
It is a practical and long-lasting method Appearance of anemia due to longer and heavier periods that the copper IUD can cause
No forgetting Risk of infection of the uterus
Does not interfere with intimate contact If a sexually transmitted infection occurs, it is more likely to progress to a more serious condition, pelvic inflammatory disease
Fertility returns to normal after removing Increased risk of ectopic pregnancy

Depending on the type, the IUD may have other advantages and disadvantages for each woman, and it is recommended to discuss this information with the gynecologist when choosing the best contraceptive method. Find out about other contraceptive methods and their advantages and disadvantages.

How it works

The IUD works by preventing pregnancy through changes in the uterus and cervical mucus that prevent sperm from reaching the released egg, preventing fertilization and, consequently, pregnancy.

The copper IUD releases small amounts of copper into the uterus, which causes changes in the endometrium, preventing the egg from implanting in the uterus, as well as interfering with the survival time of the sperm. This type of IUD provides protection for approximately 10 years.

The silver IUD works in the same way as the copper IUD, however there is also the release of silver in the uterus, which works to reduce the risk of oxidation of the copper part of the IUD and increase the contraceptive effect. In addition, silver helps reduce menstrual flow, being less intense than the flow that happens when you have a copper IUD.

The hormonal IUD, by the action of the hormone, makes ovulation difficult and prevents the egg from attaching to the uterus, thickening the cervical mucus to form a kind of plug that prevents sperm from getting there, thus preventing fertilization. This type of IUD provides protection for up to 5 years.

How it is placed

The procedure to insert the IUD is simple, takes between 15 and 20 minutes and can be done in the gynecological office. The insertion of the IUD can be done at any time of the menstrual cycle, however it is more recommended that it be inserted during menstruation, which is when the uterus is most dilated.

For IUD placement, the woman should be placed in a gynecological position, with her legs slightly apart, and the doctor inserts the IUD into the uterus. Once inserted, the doctor leaves a small thread inside the vagina that serves as an indication that the IUD is placed correctly. This thread can be felt with the finger, however it is not felt during intimate contact.

Because it is a procedure that is not performed with anesthesia, the woman may feel discomfort during the procedure.

Possible side effects

Some of the side effects of this contraceptive method include:

  • Uterine pain or contractions, more frequent in women who have never had children;
  • Slight bleeding right after IUD placement;
  • Vaginal discharge;

The copper IUD can also cause longer, more bleeding, and more painful periods only in some women, especially in the first few months after the IUD is inserted.

The hormonal IUD, in addition to these side effects, can also cause reduced menstrual flow or absence of menstruation or small menstrual blood outflows, called spotting, in addition to pimples, headache, breast pain and tension, fluid retention, ovarian cysts and weight gain.

When to go to the doctor

It is important for the woman to be alert and go to the doctor if she does not feel or see the IUD guide wires, symptoms such as fever or chills appear, swelling in the genital region is noticed or the woman experiences severe abdominal cramps. In addition, it is recommended to go to the doctor if there is increased vaginal flow, bleeding outside the menstrual period or if you experience pain or bleeding during sexual intercourse.

If any of these signs appear, it is important to consult the gynecologist to assess the position of the IUD and take the necessary measures.

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