“Is an IUD right for me?”

This is a question I deal with often, as I counsel frequently on contraceptive methods with my female patients. There are multiple methods, including family planning (“rhythm method”), birth control pills, barrier methods (male and female condoms, diaphragms), the patch, the “shot”, implants, and IUDs.

At my clinic, I place IUDs (intrauterine devices) of the Mirena type, which is a 5 year long, progesterone-releasing method. There are other types of IUDs, such as the copper-T and Paragard that do not contain hormones and last longer than 10 years. IUDs are not only used for birth control, but also potentially to control heavy menstrual bleeding, severe menstrual cramping, and conditions such as ovarian cysts, endometriosis, and other female organ disorders.

The following is the general information I give female patients when they’re considering this method:

We are placing an IUD today, and I hope that you’ve had a chance to review either the brochure or research online about this birth control method. Feel free to ask whatever questions you may have before our procedure.

Benefits

-We hope that you’ll be able to keep the IUD for as long as you want, for up to 5 years. If older than 35years old, it’s a good idea to make sure you include a good amount of vitamin D and Calcium in your diet as the IUD may stop your periods for 5 years, which equals a sort of “early menopause.” These vitamins help protect your bones.

As long as you have not had any ectopic (tubal) pregnancies or recurrent STDs (gonorrhea or Chlamydia), there is little reason notto have an IUD if you want. It does not, however, protect from STDs, so condoms must still be used.

Risks & possible complications

-Anytime ‘outside’ objects are introduced to our ‘insides’, there is always the potential for infection and discomfort. We do our best to keep the procedure sterile (gloves, cleaning solutions, instruments, IUD), but it is possible still. You also should have taken the medicines I have you beforehand to reduce discomfort, which can feel like strong menstrual cramping.

Also, most of the instruments used are metal but not all sharp fortunately. There is the potential for bleeding. The most concerning risk is for the instrument to break through the tissue or muscle of the uterus causing hemorrhage, which is an emergency, for which we call 911.

What to expect after the procedure-

We will make sure you feel ok before leaving Please ask for Tylenol if you feel you need it before discharge. You can expect some vaginal bleeding during the first 24-48 hours afterwards with menstrual discomfort. You can use you Ibuprofen for this every 8 hours as needed. Bed-rest is not required, but I would defer from strenuous activity. Going to work from here is fine.

Some women experience irregular bleeding for up to 3-6months after placement. After than, you’ll join 1 of 3 groups: one-third of women continue irregular bleeding for the duration, the second group continue their normal monthly cycles, and the latter one- third stop having their periods altogether. Everyone responds differently and we don’t know which group you’ll fall into until the IUD is placed. The good news is you can return to have it removed whenever you want.

If you feel back to normal after 24-48hours, resume normal activity, which includes sexual intercourse and tampon use if desired. However, you can also wait to see e at your 1 week follow-up to check the string and make sure thing are stable. Call us here if you have any questions during that week, or problems including fever, severe stomach pain, extremely heavy vaginal bleeding, or foul-smelling vaginal discharge.

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