What are intrauterine devices?
IUDs are small, T-shaped devices that sit inside the uterus. There are two different types of IUDs, copper and hormonal, both of which provide long-acting protection against pregnancy. Both copper and hormonal IUDs are listed in the World Health Organization’s Essential Medicines List, and the efficacy and safety of these products has been demonstrated in women through large clinical trials. IUDs can be inserted at any time in the menstrual cycle by a qualified healthcare provider if the provider is reasonably certain the woman is not pregnant.
Copper IUDs are non-hormonal and contain copper. They work by causing a chemical change that damages sperm and egg before they can meet. Depending on the type, or brand, they can last for up to 10 years.
Hormonal IUDs contain a synthetic progestin called levonorgesterel. This device releases a small number of hormones into the uterus, thickening the cervical mucus, inhibiting sperm survival, and thinning the lining of the uterus. The hormonal IUD can be used to prevent pregnancy for up to 8 years, depending on local approvals.
Both types of IUDs are about 99% effective at preventing pregnancy.
What are the benefits of IUDs?
Copper IUDs can be used as an emergency contraceptive method and be inserted up to five days after sexual intercourse. They can also be used by women who cannot use hormonal contraception.
Hormonal IUDs are also approved to treat heavy menstrual bleeding. The hormone, levonorgestrel, acts by controlling the monthly development of the womb (uterus) lining, making it thinner, so that there is less bleeding every month.
Both copper and hormonal IUDs act locally in the uterus.
What are the side effects?
The most common side effects of the copper IUD include heavier or longer menstrual bleeding, pelvic infection, pain or dysmenorrhoea, discomfort or menstrual-like cramping.
The most common side effects of the hormonal IUD include vaginal bacterial infection, acne, nausea or vomiting, and abdominal pain, pelvic pain, weight increase, mood changes, back pain, yeast infection of the other part of the vagina, headache, pain during sex, breast pain, depression, vaginal discharge, anxiety, and menstrual-like cramping.
For the first 3 to 6 months, the hormonal IUD can cause a woman’s period to become irregular and the number of bleeding days may increase. After a woman has used the hormonal IUD for a while, the number of bleeding and spotting days is likely to lessen. For some women, menstrual periods will stop altogether.
It is not uncommon for women to have no bleeding when using the hormonal IUD. This absence of bleeding is not harmful. When the hormonal IUD is removed, a woman’s menstrual periods will likely return to their former pattern
Misconceptions about IUDs
IUDs do not:
- Increase the risk of miscarriage when a woman becomes pregnant after the IUD is removed
- Cause birth defects
- Cause cancer
- Cause discomfort or pain for the woman or the man during sex
- Increase the risk of contracting STIs, including HIV
- Get lost in the body. It has strings attached so it can be easily removed when requested
- Cause infertility. There is no delay to fertility when it is removed
- Cause abortion
What are contraceptive implants?
- Contraceptive implants are a reversible, long-acting, effective, and safe contraceptive option, suitable for almost all women including women who have just had a baby and are breastfeeding.
How do they work?
- Implants contain a synthetic version of the natural hormone progesterone, which works to prevent pregnancy by preventing the release of the egg from the ovary (ovulation) and thickening of cervical mucus which make it difficult for sperm to enter the womb.
- Implants are inserted just under the skin of a woman’s upper arm by a trained healthcare provider using a disposable inserter or trocar. This simple insertion takes a few minutes in the clinic setting with local anaesthetic
How effective are implants?
- They are 99% effective in preventing pregnancy and last 3 to 5 years depending on the type
What are the benefits?
- Action to prevent pregnancy is not required once the implant is inserted. It can be removed at any time at the woman’s request.
- Levoplant™, our implant, can be used by almost all women of any age including those who have just given birth, are breastfeeding, or women who have had an abortion
- Implants do not contain estrogen so may be suitable for women who experience side effects related to combined hormonal contraceptive methods
- They can be removed at any time by a trained health care provider
What are the side effects of implants?
- The main side effects are changes in bleeding patterns – bleeding may become lighter, more irregular or stop completely. These changes are not harmful and do not mean the implant has stopped working
- Some women also report abdominal pain, weight changes, breast tenderness, mood changes, and headaches
