Intra-Uterine Contraceptive Devices (IUCD/IUD) are small (<4cm), ‘T-shaped’, flexible, plastic items. These can be inserted into a woman’s uterus via the vagina for pregnancy prevention. IUCD are one type of long-acting reversible contraception (LARC). IUD do not protect against Human Immunocompromised Virus (HIV) or sexually transmitted infection (STI).
- The procedure is readily performed in a clinic setting with the woman fully awake. Sedation is not required.
- A preferred time for insertion is within the first 7-10 days of a woman’s cycle when she may still be bleeding.
- The insertion process often lasts as long as it takes to do a Pap Smear test i.e. 6-8 minutes.
- Insertion may be uncomfortable but should not be painful.
- A woman may experience period-like, pelvic cramps a few hours after insertion and perhaps for a couple of days afterwards. Pre-insertion, simple painkillers e.g. can be used with good effect.
|STEP 1||RESEARCH||Patient and partner do research from multiple sources e.g. conversations with other women who have used IUCD, online, family planning nurses, doctors.|
|STEP 2||CONSULTATION||Consultation with a family planning nurse or doctor e.g. general practitioner or gynaecologist to discuss the benefits and risks for the specific patient and her family planning needs.|
|STEP 3||PAP SMEAR||Updated Pap Smear examination. Recommendations require evidence of a healthy Pap Smear test result 3 years or less, before insertion of IUCD.|
|STEP 4||APPOINTMENT||Schedule dates for insertion & follow-up checks.|
TYPES OF IUCD
Currently there are two (2) types of IUCD/IUD available.
|Active material||Progesterone (LNG-IUS)||Copper (Cu-IUD)|
|Mode of pregnancy prevention||
|Duration of use||3-5 years||10 years|
||· Unplanned pregnancy (risk 0.8%)
· Infection risk: Operator dependent
· Perforation of uterus (risk <0.001)
|Effect on periods||Lighter flow or shorter number of bleeding days||May experience heavier flow or greater number of bleeding days|
|Suitable patients||Tolerant to progesterone||Can wear costume jewellery without reaction|
|Suitability after pregnancy & delivery||Yes, six (6) weeks after delivery||Yes, six (6) weeks after delivery|
American College of Obstetricians & Gynaecologists (ACOG):
National Institute for Health and Care Excellence (NICE): https://www.nice.org.uk/guidance/cg30
Faculty of Sexual and Reproductive Health of the Faculty of the Royal College of Obstetricians and Gynaecologists (FSRH): United Kingdom Medical Eligibility Criteria for Contraceptive Use (2016) http://ukmec.pagelizard.com/2016#sectionb/cover