Spirals

Intrauterine device (IUD)

The intrauterine device is a long-acting reversible contraception (LARC) inserted into the uterine cavity. One of the most effective contraceptive methods with a failure rate under 1%.

Types of IUDs

• Copper IUD (Cu-IUD) — contains copper coils creating a spermicidal environment. Lasts 5-10 years. Hormone-free.
• Hormonal IUD (LNG-IUS) — releases levonorgestrel locally. Lasts 3-8 years. Reduces menstruation.

How does the IUD work?

• Copper — copper ions alter cervical mucus, inhibit sperm motility, prevent implantation
• Hormonal — thickens cervical mucus, atrophies endometrium, inhibits ovulation in some women

IUD advantages

• High effectiveness — >99% pregnancy protection
• Long-lasting — 3-10 years without daily concern
• Reversible — fertility returns immediately upon removal
• Breastfeeding-safe — doesn't affect breastfeeding
• Emergency contraception — copper IUD can be used up to 5 days after unprotected intercourse

IUD insertion

• Ideal timing — during menstruation (cervix is softer and more open)
• Duration — 5-10 minutes outpatient
• Follow-up — ultrasound position check after 4-6 weeks

Side effects and contraindications

• Copper IUD — heavier and more painful periods (first 3-6 months)
• Hormonal IUD — irregular bleeding initially, then significant reduction or cessation
• Contraindications — active pelvic infection, uterine cavity anomalies, suspected pregnancy