Copper or hormonal, the IUD is a very reliable method of contraception. More effective than the pill, it still suffers from prejudices.
Are you considering having a intrauterine device (IUD), also called IUD. Is its pose painful? Are there any side effects? contraindications? Copper IUD or IUDhormonal ? We take stock.
Its pose only lasts a few minutes
Women are often surprised at how small an IUD is: 3.5cm long for the T-shaped body, 3cm wide for the arms. The “shorts”, for those who have not yet had a child, are shorter (3 cm). Compared to tampons, it’s tiny.
During a first consultation, the doctor measures the size and shape of the uterus to choose the right intrauterine device (IUD). At the next consultation, using a speculum, he inserts it into a thin tube at the bottom of the uterus, in a few minutes.
- The IUD is not likely to move during sports or sexual intercourse. Exceptional, its spontaneous expulsion which can occur during heavy and painful periods.
- If ever the partner feels the nylon threads that are used to remove it (they protrude from the cervix by 2 cm), the doctor may cut them shorter. You can contact general practitioners, gynecologists, family planning centers or midwives.
Some doctors refuse to insert an intrauterine device
Although the Haute Autorité de santé recommends the IUD for “all women”, whether they have had children or not, some doctors are reluctant to put one on a young girl. “One of them refused because I don’t have a stable married life,” says Cora, 19. He said I was at risk of getting infections. At Family Planning, I was told that it is not the IUD that promotes infections, but the multiplication of partners. ” This fear of infection dates back to old IUDs, withdrawn from the market for more than thirty years.
“The IUD does not increase the risk of infection compared to another contraceptive, assures Professor Vincent Lavoué, head of the gynecology department of the Rennes University Hospital. On the other hand, the pill makes the mucus less permeable to bacteria, and therefore has a slightly protective effect. If you forget your pill, the IUD is a good choice, 99% effective over a long period (three to ten years depending on the IUD). In women under 25, it is legitimate to make a chlamydia screening to avoid contamination of the uterus during insertion, with a check three to six weeks later. “
You can have contractions after inserting an IUD
I was afraid of being in pain, ” says Jeanne, 31. My gynecologist prescribed an anti-inflammatory to take an hour before. It reassured me. “Tara, 26, forgot to take it:” I was sorry. Not so much during the pose, because the pain only lasts a few seconds, but a few hours later, I was doubled over. ”
Professor Vincent Lavoué explains: “Some women experience small contractions that rarely persist beyond 24 hours. Otherwise, you have to call your doctor back. Rest them period pain : If after a few cycles, the patient suffers from it and prefers to remove the IUD, it only takes a few minutes. “
Rules can go away
Caroline, 32, takes a treatment that thins the blood, Copper IUD was not a solution for her. The latter tends to amplify the abundance and duration of periods in those for whom they already are. Her gynecologist therefore recommended a Hormonal IUD. This diffuses a progestogen hormone, levonorgestrel, delivered in small quantities in the uterus, continuously. It thickens the secretions of the cervix, hindering the passage of sperm and preventing the lining from preparing to receive an oocyte, without blocking ovulation. In 20% of cases, the rules disappear completely.
Namely, small bleeding may persist, more or less well tolerated. Your period, and fertility, returns as soon as the IUD is removed.
The hormonal IUD may have side effects
- There is no no side effects for a copper IUD whose mode of action is mechanical: the copper sleeve around the rod neutralizes spermatozoa. It has no impact on the menstrual cycle.
- For the Hormonal IUD that diffuses a progestin (levonorgestrel), undesirable effects (migraines) have been listed. Explanations from Dr Hassoun: “The IUD only diffuses progesterone, and at a lower dose than the pill, the passage into the bloodstream is much reduced. But acne-prone women will haveacne. They may find it bearable or too uncomfortable. It’s up to everyone to decide. The debate has in any case seized social networks. One of the most common hormonal IUDs, the Mirena, was questioned in 2017 by its users, who denounced undesirable effects not listed (fatigue, seborrhea, anxiety, etc.). The National Medicines Safety Agency, which launched an investigation, has for its part created information documents to better inform women about possible side effects.
This contraceptive method lasts a really long time
I had a copper IUD that was supposed to last ten years inserted but learned that in the United States it is approved for twelve years. So I stopped stressing for having passed the withdrawal date, ”observes Marina, 47 years old. A study published in March 2015 in Obstetrics and Gynecology shows that five-year IUDs continue to protect pregnancies for at least one more year. “In a 25-year-old patient, I change the IUD at the end of the expected duration, even if it is not within a few months, even less in a forty-something whose fertility is declining”, explains Dr. Danielle Hassoun.
The IUD is contraindicated in some women
- The Copper IUD is contraindicated for women with a fibroma, a malformation of the uterus, an STI that has not been treated or has not been cured for three months, unexplained bleeding or cancer of the uterus.
- The Hormonal IUD is contraindicated, in addition, for those who have the risk of thrombophlebitis or embolism, or certain tumors (hepatic or hormone-dependent). It can be advised, on the other hand, in case of endometriosis.