Intrauterine Device Insertion
En Español (Spanish Version)

Definition
An intrauterine device (IUD) is a type of temporary birth control for women. It is inserted by a doctor.

There are two types of IUDs:

  • Hormone-releasing—releases the hormone progestin. Can be left in the body for five years before it needs to be replaced.
  • Copper—releases copper ions. Can be left inside the body for 10 years.
Intrauterine Device

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Both devices are shaped like a letter “T” with a tiny string attached. When the device is removed, most women can become pregnant again.

Reasons for Procedure
This procedure is done to prevent pregnancy. It does not protect against sexually transmitted diseases. The hormone-releasing IUD may also have other benefits, such as treating:

Possible Complications
Serious complications are rare, but no procedure is completely free of risk. Your doctor will review a list of possible complications, including:

  • Cramping
  • Abnormal bleeding and increased spotting for a few months
  • Irregular or no menstrual period (hormone-releasing IUD)
  • Heavier menstrual periods (copper IUD)
  • Pain when menstruating
  • IUD can slip out of the uterus or vagina
  • Infertility
  • Pelvic infection
  • Damage to the uterus or other pelvic organs
Even with an IUD inserted, there is a chance that you can still get pregnant. If so, there is a possibility of an ectopic pregnancy . This happens when the fetus develops outside the uterus. Other possibilities include miscarriage, premature labor, or delivery.

An IUD is not for every woman. Certain things would make a woman a poor candidate for IUD insertion, such as :

  • Pregnancy
  • Vaginal bleeding of unknown cause
  • Deformed uterus
  • History of ectopic pregnancy
  • History of pelvic infection after childbirth or after an abortion in the last three months
  • History of pelvic inflammatory disease , unless there has been a normal pregnancy since then
  • Sexually transmitted disease or other infection in the pelvic area
  • Increased risk of pelvic infections
  • Cervical or uterine cancer
  • Liver disease or liver cancer (for the hormone-releasing IUD)
  • Breast cancer (for the hormone-releasing IUD)
  • Allergy to copper (for the copper IUD)
  • Wilson’s disease (for the copper IUD)
Discuss these risks with your doctor before the IUD insertion.

What to Expect
Prior to Procedure
You will be asked about your medical history. A physical exam will be done. Tests may include checking for pregnancy or infection.

You may want to ask someone to give you a ride home after the procedure.

Anesthesia
Local anesthesia is used to keep you comfortable during the procedure.

Description of the Procedure
This procedure is usually done in an office or clinic setting with no need for an overnight stay.

You will lie on an exam table and put your feet in foot holders. A speculum will be inserted into your vagina to allow access to the cervix. Your cervix and vagina will be cleansed with an antiseptic. Another instrument called a tenaculum will be used to grasp the cervix and keep the uterus in place during the procedure. The doctor will insert a special instrument to measure the depth of your uterus to make sure that it will fit the IUD.

The T-shaped IUD will be folded and inserted into a tube. The tube will be inserted into your uterus through the vagina. The tube will then be pulled back. The IUD will open into its T-shaped position inside your uterus. The tube and tenaculum will then be removed. The IUD's tiny strings will hang out of your cervix and into the far back of your vagina. The speculum will then be removed.

Insertion of IUD Into Uterus

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How Long Will It Take?
Actual insertion takes about five minutes.

Will It Hurt?
You may feel cramping or mild discomfort while the IUD is being inserted. You may asked to take nonsteroidal anti-inflammatory medication such as ibuprofen an hour before the procedure.

Post-procedure Care
At the Care Center
You may be given medication to ease any discomfort. When you are ready, you will be able to leave.

At Home
Be sure to follow your doctor’s instructions. When you return home:

  • Resume regular activities as soon as you feel comfortable.
  • Check that the strings are present in the back of your vagina each month.
Copper IUDs are effective right away.

Hormone-releasing IUDs are not always effective right away. Talk to your doctor about alternate methods of birth control until the IUD takes effect.

Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:

  • Notice change in the length of the strings
  • Cannot feel the strings with your fingers
  • Feel the "T" part of the IUD passing through your cervix
  • Think you may be pregnant
  • Heavy periods or periods that last longer than usual
  • Missed, late, or unusually light period
  • You or your partner have or are exposed to a sexually transmitted disease
  • Severe cramps, pain, or tenderness in your abdomen
  • Pain or bleeding during sex
  • Unexplained fever or chills
  • Flu-like symptoms, like muscle aches or tiredness
  • Unusual discharge from the vagina or sores on your genitals
  • Unexplained vaginal bleeding
  • Severe headaches
  • Rapid heartbeat



RESOURCES:

Women's Health—US Department of Health and Human Services

CANADIAN RESOURCES:
The Society of Obstetricians and Gynaecologists of Canada

Women's Health Matters

References:
Endometrial hyperplasia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 26, 2013. Accessed March 18, 2014.

Intrauterine device (IUD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 17, 2014. Accessed March 18, 2014.

IUD. Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/iud-4245.htm. Accessed March 18, 2014.

Johnson BA. Insertion and removal of intrauterine devices. Am Fam Physician. 2005 Jan 1;71(1):95-102.

The American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 110: Noncontraceptive Uses of Hormonal Contraception. Obstet Gynecol. 2010;115(1):206-218. Reaffirmed August 2012.

Last Reviewed March 2014



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