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IUD: Is it safe and effective?
I am considering an IUD for contraception. How does it work? Are they safe?
Until recently, it was felt that the intrauterine device's (IUD) main contraceptive activity was through inhibiting the implantation of a fertilised egg or by causing it to be dislodged from the uterus (abortifacient). Recent research, however, suggests that the IUD may inhibit sperm from successfully swimming across the uterus. Users’ careful selection of this method, as well as the advent of new IUDs, appear to make it a safe alternative for many women. Your GP can help you determine if this is an appropriate option for you.
Several studies suggest that interference with sperm migration or function and with fertilisation may be the most important mechanisms in the contraceptive action of IUDs. There appears to be only limited compelling evidence that the IUDs act as abortifacients. Women who are not at risk of pelvic inflammatory disease or sexually transmitted diseases are appropriate candidates for the IUD. Through better selection of candidates the risk for pelvic inflammatory disease is now very low, but even this low risk may be unacceptable for women who have never had children, as it may lead to tubal blockage and subsequent infertility.
With regard to their efficacy, IUDs are 98-99% effective. This means that 1 or 2 women in 100 will get pregnant during 1 year of IUD use.
IUDs can make periods heavier. Approximately, five to 15 per cent of IUD users have their IUD removed because of bleeding or pelvic pain in the first year. Women who experience intermenstrual bleeding, significant pain, or excessive menstrual bleeding in the first month after insertion are at high risk for a removal in the first year after insertion.
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