Who is the IUD for?

2023-06-09 15:23:21

180 million women worldwide use an IUD, making it most used contraceptive method. However, in France, it is much less prescribed and less posed, the pill remaining the number 1 method of contraception. And since the scandal of the 3rd and 4th generation pills, many French women have turned to other methods of contraception, in particular the IUD. According to a Statista study¹this scandal thus provoked a decrease in the use of the contraceptive pill between 2016 and 2021 to turn to the IUD.

What is an IUD?

The IUD, or intrauterine device (IUD) is a “T” shaped contraceptive that measures approximately 3,5 cm de long. The copper IUD prevents the egg from implanting in the mucosa and disrupts sperm motility. It is retained by a thread so that the healthcare professional, midwife, gynecologist or general practitioner can easily remove it using small pliers. There are several sizes, we put some a scale model for women who have not had children and a bigger model for women who are already mothers. There are two types :

• The copper IUD : Perfect for women who do not want to be on hormones so as not to suffer the potential side effects of the pill (weight gain, reduced libido, acne problems, or simply the desire to put their body “to rest” ” and to stop taking hormones. Copper naturally makes sperm inactive. Small flat : periods can be more painful and hemorrhagic when wearing a Copper IUD.
• The hormonal IUD : It is he who is called IUS or intrauterine delivery system. Unlike its cousin, this method of contraception contains hormones that are released gradually day by day. He is what is called un microprogestatifthe hormonal IUD Mirena is a classic in terms of IUS and releases levonorgestrel, a substance close to the progesterone. Like taking the contraceptive pill, the hormonal IUD has side effects the most common of which are: headaches or stomach aches, bloating or other side effects such as: depression, anxiety, irritability, low sexual desire, skin problems.

The copper intrauterine device (IUD). is made of plastic and covered with copper wires, it is a contraceptive method without hormones. The more copper it contains in mm2 the more efficient it will be. Copper blocks fertilization and prevents sperm from reaching the egg. The presence of copper also prevents the fixation of the egg in the uterus. He can be effective for 5 to 10 years depending on the models.

The hormonal IUD has a contraceptive effect thanks to its action on the cervical mucus, it thickens it, thus blocking the passage of sperm into the uterus and it thins the endometrium thus preventing an embryo from clinging to it. When wearing a hormonal IUD, we observe a lack of rules, it appears to be a good solution for women with heavy periods and an irregular cycle. Its reliability is 99%.

To better understand how does the IUD work, this illustration shows how this device does its job:

First of all, you have to consult your general practitioner who will measure the size and shape of the uterus to advise us on choice of intrauterine device. During a second appointment, the healthcare professional will insert the IUD. The doctor inserts a speculum and a long, thin tube specially designed to place the IUD. The insertion is carried out quickly, the copper IUD can be placed at any time, regardless of the moment of the cycle. The hormonal IUD should be placed ideally within a week of menstruation. The placement of the IUD can be quite unpleasant depending on the case and the sensitivity of each. It is possible to feel uterine contractions, pain in the cervix, bleeding and a feeling of pinching or pain similar to that felt during menstruation. But don’t panic, health professionals recommend to use painkillers before coming to the appointment.

To note : the copper IUD can also be inserted after a potentially fertile sexual intercourse, as emergency contraception in order to avoid having to take the morning after pill.

The advantages of the IUD

In terms of efficiency, they are 99% reliable, copper or hormonal IUDs have the enormous advantage of being forgotten for several years! The risk of unwanted pregnancy is much weaker than with the pill. And contrary to popular belief, the IUD is not just for women who have already had children. An IUD can perfectly be placed in women who have not yet had a baby (or “nulliparous”). In addition to being used as contraception, according to several studies, the IUD would limit the risk of contracting several cancers that affect women, in particular endometrial cancer. The copper or hormonal IUD can be inserted 4 weeks postpartum if you had no complications when you were pregnant.

The disadvantages of the IUD

The IUD is designed as a “long-term” contraceptive since it remains in place for several years in the uterus. However, you must regularly go to your gynecologist to check that the IUD is still in its place. Also, in case of desire for pregnancy in the short or medium term, it is better to move towards another more flexible method (pill, condom) to decide on the date of cessation. Menstrual cycles can be a little messed up at first: heavy periods, anarchic and irregular, abdominal pain, absence of periods, pain during sexual intercourse. In rare cases, if a sexually transmitted infection occurs while wearing an IUD, there is a risk of pelvic infection, which can lead to complications. Epidemiological studies² showed that the copper IUD was a more common form of contraception among women who had lived an ectopic pregnancy but this risk remains, here again, very low.

The IUD and IUS are dispensed in pharmacies and require prescription by prescription. The price of the copper IUD is around 30€ and the hormonal IUD is more expensive around 100€. Good to know: copper and hormonal IUDs are reimbursed by Health Insurance at 65%.

It is possible to have their IUD removed at any time, provided they inform their gynecologist, general practitioner or midwife. To remove it, the health professional equips himself with forceps and a speculum, then he only has to pull gently on the wire attached to the end of the IUD. at the entrance to the uterus. The extraction is done fairly quickly and most of the time, the IUD comes out easily. At the level of the pain felt during the withdrawal of the IUD, just like for the installation, it is variable according to the women, however, it is preferable to wear sanitary protection before coming to the appointment because bleeding may occur.

Attention : the hormonal IUD is not recommended for women with a history of phlebitis, pulmonary embolism or cancer.

More info on

1 Etude Statista : Contraception in France – Facts and figures

2 Transparency Committee, Mirena Extra uterine pregnancy

Read also:

• Male contraception: what are the possibilities?

• How to use the female condom?

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