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Intrauterine Contraception

Intrauterine contraceptive (IUC) is a small soft device that is placed into the uterus by a trained health care provider. There is one kind of IUC that contains copper. The copper slowly dissolves over a period of years and causes conditions inside the uterus sperm cannot tolerate. So, the sperm are unable to reach the woman's egg to fertilize it.

There are two kinds of IUCs that contain hormones. These IUCs slowly release a synthetic progesterone (called progestin) which stops eggs from being released from the ovaries. Progestin also causes the lining of the uterus to become thinner and it causes blocking of the cervix to keep sperm from entering.

Intrauterine contraceptive devices work primarily by preventing fertilization of the egg. Should the primary action fail, a secondary action could occur: the changes in the uterine lining would prevent any fertilized egg from implanting in the uterus.

Intrauterine contraception provides extremely effective birth control. For many women it is a safe and easy method to use.

Advantages of intrauterine contraception include:

  • Longer-term birth control – 10 years for the copper IUD, 3-5 years for the progestin hormonal IUCs. If used for the full length of time possible, these are the most cost-effective methods of contraception.
  • Reduced menstrual flow and cramping with the progestin IUS.
  • An alternative to sterilization operation for women wanting long-term contraception.
  • Positive psychological effects may include freedom from day to day concerns about pregnancy due to the high effectiveness of this method; convenience.

Possible disadvantages and side effects:

  • No protection from HIV/AIDS or other STDs such as Chlamydia, gonorrhea, syphilis, warts, hepatitis, or human papilloma virus (HPV).
  • Increased menstrual flow and cramping is likely with the copper device in place.
  • Women who have never been pregnant may experience more discomfort during insertion of the device. Some health care providers do not want to insert IUDs in women who have never been pregnant.
  • Negative psychological effects possibly encountered: Some women may have mixed feelings about using the IUD due to the controversy over its method of action.

Possible health risks with intrauterine contraception:

  • Pelvic infections can result from bacteria getting into the uterus during the insertion process. However, this is uncommon. In some cases, pelvic infections may lead to infertility. Suspected infections must be thoroughly and promptly treated.
  • In the rare event of a diagnosed pregnancy, the IUD should be removed. This can sometimes lead to miscarriage, but is recommended nevertheless, to reduce chances of more serious problems later in pregnancy.
  • If pregnancy does occur, there may be an increased risk of tubal pregnancy, requiring prompt medical attention.
  • The uterus can be perforated by the device. This is rare and is most often associated with the insertion procedure (1 per 1000 insertions).

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