For many years there have been soaring concerns regarding PID or Pelvic Inflammatory disease being associated to IUD, though it is unknown that IUD on its own doesn’t lead to PID. Rather, if one is suffering from a genital tract infection and goes in for an IUD insertion, the infection could spread into the uterus and fallopian tubes. If one is at risk of getting an STD, the doctor would examine and suggest appropriate treatment prior to getting an IUD.

Intrauterine devices lower the risk of getting pregnant inclusive of ectopic or tubal pregnancy. However, in the case of pregnancy in the presence of an IUD, there is a greater possibility of it being ectopic. Ectopic pregnancies need medications or surgical intervention in order to terminate the pregnancy. At times the fallopian tube related to the particular side would need to be taken out.

IUD usage could be a safe contraception choice in the following situations:

• Those women having a past of ectopic pregnancy for whom the duo choices of copper IUD and LNg IUD are apposite choices.
• Those with a past of erratic bleeding during periods and pain. The LNg IUD might be suitable for such women and in those with a bleeding disorder or those that are taking blood thinning medications (anticoagulants).
• Women with a risk of getting bacterial endocarditis. An antibiotics course would be administered during both the inserting and removal procedure.
• Diabetic women.
• Women that are breast feeding.
• The LNg IUD is an ideal option for those women with a past of endometriosis.

IUD might not be the right option for you when:

• Women that have never had a past pregnancy are more prone to having pain associated with IUD and have greater likelihood of the IUD being expelled following its insertion.
• Women presently having any kind of sexually transmitted disease or STD or have had an instance in the last three months.
• Women who are unwilling to use condoms in safeguarding themselves from STD’s.
• Those with an actively occurring infection in the vagina or cervix.
• Those having pelvic inflammatory disease or PID or with a lately occurred incidence of PID.
• Women with a bleeding disorder or having blood thinning medicines (anticoagulants). Though, the copper IUD cannot be used in such cases, in its place the LNg IUD could be used.
• Women with a problematic past with IUD.
• Women having anomalies in the uterus.
• Those women having uterine infection following delivery or a septic medical termination of pregnancy.
• Those with uterine bleeding of unclear basis.
• Those allergic to copper, hence the copper IUD would not be a feasible choice.

Those women that have one of the earlier plastic versions of IUDs like the Lippes Loop, must seek consultation regarding the replacement of the older IUD to a greatly effective copper or hormonal option.

Read more at: Intrauterine Device – IUD – The Effectual Birth Control Coil – Part V

Drawbacks of using LNg IUD

The LNg IUD could lead to non-cancerous or benign formations known as ovarian cysts that normally subside on their own.

The LNg IUD could be the reason behind hormone-related side effects much alike OC pills or oral contraceptives that include tenderness in the breasts, moodiness, recurrent headaches and pimples or acne eruptions. This is uncommon. However, when the side effects do occur, they normally fade away subsequent to the initial few months.

Pregnancy alongside inserted IUD

If pregnancy occurs when IUD is in place, then the doctor would suggest its removal. This is recommended as the IUD could lead to miscarriage or premature delivery though the IUD would not lead to any congenital anomalies.

IUD removal in the initial trimester of pregnancy aids in lowering the likelihood of miscarriage or premature delivery. However, even removing the IUD could also lead to miscarriage. As pregnancy advances, the likelihood of miscarriage is reduced on IUD removal rather than leaving it in place.

When to seek medical assistance

Those women that are using IUD must be vigilant regarding certain perilous signs that signal an underlying grave issue associated with the IUD that could include:

• Periods being delayed after insertion of copper IUD or unusual spotting or quite heavy bleeding.
• Stomach pain, severe cramps or pains in the abdomen associated with sexual contact.
• Infected with or being exposed to a STD or sexually transmitted disease or signs of a vaginal infection like unnatural vaginal discharge.
• Feeling unwell or fever that is 100.4°F or 38°C or more.
• The IUD threads absent or are felt to be more long or short than usual. In such case, condoms must be used till the doctor has examined the IUD.
• Having heavy or extended vaginal bleeding.
• Skipped a menstrual cycle, except if one is having LNg IUD wherein it is usual to skip a period or menses coming to a halt and must not be a reason for worry. Those having an LNg IUD and have skipped a period with doubts of a pregnancy, then it is vital to meet up with the doctor. IUDs have high efficiency rates, but if one is apprehensive then a pregnancy test could be done.

Read more at: Intrauterine Device – IUD – The Effectual Birth Control Coil – Part IV

• An average lowering of 90% in heavy bleeding during periods subsequent to the initial few months of usage.
• There is marked improvement in erratic menstrual bleeding (spotting and extended) subsequent to three to four months of IUD insertion.
• Lowers menstrual blood loss and cramping. In certain section of women, there was eventual stoppage of menstrual periods. In this situation not having periods is harmless.
• The LNg IUD may avert endometrial hyperplasia – a condition of unnatural thickening of the lining of the uterus (endometrium) leading to a host of complications or prevents endometrial cancer or uterine cancer.
• Might lower the chance of developing PID or pelvic inflammatory disease – an inflammation of the uterus, fallopian tubes or ovaries normally caused due to bacterial infection leading to chronic pelvic pain, sterility or other complications.
• Could effectually alleviate endometriosis and is known to lower the likelihood of occurrence of side effects than the high-dosage progestin.
• Lowers the chances of ectopic pregnancy.
• It does not lead to weight gain.

Associated Risks of IUD

There are certain risks that are related to the use of the IUD that comprise of:

• Problems during menstruation – Nearly twelve percent of those women that had IUD inserted opt for its removal due to increase in bleeding during periods or heightened cramping. Some women might additionally notice unnatural spotting in between periods. However, subsequent to three months of increase in bleeding or erratic spotting, the LNg IUD on an average of 90% lowers cramping during periods and bleeding.
• Puncture or Perforation of the Uterus – In one among one thousand women, the IUD would get lodges in or perforate the uterus. Though this form of puncture is atypical, it nearly always happens at the time of inserting the IUD. If the uterus gets punctured, it is necessary to get it removed.
• Ejection – Nearly two to ten percent of IUD’s inserted get ejected or expelled into the vagina from the uterus in the initial year after insertion. This expulsion normally occurs in the initial few months of usage and more often when inserted soon after delivery or in those women that have not been pregnant. The expulsion of the IUD implies that it is no more useful in protecting against pregnancy.

Read more at: Intrauterine Device – IUD – The Effectual Birth Control Coil – Part III

The TS procedure could be carried out either during the interval time period or as post delivery or post abortion procedure. Recent studies have revealed two viewpoints – an increased risk or no risk on the links between menstrual bleeding patterns and TS.

Menstruation irregularities could be decreased/infrequent, repeated/ long-lasting or the absence of menstrual cycle bleeding. Frequent or extended bleeding could endanger the physical health condition of women due to excessive blood loss. Decreased/sporadic or no menstrual bleeding mostly gets a proclivity to be classified as ‘mere irritant’ side effect however the clinical importance of this must not be undermined. It encroaches on the sexual, cultural and religious practises of a woman and has a negative bearing on the health and overall quality of life.

Researches that raised concerns have revealed a rise in the number of women having undergone TS procedure being hospitalised for menstrual related problems and a likely biological effect could not be ruled out. Unnatural bleeding patterns and pelvic discomfort and pain were the major problems encountered following sterilization.

Increased cases of hysterectomy were performed among sterilised women either for unnatural bleeding problem or pelvic pain. Unnatural bleeding pattern could be either excessive, extended bleeding, spotting and augmented pain during menses.

The early CDC findings, British record linkage study further corroborated these associations. A large case controlled study undertaken in Scotland have shown more than expected cases of hysterectomy noted amongst sterilised women with the risk being four times higher. Women that adopted sterilization as a post-delivery procedure have less chance of hysterectomy than others. Other associated problems that could be major contributors for menstrual-associated problems are the younger age of women that opted for sterilization; increasing years after sterilization, shorter time gap between the last delivery and sterilization and the status of last contraception. The concern with the study group was a major impediment in several studies on sterilization and its impact.

A second CDC report and a mass study carried out by CREST( US collaborative Review of Sterilisation) with a control set reported that sterilised women were no more prone than other women to have menstrual irregularities.

A US study undertaken showed no persistent variations in menstrual bleeding pattern or length of cycle among sterilized women, instead they were more likely to have lesser bleeding and erratic cycles.

Certain studies also show that monilial lower genital tract infection elevated the risk element to three times for decreased/sporadic bleeding pattern and the possibility of normal menses is decreased by 50%. On adopting appropriate menstrual hygienic practices, the likelihood for frequent or extended bleeding pattern was observed to be reduced by sixty percent.

Dysmenorrhea was seen to be more likely when sterilization was undertaken as a minilaparotomy procedure than when compared to laparoscopy and post-delivery sterilization. The tissue damage during the course of the operation and ensuing adhesion could also be the possible contributors. There was also a probability of reduction in dysmenorrhea when sterilization was undertaken concurrently with caesarean section.

Counselling prior to sterilization must be highlighted as sterilization is not the reason behind either menstrual problems or dysmenorrhea. Timely diagnosis and treatment of any infection and improving menstrual hygiene practices is essential for lowering menstrual morbidity.

Reasons behind opting for IUD

One might be an appropriate entrant for an IUD if one:

• Doesn’t have any signs of infection in the pelvis during the time of IUD insertion.
• Keeping relations with one sex mate who is also monogamous and free of infection. This would mean that one is not at heightened risk of developing sexually transmitted diseases or STD’s or Pelvic Inflammatory diseases (PID), or when both partners are consensual regarding condom usage.
• Those who desire for an effectual, long lasting contraception means that needs minimal effort and can be reversed without any difficulty.
• Those women that for certain reasons cannot or don’t desire to take birth control pills or other hormonal contraceptive means.
• Those who are breastfeeding.

The copper IUD is suggested as an emergency birth control means for those who in the recent past have engaged in unprotected sex, wanting to avert pregnancy and intend to prolong the usage of IUD in the future for birth control. The copper IUD is costlier than the emergency birth-control hormone pills when used as a short term form of emergency contraception.

The Effectiveness Quotient of IUD

The IUD is an immensely effectual birth control method.

• In those who used the LNg IUD, only one from one thousand women had pregnancy during the initial year. During the five year spanning usage period, merely seven women from one thousand became pregnant.
• In those who opted for copper IUD, nearly six per one thousand women became pregnant during the initial year. During the ten years spanning usage period, nearly twenty to thirty women from one thousand women became pregnant.
• Majority of pregnancies that occurred alongside the use of IUD took place due to the IUD getting shoved out or ejected from the uterus unawares. IUD’s have a greater probability of being expelled within the initial few months following the use of IUD or after IUD insertion in those women that recently delivered or in those women that haven’t had a child.

The positive aspects of IUD’s comprise it being budget-friendly when taking time consideration it lasts for, effortless usage, lowered chances of getting ectopic pregnancy and no hindrance during foreplay or sexual act.

Read more at: Intrauterine Device – IUD – The Effectual Birth Control Coil – Part II

The IUD could be inserted during any time except when one is pregnant. The IUD is inserted into the uterus by the doctor that is procedure that lasts merely few minutes and could be performed in the doctor’s office. At times, the doctor would inject local anesthesia into the area just around the cervix, though this is not required on most occasions.

The IUD is easily inserted in those women that have previously undergone normal delivery. The doctor might request the patient to feel the IUD thread following its insertion so that the patient comprehends how it feels like. An antibiotics course might be recommended to avert any kind of infection.

Following the insertion procedure, one might need assistance to reach home as one might experience a certain degree of dizziness, cramps, mild bleeding or spotting that could last for up to two days.

The Crucial Follow-up sessions

The doctor might schedule an appointment after one month following the IUD insertion procedure to ascertain its proper placement.

One must make it a point to keep checking for the IUD thread subsequent to every menstrual cycle. This could be done by simply inserting the finger inside the vagina and try to feel the cervix located above the vagina that has a comparatively harder feeling than the rest of the vagina. One must be able to feel the fine, plastic thread dangling out of the cervical opening. The thread might curl around the cervix that at times makes it tricky to detect. One must promptly get in touch with one’s doctor it the thread or the firm end of the IUD cannot be felt.

If one cannot feel the thread, does not essentially translate to a dispelled IUD. At times, the thread is quite dodgy to detect or might have been drawn upwards into the cervical canal, which is something that is totally harmless. A physical examination and at times an ultrasound would help to decipher whether the IUD is correctly placed. One could start another contraceptive till the doctor determines that the IUD is still placed in its apposite position.

Read more at: Intrauterine Device – IUD – The Effectual Birth Control Coil – Part I

An IUD is a miniature plastic device resembling the letter ‘T’, swathed in copper or could contain hormones. The insertion of the IUD is a procedure carried out by a doctor who inserts it into the uterus. The IUD has a plastic string that is attached to the IUD end that dangles down through the cervix into the vagina. The IUD could be checked for its correct placement by feeling for the presence of the string. This string is additionally employed by the doctor during the removal procedure of the IUD.

IUD Types

• LNg or Levonorgestrel IUD – This type of IUD is additionally known by the name ‘Mirena’ that works by releasing levonorgestrel – a type of progestin. The effectiveness of LNg IUD has been noted to being slightly more than copper IUD in the prevention of pregnancy. It might lower the chances of developing pelvic inflammatory disease or PID which is an added benefit not noted in other IUD’s. The LNg IUD has been found to be effectual for a span of five years.
• Copper IUD – The widely used IUD is the copper IUD (for e.g. Paragard). The T-shaped IUD has a copper wire wrapped around its stem portion. The copper IUD is known to stay in situ for a period of at least ten years and is quite an effective contraception means.

Working Principle

Both the kinds of IUD’s are known to hinder fertilization of the egg by having a marring effect on the sperm. The IUD additionally has an effect on the lining of the uterus which is the lodging and growing location for the fertilized egg.

• LNg IUD – The LNg IUD operates by thickening the mucus in the cervix that acts like a barrier for the sperms attempting to make an entry into the uterus, thus impeding fertilization. LNg IUD also avoids the endometrial lining of the uterus from becoming quite thick that in turn makes the endometrial lining an unfavourable place for implantation and growth of the fertilized egg. The hormones present in the LNg IUD also cause a reduction in monthly periods flow and associated discomfort due to cramps.
• Copper IUD – Copper has a lethal effect on the sperm. It causes the uterus and fallopian tubes to produce fluid rich in WBC or white blood cells, copper ions, enzymes and prostaglandins that have a fatal impact on the sperm.

The emergency pill consists of a synthetic form of hormone known as Levonorgestrel much alike the innately occurring progesterone. It is additionally present in certain brands of the standard oral contraceptive pills.

It operates by thwarting the ovary from releasing the egg or if one has already been released and been fertilised, stops the implantation of the fertilised egg into the uterine wall and averts its further development.

Conventionally, duo pills have to be consumed at a time interval of twelve hours, however contemporary versions permit a sole dosage that should be consumed subsequent to ejaculation though not longer than 72 hours, following which one needs to seek medical advice that would involve administration of a higher dosage of hormone.

It is a safe pill and not like the several falsehoods that surround the pill, does not induce abortion as it would not function if a pregnancy is already present. Though not 100% percent dependable and effectual, it is noted to be nearly ninety percent effective which makes it a viable option for those definite about not conceiving.

The current brand of the emergency pill leads to negligible side effects like a minimal extent of nausea. It must under no pretext be used as a regular mode of contraception due to the higher dosage as compared to the normal contraceptive pill and it is not that reliable.

If one is faced with issues like repetitive condom rupture then one needs to be vigilant regarding the shelf life and watch out for the constituents of any spermicidals that are being used and perhaps alter the size.

When the emergency pill is taken, it might alter the menstrual pattern and the periods could commence sooner or be delayed and be heavier than normally noticed. If periods are delayed for more than a week, then one needs to seek professional advice that may involve getting a pregnancy test done.

The emergency pill when used would not offer contraception safeguard for the rest of that particular month’s cycle and a regular contraceptive would be necessary.

The emergency pill is not to be used in those with a past of liver ailment. It should be taken only under ominous and emergency circumstances like rape or rupture condom and must never be mistakably employed as a regular contraception means. As the emergency pill offers no protection against sexually transmitted diseases, one is needs to get tested if one undergoes rape or detects a ruptured condom.

The female condom is intended to be introduced within the vagina prior to sex. The casing holds a stretchy ring on both ends. One of the rings is to be placed within the vagina and aids in keeping the condom in the appropriate position and placing. The outer ring remains on the exterior part of the body which would aid in stopping the condom from being thrust within the vagina. A lubricant is normally supplied in the packaging along with the condom, though additional amounts might be required.

There are many pros and cons to the use of the female condom. The plus points to its use comprise of:

• It is the amongst the few female contraception means that offer a certain degree of protection from STD’s.
• Due to its manner of use, a section of the exterior genitals get a kind of covering that makes it more effectual in warding off STD’s as compared to the male condoms.
• The female condom could be introduced prior to the act commencing, thus there is no disruption or waiting time for erection to be able to use as in male condoms.
• It has no evident side effects and does not require doctor’s consultation, prescription or any fitting required, which is not the case for several other means of female contraception.
• There is no notable lowering of sensation in the use of female condom as compared to the case of male condoms wherein many men report decreased sensation. Hence, it is favourable for both sexes.
• Following the act, immediate withdrawal by the man is not necessary as in the case of male condoms.

The shortcomings of the female condom comprise of:

• It might seem to have an unappealing or unusual appearance by those that use them.
• Comparatively costly than the male condoms. The average female condom has a price of two dollars.
• It might appear to be noisy, could slide out, shift or tear at the time of usage.
• The one-size- to-fit-all female condoms that are available might not favour many women.
• The external ring might cause irritation in the clitoral and labial region.
• Data regarding its effectuality and safety is still inadequate.

The single use female condom must never be used again. Following use one needs to cautiously remove it from the vagina to avoid any semen spillage within the vagina. The female condom must not be used during the same instance as a male condom. It usage for anal purposes is still being investigated by scientists.

Women that have opted for this means of contraception have been noted to follow it much similar as the usage of male condoms. The key motive for its stoppage is been due to its odd appearance.

• The period-halting, low dosage, birth control pill known as the Lybrel is intended to be consumed through the year.
• With the estrogen-progestin combo birth control pill, Seasonale, has to be taken for three months, followed by a no-pills week, there would be just four menstrual cycles annually.
• The estrogen-progestin combo Seasonique has to taken for three months, after which a week of having estrogen-low pills, would lead to four lesser, shorter-spanned menstrual cycles annually.
• A month-lasting, PMS-reducing pill known as Yaz comprises of a total of 28 pills of which 24 are active and 4 are inactive. This makes the menses regularised, flow lesser and short-spanned.
• The PMS and pimple-reducing monthly pill, Yasmin is available in a set of 28 pills, of which 21 are active ones while 7 of them are inactive. This pill causes lesser and regularised flow.

Most women can conceive after close to two months subsequent to halting the intake, though there are few who take longer time, as is the case with the usual birth control pills. Many are apprehensive about health concerns of stoppage or repressing of periods, which actually has no effect on the health and is a good option for those who suffer from heavy, painful menses.

Those above 35years and particularly those who smoke are at greater risk of blood clotting when they consume birth control pills. But this hazard is prevalent even in the usual birth control pills. Even heightened cervical cancer risk plummets as soon the pills are halted. Consuming these pills for five or further years was linked with increasing cervical cancer risk by twofold, but their perils were similar to non-pill takers when they halted the dosage.

The latest research has revealed that there is no basis to summarise that breast cancer risk heightens over the lifetime consumption of the continual birth control pills. Although, hormone replacement therapy or HRT has been related to slightly raise the chances of breast cancer, the estrogen-progestin hormones used in HRT are different than those used in the birth control pills.