IUD: take your doubts and find out if it is a good option for you

The Intrauterine Contraceptive Device, popularly known as IUD, is considered the most effective reversible contraceptive on the market. According to gynecologist Rodrigo da Rosa Filho, although the method still has a low rate of use, it has been growing exponentially in popularity, especially in the last decade. Learn more about the IUD, ask your questions and find out if it is a good alternative for you.

9 questions about the IUD answered

The choice of IUD should always be done with medical advice, because, like any contraceptive method, it has its pros and cons. Below, the gynecologist clarifies some of the most common doubts about the device:

1. How does the IUD work?

According to the professional, there are different types of IUDs, but most are made of polyethylene, with or without the addition of metallic substances (copper) or hormones (progesterone). “When implanted, the IUD creates an intrauterine environment that is hostile to sperm, preventing them from reaching the fallopian tubes or having a spermicidal effect,” says Rodrigo.

2. How to insert the IUD?

“When the patient, together with her doctor, opts for the IUD, the gynecologist inserts the piece into the uterus through a surgical procedure. The device can be housed for five to 12 years, depending on its structure”, explains the doctor.

3. How is the IUD removed?

The validity of the effectiveness of the copper IUD can reach 10 years, while the hormonal one lasts five. But, if the patient wants to remove it before, there is no problem. Rodrigo explains that “the ideal is to wait six months, at least – time in which the effects are still adapting to the body. After that, it can be removed in the office, pulling the device along the threads left visible. If they are not reached, sedation or surgical removal may be necessary”.

4. What is the price of the IUD?

The value of the IUD varies greatly depending on the product chosen and the placement fee charged by the healthcare professional. On average, it costs between BRL 70.00 to BRL 700.00 and placement between BRL 250.00 and BRL 600.00. But an advantage is that the insertion of the IUD is provided for in most health plans and the SUS also offers free (copper) insertion.

“In general, the copper IUD is usually a cheaper device and more accessible to the population as a whole. Taking into account that the device can last up to ten years, its use can financially compensate for expenses with other contraceptive methods such as pills”, comments the specialist.

5. What are the chances of getting pregnant using the IUD?

The doctor says that the IUD, when implanted, works as a mechanical barrier that prevents pregnancy. But, if the woman wants to become pregnant, the indication is that the device is removed about three months before trying to conceive, so that the body has enough time to return to its physiological normality and the pregnancy has a better chance of success.

6. Does the IUD protect against STIs?

The copper or hormonal IUD is a contraceptive method and does not protect against sexually transmitted diseases. Therefore, it is still necessary to use a condom.

7. What are the risks of the IUD?

“It is possible that at the time of placement of the IUD, the muscle contracts and ends up entering the myometrium. In some cases, it can migrate to the abdominal cavity and the worst possible consequence is bowel perforation”, warns the gynecologist.

8. Can any woman use the IUD?

“The method is indicated for patients of childbearing age, as long as there is no suspicion of pregnancy, congenital malformation of the uterus, uterine neoplasms, uterine bleeding of unknown cause, coagulopathies, pelvic inflammatory disease, cervix and risk of sexually transmitted diseases”, he explains. Rodrigo.

9. Do you have any contraindications?

According to the doctor, despite being very effective and helping to avoid side reactions caused by hormones, the device can have some side effects. “In the first three months after IUD placement, the patient may experience worsening menstrual cramps, lengthening the menstrual period by about a day and still having uterine bleeding,” she says.

Once doubts are clarified, it becomes easier to rethink your contraceptive method and consider the possibilities that the IUD offers.

Types of IUD

The two IUD options are Copper and Hormonal. The gynecologist Rodrigo da Rosa Filho explains the characteristics and differences between each of them:

Copper IUD: It is a small and flexible device, in the shape of a T, that is placed inside the uterus in a procedure in the doctor’s office. It acts at different stages of the reproductive process, from making it difficult for the sperm to pass through to preventing the egg from implanting in the uterine wall. Its effects last for about 10 years. It does not require monthly maintenance, only periodic visits to the gynecologist and ultrasound to assess whether it is properly positioned. It can cause changes in the cycle, especially in the first three months. Reports of increased flow, bleeding between periods and more intense cramping are common, varying from woman to woman.

Hormonal IUD: The Intrauterine System (IUS) or Mirena, also known as the hormonal IUD, releases hormones into the body, preventing the sperm from finding the egg. Like the copper IUD, it needs to be placed in the doctor’s office. Because it is hormonal, there is a decrease in flow and duration of menstruation. The effectiveness rate is high, similar to contraceptive methods such as tubal ligation and copper IUD. It lasts up to five years. As with the copper IUD, there are rare cases of perforation of the uterus wall or dislocations.

The specialist emphasizes that a prior consultation is necessary, so that the gynecologist can get to know the patient better, and together, they can decide on the most appropriate one.

IUD x Other methods

Defining the best contraceptive method depends on the characteristics of the organism, routine and habits of each woman. Know the differences of the IUD compared to other methods:

Contraceptive pill

The pill is given continuously and requires daily ingestion of the pills. The pack, which can contain 21 to 28 tablets, should be started on the first day of the menstrual cycle.

When used correctly, it prevents pregnancy more than 99% of the time, but it can have side effects such as nausea and headaches, in addition to bleeding (escapes during the month) and swelling due to fluid retention.

The woman who wants to use the contraceptive pill just cannot be a smoker, as it increases the risk of heart attack and cardiovascular diseases. The IUD, on the other hand, although it can also have some side effect, does not need to be reminded daily and the woman can be more carefree.

vaginal ring

It is a malleable piece, with a rounded shape and made of polyurethane, which is introduced into the vagina as if it were a tampon. It can be inserted by the woman herself and remains inside the vagina for 21 days.

It works by releasing hormones that, like those in the pill, inhibit ovulation – small doses of the substance are released daily and absorbed through the wall of the vagina.

In case of discomfort or expulsion, the ring can stay out of the body for up to three hours, be cleaned and replaced by the woman herself without problems. Unlike the IUD, it does not need to be inserted by a doctor. On the other hand, the IUD does not need to be replaced every month.

Injection

Birth control injections can be monthly or quarterly. After application, the substance is stored in the muscles and is gradually absorbed by the body. Those given quarterly do not have the same positive effect on the skin. Like the IUD, the procedure is done once and does not require a daily reminder.

sticker

Like the vaginal ring, the hormone in the contraceptive patch is absorbed into the skin in small amounts daily for a week. After application (which should be done on the first day of menstruation), it must be changed weekly and a break must be made after the third week, so that menstruation comes down. The main disadvantage in relation to the IUD is the need for constant replacement, in addition to the risk of detachment from the skin.

Diaphragm

The diaphragm is a barrier method, that is: while other methods directly interfere with the menstrual cycle, barrier methods work locally and have been increasingly sought after by women who do not adapt to the use of hormones.

The diaphragm is made of silicone, resembles a hood and must be fitted to the bottom of the vagina by the woman herself, just like menstrual cups. It can also be used together with a condom and does not run the risk of falling out of place during intercourse by creating a vacuum in the region.

It should only be placed at the time of sexual intercourse or minutes before and, in addition, the woman should use a spermicidal gel to increase its effectiveness. It can only be removed from the vagina six hours after intercourse, ensuring that all sperm have already died.

Although it is easy to find, it is necessary to consult your gynecologist to find out which size is right for you.

Condom

It is also a barrier method, without any hormonal interference in the cycle. It is worth remembering that condoms are the only way to prevent both fertilization and sexually transmitted diseases (STDs). The condom must always be placed at the time of intercourse and cannot be used again, even on the same occasion – for each penetration it is necessary to change the condom. When properly placed, the condom creates a “vacuum” and prevents semen from leaking, keeping it stored in the tip of the condom.

The most important thing before opting for the IUD or any other method is to evaluate the pros and cons, understand which one best fits your profile and consult a doctor so that the choice is made without risks and without unwanted consequences.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.