Intra Uterine Devices (IUD) / ALat Kontrasepsi Dalam Rahim

What is the IUD?

The IUD is a copper and plastic T-shaped device, about 1.4 inches long and 1.2 inches across at the "T." It is inserted and stays in the uterus. It has two fine strings at the bottom that will protrude about 1" from the cervix into the vagina. These strings should cause no discomfort for the woman or her sexual partner.

How does it work?

The IUD probably works in several ways to prevent pregnancy, interfering with 1) movement of sperm,
2) fertilization of an egg, and
3)implantation of a fertilized egg in the uterine wall. The IUD does not prevent ovulation or sexually transmitted infections.

How effective is it at preventing pregnancy?

The IUD is very effective at preventing unplanned pregnancy. If 100 women use the IUD for one year, only one might be expected to get pregnant (a failure rate of 1%). This compares to failure rates of 3% for oral contraceptive pills, 12% for condoms alone, 18% for diaphragm, 18 to 26% for vaginal sponges, 20% for periodic abstinence ("rhythm method") and 85% for no method of contraception.

What are side effects of the IUD?

While the IUD is being placed, the following may occur:

· Pain, usually uterine cramping or low back pain, that usually resolves within one hour of insertion.

· Fainting, rarely

· Some vaginal bleeding is common for a few days

· Partial or total perforation of the IUD through the uterus wall, usually accompanied by persistent uterine cramping, bleeding or low back pain. This is very rare.

Once the IUD is in place, the following may occur:

· Bleeding between menstrual periods during the first 2 to 3 months

· Heavier and longer menstrual periods, more common during the first 2 to 3 months

How well do women tolerate the IUD over time?

In clinical studies, the IUD falls out during the first year of use in 5 to 6 women out of 100 (5-6%). Twelve percent of women have the IUD removed because of bleeding and pain.

What effect does the IUD have on future ability to have children?

Once removed, the prior contraceptive effect of the IUD ends; it should not have lingering effects on fertility. In one study of 293 women whose IUD was removed, 78% seeking pregnancy became pregnant within one year.

Special Concerns

Women who use IUDs are more likely to contract infection in the female organs: uterus, fallopian tubes, ovaries and surrounding tissue. This is called "pelvic inflammatory disease" (PID). Infection is more likely in women with multiple sexual partners. You should not use the IUD if you have ever had PID or have more than one sexual partner.

Women who use IUDs only rarely become pregnant while the IUD is in place. However, if they do, that pregnancy is more likely to be ectopic, that is, implanted outside the uterus, usually in a fallopian tube. If you have ever had an ectopic pregnancy, your risk of another one while using an IUD is greater.

This brief summary is meant to help women decide if the IUD is a good contraceptive choice for them. It does not replace the need for women who choose the IUD to read and sign the Patient Package Insert for that product.
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