USING INTRAUTERINE DEVICE (IUD)

Possible Problems While Using the IUD

Most women adjust to their IUDs with few or no problems. But for some women:

• cramping may be greater (mostly for a brief time after insertion)

• bleeding may occur between periods

• periods may be heavier and last longer (less so with IUDs containing hormones)

• there is slight risk of genital tract infection during the first three months of use

There is a small chance that the IUD may be expelled from the uterus. You may not know it, and pregnancy could result. Pregnancy with an IUD in place is rare, but if signs of pregnancy occur, you should have a pelvic exam immediately. If you are pregnant, the IUD should be removed as soon as possible. Removal lessens the chance of serious infections that can be life-threatening in rare cases. Removal also reduces chances of miscarriage or premature delivery. In some cases, however, removal may trigger a miscarriage. If you want to end the pregnancy, an abortion should be done early.

Some IUD users have had ectopic (tubal) pregnancies. But ectopic pregnancy occurs less frequently for IUD users than it does for women who use no method. In the rare case, however, when an IUD fails, there is a greater chance that the pregnancy will be in the tube. Ectopic pregnancies are life-threatening. They are usually removed with surgery.

Infection of the fallopian tubes happens more often in IUD users than in nonusers. But the risk of infection is greater only for women who have more than one sex partner or whose partner has other partners. Women who wear IUDs must use condoms if:

• they have more than one partner

• they take a new partner or change partners

• their partner has more than one partner

Infection, with or without symptoms, may increase the risk of tubal pregnancy, cause sterility, or, very rarely, require removal of reproductive organs. An infection that is not treated might become fatal.

Rarely, the IUD may puncture the wall of the uterus. This is usually associated with insertion. In such cases, surgery may be required to remove the IUD.

Warning signs

Tell your clinician immediately if you are not able to feel the string or if you have:

• a missed, late, or light period

• severe cramping or increasing pain in the lower abdomen

• unexplained fever and/or chills

• pain or bleeding during sex

• increased or bad-smelling vaginal discharge

How to Get IUDs and What They Cost

Visit your local Planned Parenthood health center, a family planning clinic, your HMO, or a private doctor. At this time in the United States, the variety of available IUDs is limited. Consult your clinician for more information.

The exam, insertion, and follow-up visit range from $175 to $450. These services are priced according to income at some family planning clinics and are covered by Medicaid.

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