IUDs are a first line option for contraception

   The most common used contraceptive methode is female sterilization,followed by birth control pills,but the intrauterine device (IUD) Is gaining popularity.In the US,Currently 15 % of women use them.In other parts of the world,the percentage is up to 50%.

 Types:

1) Non Hormonal: 

  only one brand is avilable in the US,its made of Cooper and called Pragard

2) Hormonal:

 a plastic IUD that releases the progesterone (levonorgestrel )hormone,currently 4 brand are avilable in the US,They differe in size and daily hormone dose.They are: Mirena,Liletta,Kylena and skyla.

How effective is the IUD as a contraceptive?

More Than 99% for all types,compare that to a yearly failure rate of 6% for birth control pills ,so basically the IUD is as effective as tubal ligation!

Why are IUDs preferred by gynecologists and  patients alike?

• Efficacy comparable to tubal ligation
• Easy patient compliance,you only need 1-2 visits 
• Long acting .
• Reversible 100% ,with quick return to fertility
• smaller dose of systemic hormone compared to oral pills and injections
• Fewer contraindication,most women can use it
• Can be initiated as Emergency contraception up to 5 days after intercourse
• Health benifits outside Contraception

What are the health benifits outside contraception for Hormonal IUD?

• Reduced risk of cancers (ovary,cervix,uterus) between 30-50 %
• Reduction in average bleeding volume ,in fact Mirena is FDA approved as treatment for heavy menestrual bleeding
• Reduction in painful periods
• Reduction in endometriosis symptomes

How is patient satisfaction with IUD s compared to other methodes?

No single methode works 100% for everyone,but in the world of contraceptive methodes,IUD is considered to have a high satisfaction rate.

Compare that with the fact that the continuation rate for birth control pills at 3 years is only 30%

What is The impact of IUDs on bleeding?

The impact on IUDs on bleeding is one of the most important issues for IUD users.

Two important points to remeber:

1. The impact varies between users.
2. Most heavy or prolonged bleeding patterns significantly improve over the first 6 months.

Copper IUD bleeding impact:

• User may have heavier ,longer or more painfull periods initially in the fisrt few months
• These changes rapidly improve ,after 6 months there is about 80% improvement
• Persistant heavy bleeding occurs in a minority of patients ,some of them will elect to remove the IUD for that

Hormonal IUD impact:

• IUDs usually improves heavy bleeding
• However,heavy bleeding,prolonged bleeding ,unscheduled bleeding and no bleeding (amenorrhea) can occur.
• Rapid improvement in heavy and prolonged bleeding occur over the first six months.

So,In summary,If you are not happy with the bleeding pattern,if you are able to tolerate that for six months,there is a good chance that your bleeding will improve and you would be able to continue using it!

What is the chance that I will stop having my periods all together (Amenorrhea)?

• The higher Hormone dose in the IUD,the higher the chance.
• Over time,The chance will increase
• No health side effects if that happens!
• Some patients are happy with this side effect,some prefer to have some monthly menestrual bleeding.

What are the other risks that I need to know about?

• Expulsion: 3 % 
• Perforation: 0.1%
• Malposition : up to 10 % 
• At our office we use 2D &3D Ultrasound to decrease the risk of these complications.

If you want to go over your contraception methodes,call to make an appointment at our office