A small T-shaped device placed inside the uterus provides long-term contraception. Copper IUDs are effective for up to 10 years and hormonal IUDs for 5-8 years.
Indication
- Desire for long-term and reversible contraception
- Preference for copper IUD when hormonal methods are contraindicated
- Hormonal IUD as an option for menstrual irregularity or heavy bleeding (menorrhagia)
- For women who have difficulty taking the contraceptive pill regularly
- Emergency contraception (copper IUD within 5 days after intercourse)
- Therapeutic use of hormonal IUD in endometrial hyperplasia
Preparation
- Insertion is preferred during or shortly after menstruation
- Examination and, if needed, smear/culture to exclude active vaginal/pelvic infection
- Beta-hCG test if pregnancy is suspected
- Taking an analgesic (NSAID) 30-60 minutes before the procedure may reduce discomfort
- Cervical-softening medication may be recommended by the physician if needed
How it's performed
- The patient is placed in the gynecologic examination position and a vaginal speculum is inserted
- The cervix is cleansed with an antiseptic solution
- Uterine depth and direction are determined with a sound (measuring device)
- The IUD is placed into the uterine cavity through a thin applicator
- The threads are trimmed to 2-3 cm into the vagina to allow checking
- For removal, the threads are gently pulled to extract the device
Post-procedure
- Spotting and mild cramping may occur in the first week; an analgesic is sufficient
- Follow-up examination at 1 month confirms thread position and correct placement
- Copper IUDs may stay in place for up to 10 years and hormonal IUDs for 5-8 years
- Self-checking the threads with a finger after each menstruation is recommended
- Heavy bleeding, fever or severe abdominal pain require immediate evaluation
Risks
- Temporary pain, cramps and vasovagal syncope (rare) during insertion
- Uterine wall injury (perforation, 0.1-0.2%)
- Displacement or expulsion of the IUD (2-10% in the first year)
- Heavier and more painful periods possible with copper IUDs
- Spotting in the first months and decrease or cessation of periods with hormonal IUDs
FAQ
Is the procedure painful?
Most women describe pain similar to menstrual cramps. The procedure takes 5-10 minutes and generally does not require anesthesia. Discomfort can be slightly greater in women who have not given birth.
Can I get pregnant immediately after IUD removal?
Yes. Fertility usually returns from the first menstrual cycle after removal. Removing it 1-2 months before a planned pregnancy is sufficient.
Which type of IUD is more suitable for me?
If your periods are regular and light, a copper IUD may suit you; if you have heavy and painful periods, a hormonal IUD may be more appropriate. The decision is based on age, fertility plans and medical history.
Can the IUD be felt during intercourse?
No. A correctly placed IUD is not felt during intercourse. A partner may sometimes feel the threads, in which case the physician can shorten them.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Dilation and Curettage (D&C)
Obstetrics Services
Dilation and curettage (D&C) — curettage of intrauterine tissue for diagnostic or therapeutic purposes (cervical dilation and uterine curettage).
Ectopic pregnancy treatment
Obstetrics Services
Ectopic pregnancy treatment — medical (methotrexate) and surgical (salpingostomy/salpingectomy) options for a pregnancy implanted outside the uterus.
Vaginal Birth
Obstetrics Services
Vaginal birth — the safe, preferred method of delivery in suitable pregnancies, in which the baby is born through the birth canal.
Cesarean delivery
Obstetrics Services
Cesarean delivery — surgical delivery of the baby through the abdominal wall for medical reasons.
Hysterectomy
Obstetrics Services
Hysterectomy — surgical removal of the uterus, performed for medical reasons.
Hysterosalpingography
Obstetrics Services
Hysterosalpingography (HSG) — radiological evaluation of the uterus and fallopian tubes.
Colposcopy
Obstetrics Services
Colposcopy — magnified examination of the cervix, vagina and vulva.
Myomectomy
Obstetrics Services
Myomectomy (fibroid surgery) — uterus-sparing removal of benign fibroids in the uterine wall.