IUD

Definition

An IUD is an intrauterine device made of plastic and/or copper that is inserted into the womb (uterus) by way of the vaginal canal. One type releases a hormone (progesterone), and is replaced each year. The second type is made of copper and can be left in place for five years. The most common shape in current use is a plastic "T" which is wrapped with copper wire.

Purpose

IUDs are used to prevent pregnancy and are considered to be 95-98% effective. It should be noted that IUDs offer no protection against the acquired immune deficiency syndrome (AIDS) virus or other sexually transmitted diseases (STDs).

Precautions

IUDs are placed in the uterus by physicians. Prior to placement the doctor will take a medical history, do a physical examination, and take a Pap test. Women who have had tubal pregnancies, an abnormal Pap smear, or abnormal vaginal bleeding are generally disqualified from using this form of contraception. Also, women who have STDs, an allergy to copper, severe pain with periods (menstruation), sex with multiple partners, or who are currently pregnant are not eligible for an IUD. There are no age restrictions.

Description

There is continuing controversy over exactly how IUDs prevent pregnancy. Some researchers think pregnancy is controlled by preventing conception (fertilization), while others believe that the devices prevent embryo attachment to the uterine wall (implantation).IUDs which release a hormone may prevent pregnancy in several ways. Since one hormonal response is a thickening of the mucous at the entrance to the uterus, it is more difficult for the sperm to gain entry. This prevents the sperm from reaching an ovum. At the same time, the lining of the uterus becomes thinner, making it more difficult for a fertilized egg to implant itself in the uterus. The copper device slowly releases copper which is believed to weaken and perhaps kill sperm. An alternate explanation is that these objects "sweep" the uterus, dislodging any fertilized egg that attempts to implant itself. In addition, both devices tend to cause a mild inflammatory reaction in the lining of the uterus which also has an adverse impact on implantation.

Preparation

After the physician approves the use of an IUD, the woman's genital area is washed thoroughly with soap and water in preparation of IUD insertion. The opening into the uterus (cervix) will also be cleaned with an antiseptic such as an iodine solution. Actual IUD insertion takes about five minutes, during which a local anesthesia is used to reduce any discomfort associated with the procedure. A plastic string connected to the IUD will hang out of the uterus into the vagina. The string is used to periodically check the position of the IUD.

Aftercare

The woman will be taught to watch for the signs and symptoms of potential complications and how to check the string, which should be done at least once a week. To check the string, the woman should first wash her hands with soap and water. From a squatting position, or with one foot elevated (such as on a chair), she should gently insert her finger into the vagina until she nears the cervix. If she cannot feel the string, if the string feels longer than it should, or if she can feel part of the IUD, she should notify her physician immediately. Additional information that needs to be reported includes painful intercourse and unusual discharge from the vagina.

Risks

Serious risks are rare, but include heavy bleeding, pain, infection, cramps, pelvic inflammatory disease, perforation of the uterus, and ectopic pregnancy.

Key terms

Antiseptic — An antiseptic is a chemical that prevents the growth of germs.Hormone — Hormones are chemicals that are produced in an organ or gland and then are carried by the blood to another part of the body where they produce a special effect for which they were designed.Pap test — This is a procedure by which cells are collected from the cervix and vagina by inserting a swab into the vaginal canal. These cells are then examined under a microscope in order to detect signs of early cancer.

Resources

Organizations

Planned Parenthood Federation of America, Inc. 810 Seventh Ave., New York, NY,10019. (800) 669-0156. http://www.plannedparenthood.org.

device

[de-vīs´] something contrived for a specific purpose; usually a simple mechanical apparatus.assisting d's (assistive d's) tools and implements that aid a person with a disability in carrying out mobility or activities of daily living.intrauterine device see intrauterine device.left ventricular assist device a circulatory support device consisting of a pump connected to an external pneumatic power source and control circuit; it has afferent and efferent conduits attached respectively to the left atrium or ventricle and the ascending aorta. Each conduit contains a porcine valve to ensure unidirectional blood flow and maintain systemic circulation when the heart is unable to do so. The device is used as a bridge to transplantation.mobility device a device such as a wheelchair, motorized scooter, cart, or stroller that permits the disabled individual to move about and have greater access to the environment.terminal device the end piece of a prosthesis for the upper limb; it may be a hook or a mechanical or cosmetic hand.

intrauterine

[in″trah-u´ter-in] within the uterus.intrauterine device (IUD) (intrauterine contraceptive device) a mechanical device inserted into the uterine cavity for the purpose of contraception. These devices are made of metal, plastic, or other substances and are manufactured in various sizes and shapes. Their effectiveness is based on their alteration of the endometrium and consequent disruption of implantation; there is generally no effect on the menstrual cycle.
After the IUD has been inserted, the patient is instructed to have yearly follow-up examinations. Contraindications to insertion include recent pelvic infection, suspected pregnancy, cervical stenosis, myoma of the uterus, and abnormal uterine bleeding. IUDs are not recommended for women who have never been pregnant because of the severe pain and bleeding that they produce in the majority of these patients.
The IUD is not 100 per cent effective and its use carries some risks. The device does not prevent ovulation or extrauterine implantation; therefore, ectopic pregnancy must be suspected when irregular bleeding or pelvic pain develops in a patient with an IUD. Four to five per cent of all pregnancies occurring in women with IUDs are likely to be outside the uterus. The increased risk for pelvic inflammatory disease is from three to five times that of women who do not use an IUD. Because pelvic inflammatory disease frequently leads to an inability to conceive as a result of scarring and narrowing of the fallopian tubes, the IUD also increases the chances for infertility. Many experts advise against the use of IUDs in women under 25 years of age and in those who hope to have children later in life.
Other possible adverse effects associated with the use of IUDs include uterine perforation, which is rare, and severely increased menstrual flow. Increased dysmenorrhea and intermenstrual bleeding are common in women who have an IUD in place.

Intrauterine contraceptive device (IUD). From Nichols and Zwelling, 1997.

IUD

Abbreviation for intrauterine device.

IUD

abbr. intrauterine device

IUD

1. Intrauterine death.2. Intrauterine device—a contraceptive device that prevents pregnancy primarily by mechanical disruption of the endometrium Types Coil, loop, triangle, or T-shaped, made of plastic or metal Co-morbidity Actinomycosis affects 85% of ♀ with an IUD in place for ≥ 3 yrs; ± 20% of ectopic pregnancies occur in IUD users; pelvic infections are 3 to 7-fold ↑ in IUD users, often polymicrobial–eg, aerobic and anaerobic bacteria, mycoplasma, Chlamydia spp. See Copper-Seven, Dalkon Shield, Pearl index.

IUD

Abbreviation for intrauterine device.

IUD (intrauterine device)

any device such as a plastic/copper coil that is introduced into the female uterus as a means of preventing either fertilization of the egg or implantation of the embryo. see BIRTH CONTROL.

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