- It is a method of long-term contraception.
- Most effective contraceptive device for a parous lady- One who has borne at least one child.
- Usually made of inert materials like plastic, polythene, metal, etc.
- There are 3 generations of IUDs-
- 1st generation:-Lippe’s Loop
- 2nd generation-
- Earlier: Cu7, Cu T-200
- Newer: Cu T variants like-
- T-Cu 220C
- T-Cu 380A
- T-Cu 380Ag
- 3rd generation- Hormone releasing IUDs-
- Progestasert: With 38mg of Progesterone
- LNG-20: Levonorgestrel 20 with 20mcg of Levonorgestrel, a synthetic steroid.
- These cause thickening of cervical mucus which prevents entry of sperm and also makes endometrium unfavorable for implantation.
- Lippe’s Loop-
- Serpentine/S-shaped device with a fine nylon tail attached.
- Made of non-toxic, non-tissue reactive plastic
- Also contains small amount of Barium Sulphate to allow radiographic observation
- Available in varied sizes
- Copper-T-
- Most used IUD in India. E.g. CuT 200, Multiload Cu-250, etc.
- T- shaped copper structure with an attached nylon thread
- Ideally inserted during menstruation or within 10 days of the beginning of menstruation since cervical cavity is at its widest during this period.
- Can also be inserted during first week after delivery
- Makes endometrium unsuitable for implantation by evoking aseptic inflammation and cellular rection in endometrium.
- Copper has spermicidal action as well along with impairing sperm mobility and capacitation.
- Advantages-
- Quite safe- Without any adverse side-effects and suitable for hypertensives, epileptics, breastfeeding mothers, etc.
- Effective- provides long term contraception
- Reversible- Can be easily removed to go back to fertility.
- Inexpensive- distributed free of cost in PHCs
- Disadvantages-
- Requires lot of motivation and convincing on part of doctors.
- May cause heavy bleeding
- If not inserted properly, may come out accidently
- Risks of ectopic pregnancy
- May promote infection, PID, pelvic pain, and heavy periods.