What is an IUD? All the Facts on this Type of Birth Control

Contraception is a form of essential and preventive healthcare, and while there are many options in the market, there’s not much awareness on what each type does.

Let’s start with the IUD or an intrauterne device - or Copper T’s as they are called in India. The thin, inch-long device that gets inserted into your uterus.

How does an IUD work? What types are there? How effective are they as a form of contraception? And why do they remain so unpopular in India (as per our National Family Health Survey data of 2017), despite being one of the most effective types of birth control out there? In fact, they are on the World Health Organisation’s list of ‘essential medications.’

FIT breaks it down.

IUD's Explained: What they Are & How They Work

The IUD is a small T-shaped device that is inserted into the uterus by your gynaecologist or medical practitioner.

It is often classified as long-acting reversible contraception (LARC), as per Mayo Clinic. Insertion can be painful for some women, but the procedure should last only about five minutes. Your doctor may ask you to take some painkillers before just in case. The procedure works like this: the flaps of the T are folded to make the IUD a thin, wire-like, stick. It’s then inserted through the vagina and cervix, and upon reaching the uterus, the flaps open out horizontally. Then the science happens, and it begins releasing either copper or hormones depending on the type, to prevent fertilisation.

Once inserted, they last anywhere from 3-10 years and be taken out upon request. Many women prefer this form of birth control because it doesn't require daily care.

According to WebMD, if used correctly, the chances of pregnancy with an IUD are less than 1 per cent.

How Do They Work?

IUDs basically prevent the sperm from reaching and fertilising the ova and thus preventing fertilisation.

In India, there are two types of IUDs:

• the non-hormonal or un-medicated one that is copper-based and called copper-T,

• and the hormonal or medicated IUD

Copper-T works by releasing copper ions into the uterine area that kill sperms and prevent pregnancy. This is free for low-income patients at government health centers.

The medicated IUD releases a form of progestin which then thickens the cervical mucus and makes it impossible for the sperm to reach the ova, preventing fertilisation.

IUD Myths

One of the myths around IUDs is that only women who have been pregnant can use them - but that’s just not true. Any woman who wants an effective, safe long-form of birth control can use them. It has nothing to do with vaginal delivery, age or any other factor.

Of course, you should avoid using them if you are:

• pregnant

• had a recent STD or pelvic infection

• Have cervical or uterine cancer

• Have unexplained vaginal bleeding

You also can't use the copper-T if you have a copper allergy or Wilson’s disease where your body makes too much copper. WebMD recommends staying away from hormonal IUDs if you have cancer or are at risk of cancer, or have had liver disease.

IUDs in India

Once upon a time, in the 1950’s IUDs were one of the most popular forms of contraception in India. In a newly Independent India, when family planning was a major goal, IUDs were the most popular form of contraceptive, and then came condoms, female sterilization and the pill. However, along the years, they’ve gotten a bad reputation due to some faulty devices on the market, general mistrust and more.

The lack of popularity of the IUD is a cause of concern the world over. The IUDs were popular, until a design flaw in 1970 resulted in women becoming pregnant while on the contraption, or worse, caused serious infections and even death. While this has since been corrected on the newer models, the IUD took a serious reputation hit - and hasn't fully recovered yet.

Doctors were also hesitant in recommending them, and many women feared their side-effects.

According to this report in Cosmopolitan, doctors reported that women would even prefer having abortions than inserting an IUD!

The myths around the device, and the lack of awareness and education around contraceptive options creates more barriers, and many women wrongly assume that abortions are a form of birth control too. Besides, in India, the most preferred contraceptive method, especially in rural areas, still remains sterilisation.

What might help is more hormonal IUDs, like in America, but there aren't enough made at affordable rates in India. Like always, women’s health, especially their sexual health and comfort, is not prioritised and lacking for funds.

IUD Complications

Some of the fears around the IUD are not without reason. Some women report an increase in cramping or excessive bleeding and painful menstruation, especially with the copper-T. With hormonal IUDs, women have fewer cramps, some spotting and then lighter or no periods. However, you can expect cramping for the first few days post insertion.

One of the most serious complaints is the risk of infection, but this is rare and occurs in less than 1 per cent of women. WebMD says that an IUD does slightly increase your chance for pelvic inflammatory disease (PID) which is an infection of the uterus, fallopian tubes, or ovaries. It’s important to treat this quickly to avoid further complications, and one can notice the signs of stomach pain, pain during sex, heavy bleeding, chills, fever and vaginal discharge with a foul odour.

Another rare complication? Perforation, which is when the IUD pokes through your uterus walls. This was more likely with the older models of the IUD.

The Bottom Line on IUDs

Deciding on your birth control option is a personal choice. Like with any other contraceptive option, it’s best to talk to a healthcare provider and make an informed decision.

IUDs are a safe, long-term option that are very effective at preventing pregnancy.

Check with a doctor about which IUD to use, a copper-T or a hormonal one.