Information for Intrauterine Device Users

1. Intrauterine Device (IUD)

  • IUD is a small device which can be used as a regular contraceptive method. It is very effective and the failure rate is only 1 to 2% in the first year
  • According to research findings, the fertility rate between IUD non-users and ex-users are similar
  • It is inserted into the uterus by the doctor. Before insertion, the doctor will review your medical history and perform pelvic examination to assess your suitability for an IUD. After insertion, you need to attend regular check-ups
  • Two types of IUDs are used in the Maternal & Child Health Centres (MCHCs): "T" type and "Umbrella" type; both bear a thread at their base for self-inspection or examination by the doctor. The "T" type needs to be changed every 5 to 10 years depending on the models, whereas the "Umbrella" type needs to be changed every 5 years

2. How IUD works

Copper IUD can change the environment of uterus, interfere with sperm motility and decrease the chance of fertilisation. Moreover, it can cause changes in the uterine lining, prevent implantation of the fertilised egg and thus preventing pregnancy

3. Who are not suitable for using IUDs

Majority of the women can use IUDs. Seek advice from your doctor if you have any of the following conditions:

  • Known copper allergy (IUDs used in MCHCs contain copper)
  • History of gynaecological diseases (e.g. uterine or pelvic infection, tumour, ectopic pregnancy, sexually transmitted infections)
  • You or your sex partner have more than one sex partner (there is a higher chance of contracting pelvic infection)
  • Known heart problems, e.g. arrhythmia

4. Possible complications

During insertion procedure

  • Fainting or syncope (Vasovagal syncope)
    • During the insertion procedure, minority of the women may experience fainting or syncope due to pain or anxiety
    • It is an uncommon condition and is usually mild
  • Perforation of uterus
    • Occurs in less than one out of every 1,000 insertions
    • The risk of perforation was independently increased in the following women:
      • Who are breastfeeding at the time of insertion
      • Insertion within 36 weeks after giving birth

While using

  • Displacement or expulsion of the IUD
    • This happens in about 5% of users.
    • It commonly occurs in the first 3 months of using the IUD
  • Ectopic pregnancy
    • The risk of ectopic pregnancy for a woman using an IUD is lower than the risk of ectopic pregnancy for a woman without any form of birth control

For IUD users, it is important to rule out ectopic pregnancy promptly if you suspect you are pregnant

5. Common side effects.

  • Effect on menstrual periods: You may experience increased menstrual flow, slight menstrual pain, and increased amount of normal vaginal discharge in the initial period after insertion
  • Pelvic infection: Though not common, the risk of pelvic inflammatory disease is increased in the first 3 weeks following insertion

6. Point to notes after insertion

  • You have to abstain from sexual intercourse or use condoms in the first one week after insertion to decrease the possibility of pelvic infection
  • You need to attend the check-ups including pelvic examination 6 weeks, 6 months and then yearly after the insertion to ensure the IUD is not displaced
  • During menstrual period, inspect the sanitary pads to watch for expulsion of the IUD
  • You are advised to check whether the IUD threads is still in place after menstruation
  • If you cannot feel the IUD threads, please return to MCHC for assessment promptly. At the same time, you have to abstain from sexual intercourse or use an extra contraceptive method such as condoms
  • The IUD must be removed within 1 to 2 years after menopause

Return to MCHC or seek advice from your health providers promptly if you have the following conditions

  • Delayed menses, scanty or lighter menses; heavier and longer menses or vaginal bleeding between periods (intermenstrual bleeding)
  • Suspected or confirmed pregnancy
  • Abnormal or severe abdominal / pelvic pain
  • Foul smelling or pus like vaginal discharge
  • Suspect displacement or expulsion of the IUD
  • You or your partner feel the IUD during sexual intercourse
(Content revised 09/2015)