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Understanding IUDs
From Planned Parenthood Federation of America
1996
How IUDs Are Used
IUDs are inserted into the uterus by trained clinicians. Insertion is often done during
menstruation, when the opening of a woman's cervix is softer and she is not likely to be
pregnant.
Preparing for Insertion
Your Medical History
If you are considering having an IUD inserted, your clinician will ask you a number of questions about your medical history, including your lifestyle. Being open and honest about your sex life is extremely important because the IUD isn't suitable for all women.
Your clinician will want your assurance, for example, that you have only one sex partner who has no other sex partners, because the IUD provides no protection from sexually transmitted infections.
The Pelvic Exam
An instrument called a speculum is placed in the vagina. It separates the vaginal walls enough so that the vagina and cervix can be seen to make sure both are normal.
The Bimanual Exam
After removing the speculum, the clinician puts one or two fingers of one hand into the vagina. The other hand is placed on the abdomen. Then both hands are gently pressed together to check the size, shape, and position of the uterus and ovaries.
Scheduling the Insertion
An IUD can be inserted at any time. The most comfortable time may be during a menstrual period, when the cervix is softest. The menstrual fluid also provides lubrication during the insertion. Another good time to have an IUD inserted is midcycle, because the cervix is naturally dilated during ovulation. It is more likely, however, that insertion after menstruation may interrupt or injure a developing pregnancy. This may result in increased bleeding or expulsion.
Insertion
Some clinicians instruct women to take an over-the-counter painkiller an hour or so before
insertion to lessen the cramps that insertion may cause. Because possible infection with
IUD use is most often associated with insertion, some clinicians give women an antibiotic
to protect against infection during insertion.
To insert the IUD, the clinician holds the vagina open with a speculum—as in a pelvic exam.
An instrument called a tenaculum is attached to the cervix to steady the uterus. Then another
instrument, called a "sound," may be inserted to measure the length of the cervical canal and
uterus.
After the sound is withdrawn, a tube containing the IUD is inserted. The "arms" (T bars) of
the IUD bend back as they enter the uterus through the cervix. The IUD is pushed into place
by a plunger in the tube. The arms spring open into the T shape when the IUD is in the uterus.
The tube, plunger, tenaculum, and speculum are withdrawn, and the IUD is left in place with
the filament hanging down through the cervix into the vagina. The clinician snips the string
ends, leaving about an inch to hang out of the cervix. They can't be seen outside the vagina
but are long enough to be felt by a finger inserted in the vagina.
During insertion, uterine cramps may be uncomfortable. Some women feel a bit dizzy, and
rarely a woman may faint. Deep, relaxed breathing may prevent these events. The cramping
eases with a little rest or pain medication. Many women breeze through the insertion feeling
nothing more than mild discomfort. Women with sensitive cervical tissue may need to have
a local anesthetic injected around the cervix to reduce or prevent the pain.
If you have an IUD inserted, you may want to have someone with you to escort or drive
you home. You should plan to rest at home until you are comfortable.
After Insertion
Many women adjust to their IUDs very quickly. Others may take several months to become
entirely comfortable. Heavy bleeding and cramping in the first few months may lead women
to change their minds and ask their health care providers to remove the IUD. Many clinicians
prescribe medication during the first few months to lessen bleeding and cramps during
menstruation. Overall, women's level of satisfaction with the IUD is quite strong.
More than 60 percent of women who have IUDs inserted continue to use them for more than
two years. More than 95 percent of IUD users are pleased with them.
There may be some spotting between periods during the first few months, and the first
few periods may last longer, and the flow may be heavier. It is not unusual for a woman
to have heavier and longer periods while using an IUD.
Cramping or backache may occur for several days or weeks after insertion. Simple pain
medication usually clears up cramping and discomfort. If bleeding or pain is severe
and does not seem to lessen, tell your clinician.
You should have a checkup after your first period. Don't wait longer than three months
after insertion to make sure your IUD is still in place. Women using an IUD should have
checkups at least once a year to make sure everything is all right. This is usually done
at the time of your annual physical and Pap test. Your clinician will tell you the type
of IUD that is inserted and when it should be replaced. You should write this information
down and keep it in a safe place. Otherwise, clinicians you see in the future will not
be able to tell which IUD you have or when it needs to be replaced.
Continue - Checking Your IUD
Understanding IUDs Table of Contents
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