Facts and myths about the Intra-Uterine Device (IUD)

The last few months we have experienced several contraceptive pill shortages. Some of the most-used brands were out of stock and so some women stated to consider other forms of birth control: such as the intrauterine device. A lot of women are held back from the decision to get an intra-uterine device because of misunderstandings. In this article, the most heard facts and myths about the IUD are explained by Khansa Soufidi: a gynaecologist at the Womens Health Centre in Amsterdam.

Khansa: “Let me start by saying that there are two groups of IUDs - copper spirals and hormone spirals - and that both are available in different shapes and sizes.


No implantation

In the case of copper spirals, the combination of the fact that there is "something" in the womb and the copper ensures that no pregnancy is possible. Copper stimulates the womb lining in such a way that a fertilized egg cannot implant itself.

In the case of the intrauterine device, the hormone progesterone provides the contraceptive effect. A thick mucus plug develops in the cervix, preventing sperm cells from reaching the cervix. In addition, the womb lining becomes so thin and smooth that - if there is fertilization - the egg cannot implant itself.


What is true?

1.      Placing an IUD hurts

“Placing an IUD is not painless or without discomfort. How much you feel depends on various factors. It can be more painful to get an IUD if you never had a child and you naturally feel more of a big IUD than of a small one.

It does not make much sense to take painkillers prior to placement, as the uterus will contract anyway when the IUD is placed. But if you allow someone with experience to place it and adjust yourself in advance to what is to come, then it is easy to do and the short-term pain is certainly no reason not to take an IUD.

The introduction of an intra-uterine device has been a very unpleasant experience for a few, but fortunately that is not the case for the majority of women. Otherwise, we as gynaecologists would of course not support it.

Since last year there is a smaller version of the hormone spiral, the Kyleena. This is as effective as the larger variants, but because of the size it is more suitable for women who have never given birth. "


2.      An IUD also protects against some STD’s

“That is incorrect! No form of birth control - except the condom - protects against sexually transmitted diseases. "


3.      If your IUD is removed, it will take a long time before you can get pregnant again

“This is not true either. The great thing about an IUD is that you maintain your normal cycle and therefore also have ovulation every month. As soon as the IUD has been removed, you could be pregnant the next month, so to speak. ”


4.      Men can feel the IUD during sex

“There are strings attached to every IUD to facilitate removal. Your partner will not feel the IUD but it is possible that his penis touches those strings. Normally they are cut off one and a half or two centimetres from the cervix. Then they curl around the cervix or even disappear into it and you do not suffer from it.

If they are cut shorter, two small dots are created that can "puncture" the penis. It thus is a matter of good cutting. I advise women not to tell their partner about the strings and the "puncture possibility". If your partner does indeed feel a "shot", then he will address that himself. "


5.      An IUD can get lost in your womb

"You cannot lose an IUD, your womb is not that big. What is possible is that the uterine wall is pierced during the placement of the IUD. It is then possible that the IUD does not end up in the womb, but in the free abdominal cavity. The chance of this is greater when you have just given birth and the womb is still a whole week.

That "piercing" sounds worse than it is, because after ten days the hole is already closed. It is important to be sure that the IUD is properly placed, but if there is any doubt about that, it is easy to check with an ultrasound. Sometimes this happens as standard after the insertion of an IUD. "


6.      The IUD is much more reliable than the pill

“The pill works perfectly if you take it perfectly; at exactly the same time every day. Then there is a 0.3% chance of a pregnancy. But you also get up a little later, and if you get an antibiotic treatment, or have to vomit or have diarrhea, the effect decreases considerably and the chance of pregnancy can increase to 9%.

With an IUD there is no such difference and the chance of a pregnancy is always between 0.2% and 1%. In practice, an IUD is indeed "safer" than the pill. In addition, it is of course very easy that with an IUD you are ready for five years - with some even for ten.


Facts and myths about the Intra-Uterine Device (IUD)