Intrauterine Device (IUD)
The IUD is a soft, flexible, plastic loop or hook-shaped plastic rod, which must be uncoiled, placed into a tube like a soda straw, and inserted by a physician through the cervical canal and up into the uterine cavity, where it returns to its original coiled shape. Some IUDs are now made of stainless steel. Others have a fine threadlike copper wire wound tightly around the shaft. The small amounts of copper released in the uterus are thought to alter the functions of the enzymes involved in the implantation process and may also interfere with sperm transport within the uterus. The copper’s benefit begins to weaken in two years, and the IUD must be replaced. Another IUD, shaped like a T, releases a small amount of progesterone into the uterine cavity for one year, and then must be replaced.
No one knows exactly why the IUD is effective, but some researchers believe that it hastens passage of the ovum through the cavity of the uterus, not allowing time for it to be implanted to start a pregnancy. Others believe that the IUD causes a local inflammatory reaction inside the uterus, so that the fertilized ovum is unable to implant because the uterine lining is improperly developed. Some feel that the IUD may produce a very early abortion. In one experimental series, rape patients received insertion of copper-bearing IUDs between twenty-four and forty-eight hours later, and no pregnancies resulted.
The main complications and side effects of all IUDs are pelvic inflammatory disease (two to three times normal), septic abortions, perforation of the uterine wall, embedding in the uterine wall, fragmentation of the IUD, exposure to radiation to locate lost IUDs, and ectopic pregnancy. While the overall mortality rate for IUD use is lower than that for oral contraceptives, IUD users experience seven times more disease.
Pelvic infections occur in about 4 percent of all women who have IUDs inserted, some of these very serious, some requiring hysterectomies, and some eventually causing sterility from inflam-mation and scarring of the fallopian tubes. Even the newest IUDs can cause infection and should not be used by women who want a future pregnancy. If a woman has used an IUD, her chances of being infertile are doubled.
Accidental pregnancies in women with IUDs carry an unusual risk of being ectopic; in other words, the ovum may be implanted in the fallopian tube. The chances of this happening are ten times higher with IUD users than with non-IUD users, and spontaneous abortions are three times higher than they are in pregnancies not complicated by an IUD.
Recent data suggests that infections related to ectopic pregnancy pose the greatest single danger of death for IUD users. IUDs significantly increase the chance of abnormal pregnancies, if conception does take place, but the death rates associated with pregnancy are also dramatically increased. One type of IUD was permanently removed from the market in 1975 for these reasons.
It has been documented that using an IUD increases the amount of menstrual flow in most women, and the pattern of menstruation also seems to begin earlier and end later, extending the menstrual period by two to four days each month. Researchers estimate that 10 to 20 percent of women are forced to discontinue use of IUDs within two to three years after insertion because of excessive uterine bleeding. Many more who keep their IUDs may develop iron deficiency because of chronic increased loss of blood, and some may become anemic. Another unpleasant side effect may be a vaginal discharge—watery, clear, mucuslike, and odorless.
An estimated 10 percent of IUDs are expelled during the first year after insertion. Expulsion is most likely to occur during a menstrual period. Attached to the IUD is a firm nylon thread, which protrudes from the cervix into the vagina about one inch. The woman can touch this thread to be certain that the IUD is in the proper place. When necessary, this thread is used to remove the IUD. If tampons are used during the menstrual periods, care should be taken each time a tampon is removed to be sure the thread attached to the IUD did not become entangled, so that the IUD is pulled out along with the tampon.
The easiest time to insert the IUD is during menstruation, when the cervical os is slightly more dilated, and it is the best time because your doctor can then be sure that you are not pregnant. The IUD should never be inserted immediately after the birth of a baby. Always wait at least two months, preferably longer.
If you are using an IUD, it should be checked by your physician every year or two. If you have excessive bleeding, heavy vaginal discharge, pelvic pain (especially with fever or persistent spotting of blood between menstrual periods), see your physician immediately.
While the IUD offers a high degree of effectiveness as a contraceptive, we now know that it can and sometimes does tamper with the delicate internal mechanism of the woman’s body to a serious extent. I cannot recommend it, and I discourage its use.
Posted in Planning and Achieving Parenthood
To Ed Wheat Sr. and Gladys Gibson Wheat, whose commitment, devotion, warmth, generosity, and integrity stood for fifty years as a beautiful picture of genuine agape love.