What is an IUCD?
An IUCD is a small, t-shaped contraceptive device which is placed in a woman’s uterus (womb). It is also known as the IUD, loop or copper coil. IUCDs are made of flexible plastic with a coating of thin copper wire. It has one or two soft threads on the end. These thin threads hang through the opening at the entrance of the womb (cervix) into the top of the vagina.
How does it work?
An IUCD works by stopping sperm reaching an egg. It does this by preventing sperm from surviving in the cervix, uterus or fallopian tube. It may also work by stopping a fertilised egg from implanting in the uterus. An IUCD does not cause an abortion.
How effective is it?
There are different types of IUCDs – newer IUCDs contain more copper and are the most effective. They are more than 99% effective. This means less than one woman in every 100 women who use the IUCD will get pregnant in a year. Older IUCDs have less copper and are less effective. The IUCD is a long-acting reversible contraceptive (LARC). All long-acting methods are very effective because while they are being used you do not have to remember to take or use contraception.
Where do you get an IUCD?
You can get an IUCD from a family planning clinic or a GP. Some doctors will fit IUCDs, but not all.
When and how is it fitted?
An IUCD can be fitted at any time in your menstrual cycle if it is certain you are not pregnant. This means you must have been using a reliable method of contraception for at least 3 weeks before the insertion. This can be arranged at the first visit. An internal examination is carried out before the IUCD is inserted. The insertion visit takes approx 15-20 minutes. Insertion can be uncomfortable or painful for some women. Some women experience a period-type pain and light bleeding for a few days afterwards. Painkillers are provided for this.
How often do I need to see the doctor?
You should have a check-up 4 to 6 weeks after insertion. After this, if you have no problems and check threads monthly, you do not need routine visits. You should contact your doctor or family planning clinic if you have any concerns such as; pain in the pelvic area, unusual vaginal discharge, irregular or heavy bleeding, missed or light period, suspect pregnancy, feel you may have contracted an STI or you wish to have the IUCD removed.
When and how is the IUCD removed?
A trained doctor can take the IUCD out at any time, by gently pulling on the threads.
If you are not going to have another IUCD inserted, and don’t wish to become pregnant, an extra contraceptive method, such as condoms should be used for seven days before the IUCD is removed. This is to stop sperm getting into the body. Sperm can live for up to seven days inside a body and could cause pregnancy once the IUCD is removed. Normal fertility returns as soon as the IUCD is taken out. If you wish to have another IUCD it can be inserted directly after the old IUCD has been removed.
What if I become pregnant while I am using an IUCD?
The IUCD is a highly effective method of contraception, so it is unlikely that you will become pregnant. If you become pregnant there is a small possibility of it being an ectopic pregnancy. This is when the egg is fertilised outside the womb, usually in the fallopian tube, and starts to grow. This is rare but serious. Consult a doctor immediately if you have any lower abdominal pain and experience an unusually light, heavy or delayed period or feel that you may be pregnant.
If you become pregnant with an IUCD in place your doctor will usually remove the device, if possible. While there is a risk of miscarriage following the removal of the device leaving it in could cause miscarriage later in the pregnancy. If you do not have a miscarriage, the IUCD will not harm the baby.
What are the risks?
It is not common but there is a risk that an IUCD might perforate the womb or cervix during insertion. This may cause pain but there are often no symptoms. If this happens the IUCD may have to be surgically removed. The risk of perforation is very low when the IUCD is fitted by an experienced doctor. There is a small risk of pelvic infection in the first three weeks after insertion. Again for this reason the IFPA recommends a test for infection beforehand. The warning signs of pelvic infection are pain during or after intercourse, pain in the lower abdomen or unusual vaginal discharge, especially if you have a fever. Infection can lead to infertility. See your doctor.
The IUCD may be pushed out by the uterus (expulsion). This is most likely to occur in the first three months. It may only be partly expelled or may pass out of the vagina with blood during a period. As such it may be obvious. This is why a doctor will ask a patient to check their IUCD threads each month after their period. As stated, there is a small risk of failure. Some pregnancy complications can be more likely.
Will an IUCD affect my periods?
There may be some bleeding between periods in the first few months. Periods can become heavier and more prolonged. If periods are already heavy a hormone releasing coil (mirena or IUS) may be more suitable.
Can I use tampons?
You may be asked not to use tampons immediately after insertion, but longer term there is no problem.
What if I just had a baby?
If you have just had a baby, an IUCD is usually fitted eight to twelve weeks after the birth. Another contraceptive method will need to be used until then. It can also be put in within 48 hours of giving birth. An IUCD can be used safely while breastfeeding and will not affect milk supply.
Can I use an IUCD after an abortion or miscarriage?
An IUCD can be put in immediately after a miscarriage or abortion if you were pregnant for less than 24 weeks.
Can anyone use an IUCD?
Most women can, including those who have never had a child. However the doctor will need to check your medical history before deciding if it is suitable for you.
Can an IUCD be used as emergency contraception?
Yes, an IUCD is a very effective form of emergency contraception used after unprotected sex or contraceptive failure. There are also two hormonal methods of emergency contraception. For more information, see our Emergency Contraception Factsheet.
Will an IUCD protect me against sexually transmitted infections?
No, the IUCD does not protect against STIs, so you may have to use a condom as well.
Will the IUCD be affected if I am on other medication?
No, your contraception will not be affected by any other medication.
How long does the IUCD last for?
The IUCD acts as an effective method of contraception for 5 to 10 years depending on the device.
Can I have another pregnancy after using the IUCD?
Yes, fertility returns to normal immediately after the removal of an IUCD device.
The IFPA carries out IUCD services at our two clinics in Dublin.