What is an intrauterine device (IUD)?
An intrauterine device, commonly known as an IUD, is a small, T-shaped contraceptive device that healthcare providers insert into your uterus to prevent pregnancy. This flexible device is designed to fit comfortably inside the uterus, where it works as a highly effective form of long-term birth control.
IUDs are considered one of the most reliable contraceptive methods available today, offering years of pregnancy prevention without requiring daily attention like birth control pills. The device is completely reversible—if you decide you want to become pregnant, your healthcare provider can easily remove the IUD, and your fertility typically returns quickly.
While IUDs are extremely effective at preventing pregnancy, they don't provide protection against sexually transmitted infections (STIs). For comprehensive protection, you can combine an IUD with barrier methods like condoms to prevent both pregnancy and STI transmission.
How does an IUD work?
An IUD prevents pregnancy by creating changes within your uterus that make conception highly unlikely. The device works through multiple mechanisms to provide effective contraception.
Once positioned in your uterus, the IUD alters the uterine environment in ways that interfere with the reproductive process. It affects sperm movement and viability, making it difficult for them to reach and fertilise an egg. The presence of the device also changes the lining of the uterus, creating conditions that are not conducive to successful fertilisation or embryonic implantation.
The specific way an IUD works depends on its type. Copper-containing IUDs release copper ions that are toxic to sperm and eggs, while hormonal IUDs release progestins that thicken cervical mucus, thin the uterine lining, and may suppress ovulation. Both types create an environment where pregnancy is prevented before it can occur.
What are the different types of IUDs?
There are two main types of IUDs:
- Hormonal IUDs
- Copper IUDs
Hormonal IUDs
Hormonal IUDs contain a synthetic hormone called progestin that is slowly released directly into your uterus. This hormone works by thickening the mucus in your cervix, which makes it harder for sperm to travel through. It also thins your uterine lining and may prevent your ovaries from releasing eggs.
These devices typically last between 3 to 8 years, depending on the specific brand you choose. Popular hormonal IUD brands include Mirena and Kyleena. Many women find that hormonal IUDs also help reduce menstrual bleeding and cramping as an added benefit.
Copper IUDs
Copper IUDs are completely hormone-free and work by releasing small amounts of copper into your uterus. Copper creates an environment that is harmful to sperm, preventing them from reaching and fertilising eggs. This type also changes the uterine lining to make implantation less likely.
Copper IUDs can provide effective contraception for 5 to 10 years. Common brands include Multiload, Mona Lisa, and Nova-T. These are ideal for women who prefer to avoid hormones or cannot use hormonal contraception due to medical reasons.
Both types offer effective pregnancy prevention, so your choice often depends on your personal preferences regarding hormones and desired duration of use.
For personalised guidance about IUD options and to determine which type might be best for your individual circumstances, consider consulting a women's health specialist. You can contact Thomson Medical to arrange a consultation and receive guidance tailored to your needs.
What is the effectiveness of the IUD?
IUDs are over 99% effective at preventing pregnancy, making them one of the most reliable birth control methods available. This applies to both hormonal and copper types.
Less than 1 out of 100 women will become pregnant while using an IUD. Once inserted, it provides continuous protection without any daily effort required.
If you experience pregnancy symptoms like a missed period, nausea, or fatigue while using an IUD, contact your healthcare provider, as pregnancy is still possible, though extremely rare.
Who needs an IUD?
An IUD is suitable for most women seeking reliable, long-term contraception. It's an excellent choice for women who want effective birth control without daily maintenance, whether they're planning to delay pregnancy, space out pregnancy, or are done having children.
IUDs work well for women who have difficulty remembering daily pills, experience side effects from other contraceptive methods, or prefer a "set-it-and-forget-it" approach to birth control. Both women who have had children and those who haven't can safely use IUDs.
For women who prefer hormone-free contraception, copper IUDs offer an effective non-hormonal option, while hormonal IUDs may benefit those seeking menstrual regulation along with contraception.
Who shouldn't use an IUD?
IUDs aren't suitable for everyone. You should not use an IUD if you:
- Are currently pregnant
- Have an active STI
- Are at high risk for STI exposure
- Have been diagnosed with cervical or uterine cancer
- Experience unexplained vaginal bleeding
- Have a copper allergy or Wilson's disease (copper IUDs are not recommended)
- Have severe liver disease or breast cancer (hormonal IUDs should be avoided)
Your healthcare provider will evaluate your medical history and current health status to determine which type of IUD, if any, is most appropriate for your individual situation.
Not sure if an IUD is right for you? Request an appointment with our women's health specialists to discuss your contraceptive options and find the best solution for your needs.
Our O&G specialist
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How much does an IUD cost in Singapore?
- The insertion and removal of IUDs are charged differently according to the type of IUD used.
- The overall cost comprises expenses for the IUD itself, along with insertion fees, potentially ranging from $150 to $1000.
Where can you get an IUD fitted?
The insertion and removal of an IUD should only be done by trained healthcare professionals in healthcare clinics, as it requires examination of your internal reproductive organs. It can be administered in polyclinics, family planning clinics, women's clinics, and some trained GP clinics.
Pros and Cons of IUD
Pros of IUD
Long-term effectiveness:
The IUD offers long-lasting protection, with certain types offering contraceptive efficacy for up to 10 years.
High effectiveness rate:
Over 99% effective at preventing pregnancy.
Convenience:
Once inserted, individuals can enjoy freedom from daily or monthly contraceptive management.
User satisfaction:
Approximately 90% of users are satisfied with IUD usage.
Hormonal and non-hormonal options:
The IUD is available in both hormonal and non-hormonal (copper) variants, catering to individual preferences and health considerations, offering a range of choices.
Quick reversibility:
Unlike some contraceptive methods, fertility can promptly return after the removal of an IUD.
Cons of IUD
Initial cost:
Although cost-effective in the long term, the upfront expense, covering consultation and insertion, can be relatively high, and it might be up to $1,000.
Side effects:
Some users may experience side effects during the initial months, such as cramping, irregular periods, or changes in menstrual flow.
Insertion discomfort:
The process of inserting the IUD can be uncomfortable or painful for some individuals.
Lack of STI protection:
It does not protect you against STIs.
FAQ
How long does an IUD last?
Hormonal IUDs can remain effective for a duration of 3 to 8 years, while copper IUDs can last for a period of 5 to 10 years.
Is having an IUD painful?
The experience of getting an IUD can vary from person to person, and while some individuals may not find it particularly painful, others may experience discomfort or cramping during the insertion process. The level of pain varies depending on factors such as individual pain tolerance and the provider's technique. Some individuals may experience mild cramping or discomfort for a few days after the IUD is inserted. This discomfort is generally temporary and can be alleviated with over-the-counter pain medication.
How long do you normally experience pain after an IUD insertion?
Some individuals may experience mild to moderate cramping pain for a few days after getting an IUD. This is often the body's response to the presence of a foreign object in the uterus. While most people find that any pain or discomfort resolves within a week, others may experience intermittent cramping for a longer period. It's essential to contact your healthcare provider if the pain persists or grows severe.
What should I not do with an IUD?
With an IUD, you should avoid:
Never attempt self-removal:
Always have a healthcare provider remove your IUD professionally
Don't ignore severe pain:
Contact your doctor immediately if you experience persistent or unusual pain after insertion
Don't skip follow-up appointments:
These ensure your IUD is properly positioned and functioning correctly
Don't neglect string checks:
Check monthly that you can feel the strings and they haven't changed length
Don't ignore infection signs:
Seek medical attention for unusual discharge, odor, or fever
Don't avoid communication:
Always inform your healthcare provider of any concerns or health changes
When can I have sex after an IUD?
Copper IUD (Non-hormonal):
You can generally have sex immediately after the insertion of a copper IUD. There is no waiting period for it to become effective, as it starts working right away.
Hormonal IUD:
If you have a hormonal IUD (such as Mirena, Skyla, or Kyleena), it may take some time to become fully effective. Your healthcare provider will provide guidance on when it becomes effective, and you may need to use additional contraception during the first week.
If the hormonal IUD is inserted within seven days of the start of your menstrual period, it is usually effective immediately.
If it is inserted at any other time during your menstrual cycle, additional contraception may be needed for the first seven days.
Can I use a menstrual cup or tampon with an IUD?
Using menstrual cups or tampons is generally safe with an IUD. However, there is a slight risk of dislodging the IUD if the removal strings become tangled. It's important to be cautious when inserting and removing these products and to check the strings regularly to ensure they are in place.
Does an IUD stop your period?
The effect of an IUD on menstrual periods can vary depending on the type.
Hormonal IUDs (e.g., Mirena, Skyla, Kyleena):
Many individuals using hormonal IUDs experience changes in their menstrual bleeding patterns. These changes may include lighter periods, irregular bleeding, or, in some cases, the absence of menstruation altogether.
Over time, some people using hormonal IUDs may experience a significant reduction in menstrual bleeding, and some may stop having periods altogether. This stage is often referred to as "amenorrhoea," or the absence of menstrual periods.
Copper IUDs:
Copper IUDs are not known to suppress menstrual periods. In fact, some individuals may experience heavier or more intense menstrual bleeding as a side effect of the copper IUD.
What happens if you don't get an IUD removed?
If you do not get an IUD removed and it remains in place beyond its recommended duration, there are potential risks and complications:
Reduced effectiveness:
As time passes, the contraceptive effectiveness of the IUD diminishes. The risk of unintended pregnancy increases.
Displacement or expulsion:
IUDs can sometimes shift position or be expelled from the uterus. This is more likely to occur if the IUD is left in place beyond its recommended lifespan.
Infection:
Prolonged use of an IUD may increase the risk of pelvic infection.
Perforation:
In rare cases, an IUD may perforate the uterus and migrate to nearby organs. This risk is generally higher if the IUD is left in place for an extended period.
Can an IUD lead to infertility?
In general, IUDs are considered safe and effective forms of contraception and do not typically lead to infertility.
What are the side effects of IUDs?
Commonly reported side effects include cramping and changes in menstrual flow, particularly within the first 3 to 6 months of use, typically resolving over time.
When should the IUD be inserted?
IUDs can be inserted at any phase of the menstrual cycle, as long as the individual is not pregnant. It is advisable to go for regular check-ups to monitor and ensure the proper positioning of the device.
The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.
For more information, contact us:
Thomson Specialists (Women's Health)
Thomson Women's Clinic (TWC)
- Novena:
6592 6686 (Call), 8611 8986 (WA) - Bukit Batok:
6569 0668 (Call), 8686 3525 (WA) - Choa Chu Kang: 6893 1227
- Jurong: 6262 8588
- Katong (female doctor):
6970 2272 (Call), 8611 9020 (WA) - Punggol: 6243 6843
- Sembawang: 6753 5228
- Sengkang: 6388 8125
- Serangoon (female doctor): 6382 3313
- Tampines: 6857 6266
- Tiong Bahru: 6276 1525
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