women s health issues
Intrauterine Devices (IUDs)
Possible problems
Bleeding and pain are the main reasons that women have an IUD removed, accounting for more than half of all removals before the usual replacement time. ThecopperIUD increases the amount of menstrual bleeding and may cause cramps. NSAIDs can usually relieve the cramps.Levonorgestrel-releasing IUDs cause irregular bleeding during the first several months after insertion. But then after 1 year, menstrual bleeding stops completely in up to 20% of women. Typically, IUDs are expelled in fewer than 5% of women during the first year after insertion, often during the first few weeks. Sometimes a woman does not notice the expulsion. Plastic strings are attached to the IUD so that if she wishes, a woman can check every so often to make sure that the IUD is still in place. However, a woman typically has bleeding or pain if an IUD is expelled or is in the wrong position. If another IUD is inserted after one has been expelled, it usually stays in place. If doctors suspect that the IUD has been expelled, women must use another form of birth control until the problem is resolved. Rarely, the uterus is torn (perforated) during insertion. Usually, perforation does not cause symptoms. It is discovered when a woman cannot find the plastic strings and ultrasonography or an x-ray shows the IUD located outside the uterus. An IUD that perforates the uterus and passes into the abdominal cavity must be surgically removed, usually using Laparoscopy , to prevent it from injuring and scarring the intestine. If women conceive with an IUD in place, they are more likely to have a mislocated (ectopic) pregnancy. Nonetheless, the overall risk of an ectopic pregnancy is much lower for women using IUDs than for those not using a contraceptive method because IUDs prevent pregnancy effectively. 