They will then insert a speculum into the vagina to separate the walls, enabling them to see better. Using a small instrument, they will insert the IUD into the uterus through a small opening in the cervix.
Some people experience cramping similar to or sometimes more intense than menstrual cramps. If the pain feels unusual or unbearable, the person must tell the doctor. The whole process usually takes only a few minutes. Some people feel dizzy or faint after an IUD insertion, so it can be a good idea to have someone accompany them for the journey home.
It is usually safe to return to work or school right away. However, if a person is feeling intense pain or cramping, they may wish to rest for a day. Following insertion of an IUD, it is normal to notice some spotting.
According to Planned Parenthood, spotting can last up to 3—6 months. The individual should ask the doctor how long to wait before having unprotected sex.
One of the main benefits of an IUD is that it requires no special care. In the days following insertion, it is common to experience some cramping and spotting. OTC medication can help reduce these symptoms. Any pain should disappear in a few days. The IUD attaches to a string that enables a doctor or nurse to remove the device.
Some women can feel the string with their fingers. It is best to leave it alone. The string is not dangerous but pulling it could move or even remove the IUD. If the string causes irritation or if a partner can feel the string during sex, a person can ask a doctor to trim it. In rare cases, an IUD can come out on its own. If this happens, it is possible for the person to become pregnant. Anyone whose IUD has fallen out should call a doctor and not have unprotected sex.
Copper and hormonal IUDs can cause side effects, although these usually resolve after a few months. People with a history of cardiovascular disease, those who smoke, and those who are over 35 years old are more likely to have complications from a hormonal IUD. It is a myth that IUDs can travel to other areas of the body, such as the brain or lungs.
IUDs can prevent pregnancy for 3 to 12 years and sometimes longer. It is possible to remove the IUD at any time. During removal, a nurse or doctor will ask a person to lie on their back and put their feet in stirrups. They will insert a speculum to open the vagina and then gently tug on the IUD string.
Sarah J. Betstadt peer reviewer reports that she is on the speakers bureau for Merck. All of the relevant financial relationships listed for these individuals have been mitigated. None of the remaining planners or authors for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Reprints Share. Keywords IUD. By Rebecca H. Report Abusive Comment Thank you for helping us to improve our forums. Is this comment offensive? Please tell us why. Restricted Content You must have JavaScript enabled to enjoy a limited number of articles over the next days. Please click here to continue without javascript.. View PDF. Finally, the threads emerging from the cervical os should be cut to a length of 2 to 3 cm.
The inserter is withdrawn while the intrauterine device is released. Following insertion of either device, a follow-up appointment should be planned after the next menses to address any concerns or adverse effects, ensure the absence of infection, and check the presence of the strings. The most common adverse effects of IUDs are cramping, abnormal uterine bleeding, and expulsion Table 3.
First-year failure rates are reported to be between 1 and 2 percent. Information from references 4 , 5 , 7 , 11 , and If the IUD threads are ever not present, a pregnancy test should be performed. When the results are negative, a cytobrush can be inserted gently into the cervical canal to locate the threads. If this method is unsuccessful, radiography or ultrasonography may be used to locate the IUD. Uterine perforation, which is more likely to occur during insertion of the device, ranges from 0.
When the results of the pregnancy test are positive, an ectopic implantation must be ruled out. If the strings are visible and the pregnancy is early, the IUD can be removed but with a risk of pregnancy loss. If the strings are not visible, ultrasonography should be performed to identify the IUD for removal. An IUD should be removed at the expiration date, when the patient develops a contraindication, when adverse effects do not resolve, or on patient request.
Treatment for cervical dysplasia may be different with the IUD present. Colposcopy may be performed, but the IUD should be removed if an excisional procedure is performed. The IUD is removed by securely grasping the threads at the external os with ring forceps. Traction should be applied away from the cervix. If resistance is met, the removal should be abandoned until it is determined why the IUD is not moving.
A deeply embedded IUD may have to be removed hysteroscopically. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more.
He also is an associate professor of family and community medicine at the University of Texas Southwestern Medical School, Dallas.
Address correspondence to Brett A. Johnson, M. Wheatland Rd. Reprints are not available from the author. The author thanks Kaydance Kerrick for assistance with the preparation of the manuscript. The author indicates that he does not have any conflicts of interest. Sources of funding: none reported. IUDs—an update. Popul Rep B.
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Nelson AL. The intrauterine contraceptive device. Obstet Gynecol Clin North Am. Ronnerdag M, Odlind V. Health effects of long-term use of the intrauterine levonorgestrel-releasing system. A follow-up study over 12 years of continuous use. Acta Obstet Gynecol Scand. Levonorgestrel-releasing and copper-releasing Nova T IUDs during five years of use: a randomized comparative trial. Montvale, N. Canavan TP.
Appropriate use of the intrauterine device. Am Fam Physician. American College of Obstetricians and Gynecologists. The intrauterine device. ACOG technical bulletin no. Washington, D. Antibiotic prophylaxis for intrauterine contraceptive device insertion.
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