Frequently Asked Questions
Intrauterine Device (IUD)An IUD is a small plastic device inserted into a woman’s uterine cavity to prevent pregnancy.
Sexually transmitted infections such as gonorrhea and chlamydia are the primary direct causes of PID. By itself, the IUD does not cause PID. Poor infection prevention practices at the time of insertion may lead to PID.
Yes. There is no minimum or maximum age limit for using an IUD. An IUD should be removed after menopause has occurred—within 12 months after the woman’s last monthly menstruation. Most women who are within their reproductive years can use the IUD regardless of whether they have previously given birth. The primary factor in deciding not to use an IUD is current STI or pelvic infection. History of adequately treated STI is not a contraindication for UD use.
It is the woman’s prerogative when she wants the IUD removed. The IUD can be removed immediately anytime during the menstrual cycle. You do not have to wait for the menstrual bleeding to have the IUD removed. When the IUD’s effectivity has passed (12 years for Copper-T IUD), the woman should have it removed.
No. The woman can continue to use the IUD while she is being treated for the STI. Removing the IUD has no benefit and may leave her at risk of unwanted pregnancy. If the infection does not respond to treatment, the IUD should be removed and use another family planning method.
No. There is no delay in the return to fertility. A woman can become pregnant once the IUD is removed just as quickly as a woman who has never used an IUD, although fertility decreases as women get older. However, if she develops a PID and is left untreated, there is some chance that she will develop or be at risk for infertility.
Yes. A woman who has not had children generally can use an IUD, but she should understand there is a small risk of expulsion with smaller uterus.
No. The IUD never travels to the heart, brain, or any other part of the body outside the abdomen. Even during sexual intercourse, the IUD does not move.
If a woman or her partner complains of discomfort during sexual intercourse, the woman needs to be examined. If the cause of discomfort is the long string, the string will be cut to 3 cm. If the cause of discomfort is partial expulsion, tje IUD will be removed and a new one maybe inserted. Within the first year of use, spontaneous IUD expulsion occurs in 2 to 10 percent of women. If a woman suspects that IUD expulsion has occurred, she should see a health care provider immediately.
Rarely, the IUD may come through the wall of the uterus into the abdominal cavity. This is most often due to a mistake during insertion. If this is confirmed within 6 weeks after insertion or causing symptoms at any time, the IUD will need to be removed by laparoscopic or laparotomic surgery. However, an out-of-place IUD usually causes no problems and should be left as it is. She will need another contraceptive in the meantime.
No. IUDs are very effective in preventing pregnancies therefore are likewise effective in reducing the risk of ectopic pregnancy. Ectopic pregnancies are rare among IUD users. The rate of ectopic pregnancy among women with IUDs is 12 per 10,000 women per year. On rare occasions that the IUD fails and pregnancy occurs, 6 to 8 of every 100 of these pregnancies are ectopic.
No. An IUD can be inserted at any time during her menstrual cycle if it is reasonably certain that the woman is not pregnant. Monthly bleeding may be a good time because the woman is not likely to be pregnant but may be difficult to see signs of infection.
No, usually not. Most recent research done where STIs are not common suggests that PID risk is low with or without antibiotics. When appropriate questions to screen for STI risk are used and IUD insertion is done with proper
infection-prevention procedures (including the “no-touch” insertion technique), there is little risk of infection. Antibiotics may be considered, however, in areas where STIs are common and STI screening is limited.
In a woman who made an informed decision to use an IUD, it can be inserted as soon as the placenta comes out within 10 minutes or the first 48 hours after delivery (postpartum). In abdominal deliveries, the IUD can also be manually positioned in the fundus before closing the incision of the uterus.
After a miscarriage, the IUD may be inserted within 12 days after the first- and second-trimester miscarriage, and if no infection is present (WHO FP Guidebook, 2018), and the uterus is clinically empty or right after the evacuation. If more than 12 days after miscarriage/abortion, IUD can be inserted if no infection is present and if it is reasonably certain that the client is not pregnant.
Some women report benefits that include:
- Prevents pregnancy very effectively
- Is long-lasting (12 years)
- One time application
- Can be easily inserted or removed by a trained provider
- Immediate return to fertility upon removal
- Has no further costs after the IUD is inserted
- Does not require the user to do anything once the IUD is inserted
- Prevents cervical cancer as Copper IUD causes inflammation to the cervix that prevents the attachment of the HPV virus to the cervical epithelial cells.
- Substantially reduce the risk of ectopic pregnancy.
A woman can have IUD insertion in the following facilities:
- All city and municipal health centers provide IUD insertion for FREE.
- Government hospitals with family planning facilities.
- Private birthing homes or lying-in clinics.
- Private doctors and clinics.
Source: “Frequently Asked Questions (FAQs) on Modern Family Planning Methods: Stop Rumors, Myths And Misconceptions with Correct Answers to Everyday Questions About Modern FP Method” by the Philippine DOH, USAID and JHPIEGO