Let's learn more about the loop (Intrauterine Device - IUD)

When talking about family planning methods, you probably hear the word "IUD" a lot. Maybe you've even thought about using it, but you may have a little fear and doubt in your heart. It's normal to think things like, "What is this really?", "Will it hurt?", "Will there be problems later?" That's why, today, we'll talk about this IUD, or in medical terms, the Intrauterine Device (IUD), in a very simple way that you can understand.

Simply put, what is an IUD?

Imagine this: It's a very small, 'T'-shaped plastic device. Your doctor inserts it into your uterus. Once it's inserted, you don't have to worry about birth control for years. It's one of the most effective long-acting reversible contraception (LARC) methods of birth control, and it's non-surgical .

If you decide you want another baby, you can have it removed at any time by going to your doctor. But remember one thing. While birth control methods like condoms protect against sexually transmitted infections (STIs), an IUD does not. Therefore, if necessary, you can use a condom with the IUD to provide dual protection.

What types of IUDs are available in Sri Lanka?

There are two main types of IUDs. They are copper-containing loops and hormonal-containing loops. Both are very similar in shape. Both have two small strings at the bottom. These strings extend a little way into the vagina. This is so that when the loop needs to be removed, the doctor can grab it and easily pull it out.

How does this little device prevent pregnancy?

These two types of contraception work a little differently. Let's take a look at how they work.

• How the copper IUD works:

When this is introduced into the uterus, the body treats it as a foreign object. Therefore, a small inflammatory response occurs inside the uterus. When the effect of copper is added to this, the environment inside the uterus becomes a place that is not at all favorable for sperm. Therefore, the sperm are destroyed. Even if a sperm fertilizes an egg in some way, due to that inflammatory condition, the embryo cannot implant in the wall of the uterus (endometrium) and grow.

• How the hormonal IUD works:

The hormone levonorgestrel released from this does several key things.

1. Cervical mucus thickens: Normally, this mucus is thin, allowing sperm to swim through it easily. But due to hormones, it becomes thick and sticky. It's like blocking the path for sperm.

2. It thins the uterine wall: This makes it difficult for a fertilized egg to implant there.

3. Partially stops ovulation: This also controls the release of an egg from the ovaries in some women to some extent.

Is this right for me? Who should not use an IUD?

The IUD is a safe method that works for most people. However, there are some situations where it is not a good idea to use it. Your doctor will discuss this with you and make a decision.

IUDs are generally not recommended in the following cases:

• If you are pregnant or suspect you are pregnant.
• If you currently have an active sexually transmitted infection (STI) .
• If you have cervical cancer or uterine cancer .
• If you have unusual vaginal bleeding for which no cause can be found.
• If you have Pelvic Inflammatory Disease (PID) .

In addition,

• If you have an allergy to copper or have Wilson's disease , which causes copper to build up in the body, the copper IUD is not suitable for you.
• The hormonal IUD is not recommended if you have severe liver disease or breast cancer (or are at high risk for it).

Is it painful to insert the loop? How is this done?

This is the biggest problem for many people. To be honest, the pain from this varies from person to person. Some people can put it on without any problems. Others can experience severe pain, similar to menstrual cramps.

The process of inserting the IUD:

This takes less than 15 minutes.

1. First, you will be made to lie down on a special bed as if you were having a Pap smear.

2. The doctor then uses a device called a speculum to hold the vagina open.

3. Next, the cervix is ​​cleaned and, if necessary, a numbing medication can be injected to reduce the pain.

4. The IUD is then carefully placed in the correct position inside the uterus. At this point, you may feel a slight cramping sensation.

After this, you may feel a little dizzy, have stomach and back pain, and even have a little bleeding. So if possible, it's best to take the day off from work and go home and rest. You can take a painkiller like paracetamol for the pain, or apply a hot water bottle.

What are the benefits and side effects of an IUD?

Like any other, an IUD can have both benefits and minor side effects. Let's look at both.

Questions to ask your doctor

Before you decide to have an IUD inserted, ask your doctor all the questions you have.

• Is an IUD suitable for me?
• Is copper or hormones best for me?
• How much bleeding can occur after this is done?
• What changes will occur to my menstrual cycle?
• What should I be especially careful about after applying this?
• Will this affect my or my partner's sex life?

The IUD is one of the safest, most effective, and most convenient birth control methods available today. It's important to be fully informed about it, talk to your doctor, and make the decision that's right for you.

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