• Intrauterine devices (IUDs) are small, flexible, T-shaped plastic devices that are inserted into the uterus.
    An IUD is left in place for 3, 5, or 10 years, depending on the type, or until the woman wants the device removed. IUDs must be inserted and removed by a doctor or other health care practitioner. Insertion takes only a few minutes. Removal is also quick and usually causes minimal discomfort.
    IUDs prevent pregnancy by

    Killing or immobilizing sperm
    Preventing sperm from fertilizing the egg
    Creating an inflammatory reaction inside the uterus that is toxic to sperm

    In the United States, about 12% of women who use contraception use IUDs. More and more women are using them because of their advantages over oral contraceptives:

    IUDs are very effective.
    IUDs have no general, bodywide (systemic) effects.
    Women need to make only one contraceptive decision every 3, 5, or 10 years.

    Five types of IUDs are currently available in the United States.
    Four of them release a progestin (levonorgestrel ). One of these is effective for 3 years, and the others are effective for at least 5 years. During that time, only about 0.9% of women become pregnant with the 3-year IUD, and about 0.7 to 1.5% of women become pregnant with the 5-year IUDs.
    The fifth type, which contains copper, is effective for at least 10 years. When it is left in place for 12 years, fewer than 2% of women become pregnant.
    One year after removal of an IUD, 80 to 90% of women who try to conceive do so.
    Most women, including those who have not had children, and adolescent girls, can use IUDs. However, IUDs should not be used when the following conditions are present:

    A pelvic infection, such as a sexually transmitted disease or pelvic inflammatory disease
    A structural abnormality that distorts the uterus
    Unexplained bleeding from the vagina
    Gestational trophoblastic disease
    Cancer of the cervix or cancer of the lining of the uterus (endometrium)
    Pregnancy
    For levonorgestrel -releasing IUDs, breast cancer or an allergy to levonorgestrel
    For copper IUDs, Wilson disease or an allergy to copper

    Having had a sexually transmitted disease, pelvic inflammatory disease, or a mislocated (ectopic) pregnancy in the past does not prevent women from using an IUD.
    Religious beliefs that prohibit abortion do not prohibit the use of IUDs because IUDs do not prevent conception by causing a fertilized egg to be aborted. However, when used for emergency contraception after unprotected sex, a copper IUD may prevent a fertilized egg from becoming implanted in the uterus.
    An IUD may be inserted at any time during the menstrual cycle if women have not had unprotected sex since their last period. If they have had unprotected sex, a pregnancy test must be done before an IUD is inserted, and women are advised to use another method of contraception until the test is done. Pregnancy must be ruled out before the IUD is inserted unless women wish to use an IUD as emergency contraception after unprotected sex. In such cases, a copper IUD may be inserted to prevent unwanted pregnancy. If inserted within 5 days of one act of unprotected sex, a copper IUD is nearly 100% effective as emergency contraception. Then, if the woman wishes, it may be left in place for long-term birth control. A levonorgestrel -releasing IUD is not used for emergency contraception, and pregnancy must be ruled out before it is inserted.
    Before the IUD is inserted, doctors may recommend testing for sexually transmitted diseases (STDs) based on a woman


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