This is a small, flexible device, usually made of plastic .These contain two strings/threads which hang in to the vagina through the cervix. It is introduced in to the womb using a very simple and sterile procedure. There are two IUD’s

  • Copper bearing IUD.
  • Progesterone releasing IUD (mirena).
  • IUD’s can cause an inflammatory response , thus preventing fertilization (sperm meeting the egg).
  • It alters the lining of the womb, making it unsuitable for implantation.
  • It also can stop sperm migration in the female reproductive tract, and interferes with the transport of eggs.
  • IUD do not work by causing abortion.
  • One of the most effective long term methods (99%).
  • IUD is effective immediately after insertion.
  • Can use continuously for 10 years, after 10 years it can be removed and a new one inserted immediately. No need to have an IUD free period.
  • In addition the mirena reduces bleeding in women with excessive bleeding.
  • Even in case of failure, no harm is reported on the fetus.
  • For spacing your pregnancies.
  • To limit the number of children.
  • Those who do not want to use a method that needs regular follow up.
  • Who should not have an IUD?
  • Pregnancy.
  • History of or current pelvic infection.
  • Abnormal uterine bleeding.
  • Confirmed or suspected cancer of the genital tract.
If you are having monthly bleeds :
  • Within first 5 – 7 days of the menses
  • After child birth: Within 48 hours after delivery or wait 4 – 6 weeks. If inserted between 48 hours to 4 weeks, there is a high risk that the loop will slip out of place.
  • After abortion: Within the first 48 hours or 4 -6 weeks after abortion.
The IUD should be inserted by trained persons in an institution under sterile conditions.
Problems you may encounter after insertion
      • Cramping abdominal pain within 24 – 48 hours after insertion. You can use a mild pain killer such as paracetamol.
      • Mild vaginal bleeds during the first 3 – 4 weeks after insertion. This is harmless, don’t worry.
      • Expulsion (slipping out of place) – usually during menses. You need to check for the threads of the loop after each period to ensure that the loop is in place.
      • Prolonged heavy bleeding during the first 3-4 cycles after insertion. This too is harmless, so don’t worry. It will return to normal.
      • Very rarely the IUD can puncture the womb at the time of insertion. However, it will NOT migrate to distant parts of your body.
      • Pelvic Inflammatory Disease (PID). 
      • How to check for threads?
      • Wash your hands. Then either sit or squat down.
      • Put your index or middle finger up into your vagina until you touch the cervix. Your cervix will feel firm and somewhat rubbery, much like the tip of your nose.
      • Feel for the string ends that should be coming through. If you find them, it means that the IUD is in place and working. However, if the string ends feel longer or shorter than before, or if you can’t feel them, meet your doctor soon.
      • Do not pull on the thread ends. Pulling might make the IUD move out of place or even come out.
      • When should you be reviewed after insertion?
  • First follow up visit 4-6 weeks after insertion and every year after that.
    But, if you have any of the following, please see your doctor immediately!
      • Delayed period.
      • Prolonged or excessive bleeding or spotting.
      • Severe abdominal pain or cramps.
      • Pain or bleeding during sexual intercourse.
      • Severe abdominal pain, excessive purulent discharge, fever with or without chills (pelvic  infection).
      • Threads fallen or cannot feel threads.
      • If you feel the hard part of device.
  • Fertility returns immediately after removal. You can try for a pregnancy from the next day after removal.
How soon after the insertion of an IUD can you have sexual intercourse?
  • You can have sex as soon as you feel comfortable, after the insertion of an IUD.
    Will it cause any discomfort during sexual intercourse?
    No, it will not cause any pain or discomfort during sex. Also, sexual intercourse will not displace the IUD. Sexual pleasure will not be affected by IUD.
    Will it protect you against sexually transmitted diseases?
    No, you need to use an additional method such as condoms.
  1. MOH clinics.
  2. Government and private hospitals.
  3. Family Health Bureau – De sarem Road, Colombo 10.
  4. The Family Planning Association of Sri Lanka – Buller’s Lane, Colombo 7.