 | 
What are the risks associated with IUDs? |  |
All of the following are legitimate concerns for any woman considering an IUD. No protection against STIs -- IUDs are birth control devices, only. This is why they’re recommended only for women in stable, mutually monogamous relationships in which both partners are free of STIs. Increased risk of pelvic inflammatory disease (PID) -- PID is usually caused by a sexually transmitted infection that moves from the vagina into the upper reproductive tract (uterus, fallopian tubes, ovaries). PID increases the risk of ectopic pregnancy and can result in infertility. One way the upward movement of STI is facilitated is the insertion of an IUD, and any woman who has an IUD inserted is at increased risk of PID for the first 20 days. A woman with an IUD in place who acquires an STI is also at greater risk for PID than if she were using another form of contraception. Close monitoring for PID symptoms in the initial 20 days of use and subsequent avoidance of STIs are usually adequate safeguards. Ectopic pregnancy -- When a fertilized egg begins to develop anywhere outside the uterus, the pregnancy is termed ectopic. Ectopic pregnancy is a serious condition which overall occurs in 1-2.5% of pregnancies. IUDs do not increase the risk of ectopic pregnancy. IUDs are just better at preventing normal pregnancy than ectopic pregnancy, so a greater proportion of the very few pregnancies that do occur with an IUD are ectopic. Expulsion of the IUD -- Between 2% and 10% of women who have an IUD inserted will spontaneously expel the device within the first year, and 20% of expulsions go unnoticed. The contraceptive protection of an IUD ends immediately upon its removal, so if a woman expels the device, she will very shortly be at risk for pregnancy unless other contraceptive precautions are taken. A third of pregnancies occurring among IUD users are actually the result of the device being expelled. A woman using an IUD should regularly check that the device is still in place by feeling inside her vagina for the monofilament string hanging down from the bottom of the T-shaped frame. Perforation -- With any IUD, there is a small risk of perforation of the uterus, 1 in 1000 to 3 in 1000 (0.1% to 0.3%). This sounds painful but usually isn’t, and in most cases its noticed right away and corrected. Sometimes the IUD “migrates” through the perforation into other regions of the pelvis, in which case surgery may be required to remove the device. |
|
|
