The intrauterine device (IUD) is the simplest long-acting contraceptive method. Let's explore the entire process of IUD insertion!
How IUDs Work
The "ring," scientifically known as an intrauterine device, is placed within the uterine cavity of women of childbearing age. It achieves contraception through mechanical stimulation and chemical interference without suppressing ovulation or affecting the female endocrine system, thereby avoiding the adverse reactions common to oral contraceptives.
"IUD Insertion" Originated with Camels
Long ago, camels were the sole means of transportation across vast deserts. Ancient Egyptian merchants relied on them to carry heavy cargo on arduous journeys. However, pregnant female camels often delayed shipments.Clever merchants devised a solution: placing smooth stones into the uterine cavity of female camels to prevent pregnancy. This marked the earliest form of the intrauterine device (IUD).
The First IUDs
The earliest IUDs were circular, resembling rings. Made of metals like stainless steel, they could last for decades.
The Evolution of IUDs
Later, developers added plastic support structures and stabilizing rods to resist external forces within the uterine cavity, preventing displacement or distortion caused by aging, gynecological conditions, or uterine abnormalities.Featuring two arms that rest atop the uterine triangle, its central vertical arm incorporates a tail thread for secure retention and easy removal.
Development of Intrauterine Devices
Copper wire can be wound around the vertical arm of the T-shaped device to release copper ions, enhancing contraceptive efficacy.
After years of practical refinement, most IUDs currently used clinically are copper- or hormone-releasing devices. Their frames are made of materials like plastic, polyethylene, or shape-memory alloys, and their shapes vary widely—including circular, T-shaped, V-shaped, Y-shaped, and chain-like designs. Different materials and shapes offer distinct characteristics, making them suitable for women with varying physical conditions and needs.
Unusual Shapes of the "Ring"
While the mechanisms of action vary slightly among different IUD types, they generally achieve contraception through multiple interlinked effects: disrupting sperm survival, motility, and fertilization; and interfering with the movement and implantation of fertilized eggs.
Commonly Used IUDs in China
Commonly used in China are the metal single-ring, twisted-ring, hybrid ring, contraceptive ring, and T-shaped ring, with the metal single-ring being the most prevalent.Non-hormonal IUDs are called inert intrauterine devices. Adding progestin or copper to an IUD enhances contraceptive effectiveness, resulting in hormonal or active intrauterine devices—the currently recommended type of contraceptive device.
Intrauterine Device Insertion Procedure
How is an IUD inserted and removed? It's quite simple. First, the doctor disinfects the area. Then, using an "insertion device," the contraceptive ring is guided into the uterus. After removing the insertion device and trimming the nylon string attached to the ring, the placement is complete.
Illustration of IUD insertion and placement
After IUD insertion, note the following: (1) Remember the IUD type and whether it has a tail string, as this aids future follow-ups. (2) To prevent infection, avoid sexual intercourse for two weeks post-insertion or during any vaginal bleeding. Refrain from heavy physical labor or excessive fatigue.Post-procedure, showering is permissible, but avoid sitting baths or immersing the genital area in water. (3) During the first three months post-insertion, especially with heavy menstrual flow, monitor for signs of IUD expulsion. (4) Mild lower abdominal discomfort, heaviness, or backache within the first week after insertion are normal reactions and generally do not require treatment.
Contraceptive device insertion also has contraindications:
It is not suitable for individuals who are pregnant (including suspected pregnancy), have experienced an infectious abortion within the past three months, suffer from acute pelvic inflammatory disease, infectious endometritis, untreated cervicitis, malignant tumors (including suspected cases), bleeding disorders, or who already have an IUD in place.
Intrauterine Device Removal Procedure
Removal involves gently pulling the nylon string attached to the device or using an extraction tool to retrieve it. Both insertion and removal typically cause only mild lower abdominal discomfort. Avoid sexual intercourse and sitz baths for two weeks following removal.
Device Removal
When should the IUD be removed?(1) The insertion period has expired, and the user is still young; removal and replacement with a new IUD may be considered. (2) The IUD has partially dislodged into the cervical canal. (3) Uterine perforation was detected during insertion, but the device has not entered the abdominal cavity. (4) Irregular bleeding or excessive menstrual flow exceeding twice the normal volume, unresponsive to treatment. (5) Pregnancy with an IUD in place.(6) When acute pelvic inflammatory disease develops and fails to respond to treatment. (7) When menopause has been present for six months. (8) When planning to conceive again. (9) When malignant tumors develop in the cervix or uterine body.
The IUD acts like an excavator
When an egg is released from a woman's ovary, it is fertilized in the ampulla of the fallopian tube. The fertilized egg then develops into an embryo within the fallopian tube before being transported into the uterus.The uterus is fertile ground for nurturing life, while the IUD acts like an "excavator." It continuously scrapes the uterine lining, causing sterile inflammation. This disruption of the uterine environment prevents normal embryo implantation, achieving the goal of contraception.
Side Effects of IUDs
Like any medical intervention, IUDs carry potential side effects. Common issues include:
Side Effects of IUDs
(1) Infection; (2) Menstrual irregularities; (3) Pain; (4) Increased vaginal discharge; (5) Uterine perforation; (6) Pregnancy with an IUD in place.