Intrauterine Device (IUD)

An IUD is a small, T-shaped or umbrella-shaped device that is inserted into the uterus by a specially trained doctor through the vagina. It has a thin string attached at the bottom, which can be used by you or your doctor to check the IUD’s position or to remove it. The IUD works by preventing sperm from reaching the egg. Additionally, it thins the uterine lining, making it difficult for a fertilized egg to implant. Once placed in the uterus, an IUD can remain effective for 5 to 10 years, depending on the type. You can also choose to remove it at any time.

IUDs come in two types: copper-based and hormone-releasing, such as those containing progestin. They are mostly made of corrosion-resistant plastic, allowing them to stay in place for a long time.

 Copper IUD

Copper IUD

  • Prevents sperm from surviving in the body because copper is toxic to sperm
  • Prevents a fertilized egg from implanting in the uterus

優點及缺點

Hormonal IUD

Hormonal IUD

  • Thickens the mucus around the cervix, making it harder for sperm to pass through and reach the egg
  • Thins the uterine lining, preventing a fertilized egg from implanting

Advantages

  • 99% effective at preventing pregnancy
  • Can be used as an emergency contraceptive; it becomes effective immediately after insertion
  • No need to remember daily or weekly contraceptive methods, and it does not interfere with the sexual experience
  • Once inserted, it can prevent pregnancy for 5 to 10 years
  • Fertility returns to normal once the IUD is removed
  • Suitable for those who cannot use estrogen-based products

Disadvantages

  • Menstrual periods may become irregular, with increased flow or longer duration
  • Spotting before periods
  • Can cause menstrual cramps
  • Does not protect against HIV or other sexually transmitted infections (STIs)
  • Pain may be experienced in the days following insertion, including cramp-like abdominal pain and back pain

Advantages

  • 99% effective at preventing pregnancy
  • No need to remember daily or weekly contraceptive methods, and it does not interfere with the sexual experience
  • Can reduce menstrual cramps
  • Once inserted, it can prevent pregnancy for 3 to 5 years
  • Fertility returns to normal once the IUD is removed
  • Suitable for those who cannot use estrogen-based products

缺點

  • Reduced menstrual flow, with some women stopping their periods altogether
  • May cause irregular bleeding at first, with spotting before periods
  • Hormonal fluctuations may lead to bloating or skin changes, but this is less common
  • Pain may be experienced in the days following insertion, including cramp-like abdominal pain and back pain
  • Does not protect against HIV or other sexually transmitted infections (STIs)

Where Can I Get It Done?
If you need an IUD, you can consult a doctor at a private hospital, the Family Planning Association, Maternal and Child Health Centres, or Women’s Health Centres. The cost can range from $1 to $5,000, so it is advisable to inquire about the price beforehand. Maternal and Child Health Centres or Women’s Health Centres currently only offer copper IUDs at a price of $1, and their services are available only to women of reproductive age.

During your consultation with healthcare professionals, you can expect the following:

  • A few questions about your medical history and family history to determine the most suitable method for you.
  • You will need to inform the healthcare provider about any other medications you are currently taking to ensure they do not interfere with the effectiveness of the IUD.

How to Use and Place an IUD

  • A healthcare provider will explain the procedure for inserting an IUD, as well as the potential risks and complications. You will need to sign a consent form.
  • The doctor will perform a pelvic examination and use an instrument to assess the size of the uterine cavity (an IUD may not be suitable if the uterine cavity is too large or too small).
  • If the uterine cavity size is appropriate, the doctor will use an inserter to place the IUD into the uterine cavity.
  • You will be asked to lie on a bed, remove your lower clothing (such as pants/skirt and underwear), spread your legs, and bend your knees. This position allows the doctor or nurse to slightly expand the vagina using a speculum, making it easier to insert the IUD into the uterine cavity.
  • The string attached to the IUD will be trimmed, leaving about 2 to 3 centimeters (cm) of string outside the cervix. This string is for checking the position of the IUD and for removal by either you or the doctor.

Although the IUD is a long-term contraceptive tool, some women may not be suitable for it, such as those who:

  1. Experience heavy menstrual bleeding, severe menstrual cramps, or abnormal vaginal bleeding
  2. Have severe anemia
  3. Have an allergic reaction to copper (for copper IUDs only)
  4. Have reproductive organ abnormalities (e.g., bicornuate uterus, uterine septum)
  5. Have a history of gynecological conditions (e.g., uterine infections, pelvic inflammatory disease, tumors, ectopic pregnancy, sexually transmitted infections)
  6. Have multiple sexual partners (higher risk of pelvic inflammatory disease)
  7. Have heart conditions, such as valvular heart disease