Intrauterine devices (IUD)

Question 1

How you you counsel a patient on IUDs?

Answer 1

• see a doctor if you have signs of an infection, such as fever, unusual vaginal discharge or pain low in your abdomen because the IUD can increase the chance of pelvic inflammatory disease. It is most likely in the 3 weeks after the IUD is fitted (but can happen at other times)
• make sure you know how to check for presence and length of IUD string each month or after a period as it may be expelled unnoticed. Contact your doctor if you cannot feel the string.
• take an oral analgesic (eg NSAID) an hour before insertion if procedure causes temporary discomfort similar to period pain

Question 2

What are the AEs associated with IUD?

Answer 2

Common:

• post-insertion pain or cramps
• expulsion of device (particularly in the first year)

Infrequent
- pelvic inflammatory disease (PID)

Question 3

Discuss IUS

Answer 3

• small, plastic, T-shaped system with levonorgestrel containing reservoir
• sits inside the uterus and releases levonorgestrel directly into the endometrium
• can remain in place for up to 5 years
• fully reversible method of birth control bc device can be readily removed