|228, boul. St-Joseph, local 201, Gatineau Qc. J8Y 3X4 (819) 778-2055|
INTRAUTERINE DEVICE (IUD)
An intrauterine device is a small T-shaped piece of plastic that is inserted into the uterus by a doctor, to prevent pregnancy. In Canada, there are two types of IUDs, Nova-T and Mirena. In the case of the Nova-T, the vertical part is coated with copper and it is often called a copper IUD. As for the Mirena, the vertical part is covered by a small tube that contains progestin (a hormone) that is slowly released into the uterus.
Copper on the Nova-T destroys spermatozoids in the uterus. Copper also modifies the endometrium (inner lining of the uterus) making it impossible for a fertilized egg to attach itself, if it ever happened.
Progestin released by the Mirena thickens the cervix mucus to prevent spermatozoids from penetrating the uterus. Progestin also thins the lining of the uterus, thereby preventing a fertilized egg to attach itself, if it ever happened.
It is a very effective birth control method. The two IUDs can be left in the uterus for five years. Nova-T provides a protection rate of 98.6%, whereas the Mirena is almost as effective as sterilization, with a rate of 99.8%.
Prices for Nova-T may vary from one clinic to another, starting at $150 or more. You can get Nova-T from pharmacies or from your doctor. It is not reimbursed by the Quebec Prescription Drug Insurance Plan and very few private companies provide refunds. The Mirena is more expensive: it costs between $330 and $350. You will need a prescription to purchase it from a pharmacy. Since July 1st 2001, it is reimbursed by the Prescription Drug Insurance Plan and by private insurance companies.
Any woman who is looking for an effective birth control method can use an IUD. She would ideally have a stable relationship, which decreases her risk of contracting a sexually transmitted disease.
Other conditions may limit the use of an IUD. Your doctor will discuss those with you.
The IUD is usually put in place during menstruation in order to ensure the woman is not pregnant. If a woman already uses an effective birth control method, the IUD can be inserted at any time.
It can be inserted immediately after a miscarriage or an abortion. However, many doctors prefer waiting two or three weeks. It can be inserted four weeks after giving birth.
Before using an IUD, a woman must go for a pap test and cultures for STD detection and receive the results, even if she is in a stable relationship. It is recommended that the partner also undergo screening tests for STDs. Insertion of the IUD is done under local anaesthesia of the cervix. This is not painful but it does cause cramps similar to menstrual cramps that may persist for a few minutes after insertion. These cramps can be eased by anti-inflammatory medication taken one hour before insertion.
The copper IUD usually extends menstruation by one or two days.
With the Mirena, a woman may experience irregular bleeding during the first three or four months.
After that time, periods usually become regular but they are also much lighter. A percentage of women will have no periods after one year. This is very beneficial for women who have heavy, long and painful periods. Because of the progestin, some women may at first experience headaches, breast tenderness and nausea (rarely). These side effects are not dangerous and they disappear in the first months of use.
The IUD is removed during menstruation. However, removal may be done at any time during the cycle if there was no unprotected sexual intercourse since the last menstruation or if a woman wishes to become pregnant.
The choice you make depends on your needs and your gynaecological history. All women can use the Mirena, particularly those who have heavy, long and painful periods. However, a woman who has a regular cycle that is not painful or overly abundant will be very satisfied with the Nova-T. Talk with your doctor as he will provide you with good advice.
A copper IUD can be inserted within seven days following unprotected sexual intercourse. This would prevent pregnancy in almost all cases. It must be considered, especially if the delay for post-coitus birth control (morning-after pill) has expired. The Mirena is not effective as an emergency IUD contraceptive.
Clinique des femmes de l'Outaouais
228, boul. St-Joseph, local 201, Gatineau Qc. J8Y 3X4
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