Contraception and Safer Sex

Birth Control Pills
Depo Provera
Emergency Contraception Pill
Female Condom (Reality Condom)
Fertility Awareness Methods
Hormonal Contraceptive Patch (Evra Patch)
Hormonal Contraceptive Ring (Nuva Ring)
Intrauterine Device (IUD)
Intrauterine System (IUS)
Male Condom
Tubal Ligation

Intrauterine Device (IUD)

What is the IUD?
The intrauterine device (IUD) is a reversible method of birth control in the form of a small T-shaped plastic device which is wrapped in copper wire. The IUD is inserted into your uterus by a health care professional. The IUDs available in Canada can stay in for five years at a time. After five years you must have your IUD removed because it can start to lose its effectiveness. There are many different kinds of IUDs available worldwide, some of which can stay in for up to 12 years before having to be removed. Health Canada has not yet approved any of those versions.

*NOTE* The IUD can also be used as an emergency method of birth control. If an IUD is inserted within 7 days after unprotected vaginal sex it may prevent a pregnancy. This is known as post-coital insertion of an IUD.  You may choose to keep the IUD in afterwards for use as a regular method of birth control. 

How does the IUD work?
The IUD works in two different ways. Firstly, the copper creates a hostile environment for sperm, making it difficult for any sperm to reach the fallopian tube to fertilize an egg. Secondly, the IUD makes it difficult for a fertilize egg to implant in the uterine wall. This combination makes the IUD very effective in preventing pregnancy.
How effective is the IUD?
IUDs are approximately 99% effective in preventing pregnancy. Since they are inserted by a health care practitioner there isn’t a separate typical use effectiveness rate. 
* The IUD does not protect against sexually transmitted infections *

How do I use an IUD?
An IUD must be inserted by a health care professional. Not all health care professionals can insert IUDs so it is important to ask your health care provider before your appointment.
You can have an IUD inserted at any time, as long as you are not pregnant.  The IUD is usually inserted when you are having your period.  
Insertion only takes a few minutes, and can be performed in a doctor’s office or clinic.
An initial visit and pelvic exam is necessary before insertion of an IUD to make sure there is no vaginal infection or sexually transmitted infection present and to check the position of the uterus.
The insertion can be uncomfortable, and you may want to take pain pills prior to your appointment. 
During insertion, a speculum will be inserted into your vagina to see your cervix and then your cervix will be washed with an antiseptic solution. 
Next, an IUD is put into your uterus and the strings are cut just below your cervix. Your health care professional may have you feel for the IUD string right after insertion, to be sure you know what it feels like. 
If you feel as though the strings are too long after the insertion, you can have them trimmed.

Check the strings after each period. If you can feel the plastic part or the strings are missing, use another form of birth control such as condoms and spermicide until you can see your health care provider
Have a follow-up appointment after one month to make sure the strings and the IUD are in place 
Never attempt to remove the IUD yourself
Period like cramping and spotting is common within the first 3 months of insertion.  However, see your health care provider if any of the following occurs:
- You cannot feel the IUD threads 
- You or your partner can feel the lower end of the IUD 
- You think that you are pregnant 
- You experience persistent abdominal pain, fever, or unusual vaginal discharge 
- You or your partner feel pain or discomfort during intercourse 
- You experience a sudden change in your menstrual periods 
- You wish to have the device removed or you want to get pregnant. 

What are the advantages to using the IUD?
Very effective in preventing pregnancy
One of the least expensive methods of birth control over time. You only have to pay one lump sum of money and then it lasts for five years
Does not interrupt sex
Does not require partner’s involvement 
Can be used for a long period of time
Can be used as a form of emergency contraception
Does not interfere with breast feeding
The copper IUD is an alternative for women who are unable or do not want to take hormones
Does not require daily monitoring

What are the disadvantages to using the IUD?
The copper IUD can cause increased menstrual bleeding and cramping
Does not protect against sexually transmitted infections (STIs)
If you get a sexually transmitted infection, the IUD can increase the likelihood of developing pelvic inflammatory disease (infection of the reproductive organs), which may lead to infertility. This risk of pelvic inflammatory disease is only associated with STIs. If you do not get an STI there is no increased risk.
Cramping and discomfort during the first 24-48 hours after insertion
Possible allergic reaction to copper 
Risk of expulsion (the IUD falling out) This is most likely to occur during the first year after insertion
Must be removed by a health care professional
It is sometimes difficult to find a health care professional who can insert IUDs. 
This can be particularly hard if you are trying to have one inserted for emergency contraception purposes.

How can I get an IUD?
You can often have an IUD inserted by a health care professional at a walk-in clinic or community health centre. If you have a family doctor you can ask them if they are able to insert IUDs. 

How much does an IUD cost?
Pharmacy: approximately $60-$80, depending on the pharmacy’s dispensing fees