IUDs are polyethylene artifacts, to which copper or hormones may be added, which are inserted into the uterine cavity exerting their contraceptive function.
They act by preventing fertilization, making it difficult for sperm to pass through the female reproductive tract.
The most common problems during IUD use are expulsion of the device, pelvic pain, dysmenorrhea (irregular bleeding in the early months) and increased risk of infection (acute infection without improvement or persistent infections imply removal of the IUD). It should be placed by the physician and semi-annual control is required and whenever leukorrhea (abnormal vaginal discharge) appears.
Women who have heavy bleeding or heavy menstrual cramps, or who have any intrauterine abnormalities such as fibroids or gynecological cancer, fallopian tubes, vaginal bleeding, or copper allergy cannot use the IUD.
Pregnancy rarely occurs (high efficacy, ranging from 95 to 99.7%) with risk of miscarriage in the 1st and 2nd trimesters.
IUD removal can be done after ultrasound evaluation, considering the risks to the embryo. If withdrawal is not possible due to risk of miscarriage, the patient should be followed at short intervals and advised of vaginal bleeding and leukorrhea.