Today in clinic I watched as my preceptor demonstrated how to insert an IUD. The patient was a 22 year-old nulliparous woman who was excited but nervous to have an IUD inserted. I reassured her that the pain of insertion would be better than the pain of having a baby. Haha. She tolerated the procedure well, and like most IUD patients, will probably go on to happily every after for at least 5 years (how long the Mirena, the most common form of the IUD, is guaranteed to last).
The intrauterine device (IUD) is a wonderful little form of contraception. With an extremely high rate of success in staving off pregnancy (<1% chance of becoming pregnant), with a correspondingly low risk of failure (because once inserted, the patient doesn't need to do anything for it to work), it is a preferred method of contraception in any woman who is not contraindicated from having it. There are two types of IUDs, the original copper IUD and the levonorgestrel-containing IUD. The levonorgestrel-containing IUD is generally preferred because it contains locally-acting progesterone that prevents the endometrial lining from building up, which means that despite ongoing ovulation, a few months after insertion the woman generally no longer has menstrual periods (bonus!). However, it is contraindicated in women who have contraindications to using progesterone. The copper IUD can be used in women who have a contraindication to the hormone-containing option, although it tends to produce somewhat heavier periods than the woman normally has. Whenever the device is removed, the woman returns to having whatever menstrual cycles she would have without an IUD, and her fertility is back to what it would be for her natural history (this is why it is called a form of reversible contraception). Contraindications to receiving either form of IUD include:
Illustrations demonstrating how to insert a Mirena (the most common levonorgestrel-containing IUD):