”The IUD, also known as the intrauterine device (IUD), is a contraceptive device commonly used by women of childbearing age and has a history of nearly 100 years. It is also known as the “IUD” or “ring” for short, as it was mostly used in the early days. It is popular among women as a safe, effective, and simple long-acting contraceptive method. In China, more than half of women of childbearing age choose the IUD as a form of birth control.
Types of IUDs
There are many types of IUDs. At present, there are no less than 30 types of IUDs in use at home and abroad, which can be divided into two categories: inert IUDs and active IUDs according to the material of the IUD.
Inert IUDs are mainly made of metal, silicone, plastic, etc., but because of the high rate of IUD shedding and pregnancy with device, the domestic production has been stopped. Active IUDs, on the other hand, contain active substances such as copper ions or drugs, which can significantly improve the contraceptive effect and reduce side effects, and thus have been widely used.
Below, this article will briefly introduce several major IUDs and their respective characteristics.
1. Copper metal ring.
The copper ring as a whole is ring-shaped, which has a plastic holder, a strut inside the ring, and a free section. This ring can be divided into 4 models depending on the size.
Service life: 10 years -15 years.
Applicable people: Optional for those who require long-term placement.
Advantages and disadvantages: easy to put and take, good contraceptive effect, but easy to fall off, bleeding side effects are high.
2, containing copper T-shaped IUD.
As the name suggests, this IUD is T-shaped, with polyethylene as the support, in the longitudinal arm or horizontal arm wound with copper wire, according to the different surface area of copper can be divided into 3 types. This type of IUD is easy to place and take, with good clinical results, but the side effects of bleeding are high, and if placed improperly, the arm may cause perforation of the uterus.
Years of use: 5 – 10 years.
Population: Women without significant adverse effects can choose according to the size of the uterine cavity.
Advantages and disadvantages: adapt to the morphology of the uterine cavity, not easy to fall off, easier to place and remove, lower bleeding rate and pregnancy rate with device than metal single ring, valid for more than 20 years. Adverse effects are heavy menstruation, prolonged periods, and if placed improperly, its arm may cause perforation of the uterus.
3.Uterine copper IUD
This type of IUD is shaped by heat treatment with a common single ring, and its shape is closer to the shape of the uterine cavity, with good clinical effect, and can be placed for about 20 years.
Use life: about 20 years.
Population: Optional for those who require long-term placement.
Advantages and disadvantages: It has been reported in the literature that the pregnancy rate and detachment rate are lower than those of T-type IUD containing copper, but because its morphology is more suitable for the shape of the uterine cavity, the side effects such as bleeding and pain after placement are lower than those of T-type.
4, silicone rubber with copper V-shaped IUD
This kind of IUD is made of stainless steel V-shaped stent, which is coated with silicone rubber tube, and copper wire is wound on the horizontal arm and oblique arm.
Service life: 5 years – 8 years.
Population: Women without significant adverse effects can choose according to the size of the uterine cavity.
Advantages and disadvantages: adapt to the morphology of the uterine cavity, easy to put in and take out, better contraceptive effect, lower shedding rate, but more adverse reactions such as bleeding and abdominal pain.
5.IUD with copper without stent
Also known as Ginny IUD, it is made of copper sleeve strung on nylon thread with knots at the top to fix in the myometrium and hang in the uterine cavity.
The use of years: 5 years – 10 years.
Population: For women with different uterine cavity sizes, especially for those with upright labor, heavy physical labor and loose uterine opening. It is also suitable when the uterus has not returned to its pre-pregnancy state after childbirth because of the softness of the Ginny IUD and the fact that it does not fall off easily.
Advantages and disadvantages: It can be adapted to different uterine cavities, with little stimulation to the endometrium, and the rate of shedding and removal due to the disease is lower than that of other birth control devices.
6.Levonorgestrel IUD
It is also known as Manuel. It is a T-shaped stent made of polyethylene and contains synthetic progestin in the longitudinal tube. Due to the slow release of progestin, the endometrial glands atrophy, which is not conducive to the fertilization of eggs. This type of IUD is effective in contraception, with an efficiency rate of 99%. The main side effects include prolonged periods, spotting and bleeding, and amenorrhea.
Years of use: about 5 years.
Applicable population: Generally speaking, women with adenomyosis prefer Mannorrhea, but it has also been reported in the literature that Mannorrhea is not good for adenomyosis once it causes more than irregular bleeding, so clinicians should decide after weighing the pros and cons. In addition, it is especially suitable for women who have experienced one or more abortions, women with excessive menstruation and dysmenorrhea.
Advantages and disadvantages: The contraceptive effect is good, with an efficiency rate of 99%, and it can effectively control the volume of menstruation and shorten the number of bleeding days. The main side effects are spotting bleeding and amenorrhea.
6, containing indomethacin IUD
The material and components of the IUD include stainless steel wire base, copper wire spiral tube and silicone rubber strip containing indomethacin. The structure is in line with the morphology of the uterus and uterine dynamics. By releasing indomethacin slowly, it can reduce the side effects such as excessive menstruation after IUD placement, and the commonly used products are IUD with copper, active gamma-IUD, and IUD with cavity.
Duration of use: about 8 years.
Applicable people: For women with heavy side effects such as bleeding and abdominal pain, this IUD can be used.
Advantages and disadvantages: good contraceptive effect, less side effects
Despite the variety of IUDs available, there is no perfect IUD in terms of contraceptive efficacy, shedding rate, and adverse reactions after placement. It is important to choose the right IUD for each woman’s situation and requirements.
In clinical practice, the operator should choose the size of the IUD according to the size of the woman’s uterine cavity, and should follow the principle of avoiding large IUDs when they can be large or small, in order to reduce the occurrence of side effects. At the same time, the principle of good performance and low price should be followed as much as possible to minimize the waste of medical resources due to the need to remove due to side effects. At the same time, no matter which IUD is chosen, the patient’s right to informed choice should be respected.