Contraception is an attempt to stop the eggs from being produced or preventing the sperm from getting to the eggs. One method of contraception is the intra-uterine device (IUD) - a small T-shaped plastic device that when inserted into a woman’s uterus, makes it difficult or nearly impossible for fertilisation and implantation of an egg to occur.

IUDs prevent conception by causing a brief localised inflammation in the uterus that starts about 24 hours after insertion. This inflammatory reaction inside the uterus attracts white blood cells (lymphocytes), which then produce substances that are toxic to sperm, thereby making it impossible for the sperm to get to the egg, preventing the whole process of conception.

Types of IUD devices

1. Hormonal: progestogen releasing IUD works by slowly releasing small amounts of the hormone known as progestin, which prevents the sperm from reaching the egg. Other functions of hormonal IUDs include:

• Prevention of ovulation (the release of an egg from the ovary)

• Thickening of the cervical mucus to prevent sperm from swimming to the egg

• Thinning of the uterine lining to stop a fertilised egg from implanting

Apart from preventing pregnancies, hormonal IUDs lighten one’s menstruation and reduce cramps.

2. Non-hormonal: This type of IUD contains a small amount of copper which is toxic to sperm cells and disrupt their motility so that they are not able to swim or join with an egg, preventing pregnancy. Once it is inserted, it can last for up to 12 years. It contains no hormones, so breastfeeding mothers should have no fear of any side effects, and fertility resumes immediately after removal. It is 99.9 per cent effective in preventing pregnancy. It may cause heavier bleeding and more cramps during a period.

IUD insertion and removal

Inserting and removing IUDs should be done by a health-care professional. The process of inserting the device is safe and reliable, and for many women the most difficult part is overcoming the psychological fear of the procedure. A well-trained professional can perform the procedure in a hospital or a health centre in less than 15 minutes. IUDs can be removed at any time and studies show that the removal process is a less invasive with minimal pain when compared to insertion. The health care professional must find the cervix using a speculum, insert a special ring forceps or clamp into the vagina and grasp the IUD strings by using gentle traction to pull out the device.

In situations where the strings of the IUD cannot be located because they may have slid higher into the cervical canal, a health-care professional can use special instruments to locate the strings and remove the IUD. Complications of IUD removal are rare, and removal during the menstrual period is easier because a woman’s cervix is thought to be softer during this time.

Benefits of IUDs

-An IUD is more than 99 per cent effective in preventing pregnancy.