Among the different forms of contraception and birth control options preferred by couples, IUDs, or intrauterine devices are considered as popular. The ranking in terms of popularity is attributed to the convenience, the efficacy and the relatively lesser copper iud side effects. The safest among all birth control methods are IUDs and implants, in addition to the ability to dispense with actions that are necessary before/during/after during every intercourse. However, by virtue of the long-term nature of the contraception, it is suitable for couples who are either legally wedded or in a relationship that is expected to last long. In other words, it is not the best birth control option for couples indulging in casual sex or unplanned sex. Let us take a detailed look at possible copper IUD side effects to understand measures required to cope with or prevent undesirable effects.

Are Copper IUDs a permanent form of contraception?

Copper IUDs are a long-term form of contraception, and could offer protection from unwanted pregnancy for as long as ten years. It is, however, not a permanent birth control method, but a reversible option and is intended for women in pre-menopause stage. While it offers long term contraception from the time the device is inserted, it is effectively a temporary option, offering users the flexibility to remove the device and conceive as planned.

Are Copper IUDs only suitable for planned birth control?

IUDs are essentially a preventive birth control option, involving the insertion of the IUD; however, in certain instances, it is effective for emergency contraception for couples who have had unprotected sex. The devices can act as an emergency contraceptive method, within 120 hours of unprotected sex. The success of birth control through this option may, however, depend on various factors. Though the success rate is 99% among this category of users, it is important to view it more as a long term, reversible, planned contraceptive method.

How does Copper IUD work?

Copper IUDs are implants, that are essentially spermicides in a plastic frame in the shape of the letter T. The device is implanted or inserted in the uterus, by a trained practitioner, and is always performed only in a healthcare facility, and not in home settings. The spermicidal action is attributed to the copper in the device, in the form of coiled copper wire. The wire has proven inflammatory action of on sperm, and the sequence of actions and toxic effect, results in prevention of pregnancy or conception. The frame is inserted with strings that are used for positioning and for removal, as required. Measuring about 36 millimeters, the device comes with strings that could be as long as 10 centimeters on either side. Depending on the depth of insertion or other conditions surrounding the implant, the strings are snipped, as required.

Why does Copper IUD have to be inserted only in a healthcare setting?

The main reason for the implant procedure to be performed in a healthcare setting is the need to prevent copper IUD side effects stemming from incorrect insertion. Additionally, healthcare settings offer the right kind of specialized instruments necessary for the implant. The cervical canal and the uterine cavity need to be aligned in a particular manner, and the use of the right equipment is mandatory. Sanitization and expertise in handling the instruments and performing the procedure are other requirements for a successful implant.

How is the device implanted?

The vagina, and cervix are cleaned with special solutions with the use of a speculum. Post cleansing, the cervical canal is aligned. The antiseptic action of cleansing is important and this is one of the reasons for relying on trained practitioners. The Copper IUDs are then placed in an applicator tube in a folded down position. The devices are inserted through the inserted tube, and once in position in the uterus, the applicator tube is removed. The extra lengths of strings are then removed, leaving the IUD in place.

Are IUDs suitable for everyone?

Whilst the procedure is safe, effective, and ultra-convenient, it is not suitable for all. Women with uterine abnormalities cannot choose this procedure, as large fibroids prevent the positioning of the device. Additionally, the device needs to remain in the position for it to be effective. Large fibroids prevent positioning and retaining of the device. Consequently, the efficacy of the device is severely compromised, rendering it useless.

Other conditions also make the procedure unsuitable for certain women. Pelvic infections or any inflammatory condition may make the recipient unsuitable during the infection or the inflammation. Post-healing, and after the inflammation subsides, the option may be considered. Cervical cancer, uterine cancer and heavy vaginal bleeding are all conditions that make copper IUD unsuitable for certain women. Women who have had intense or heavy bleeding that has been resolved may opt for the procedure.

Women with allergic reactions are also advised against opting for the procedure. As the implanted device is intended to remain inside the uterus, any allergic reactions to materials can trigger undesirable outcomes. Similarly, women with Wilson’s disease are also advised against choosing this option, as the accumulated copper from the condition may trigger copper IUD side effects. Copper is known to collect in the brains, the liver and various organs in the bodies of patients with the condition, rendering the individual unsuitable for the procedure.

What kind of changes are possible when the device is inserted?

Certain conditions or reactions are likely to be experienced by women when during the insertion of the device. However, it is important to add that the reactions may not be experienced by all women, and may be experienced only by a small section. This includes a decrease in blood pressure levels and a drop in heart beat rate. In most circumstances, there is the likelihood of certain symptoms such as fainting, nausea, and dizzy feelings being experienced by women during the insertion.  The procedure is temporarily halted till the sensations or symptoms pass, following which the insertion continues. Symptoms such as fainting, nausea and dizziness are short-lived and typically last for a few minutes.

Is there a possibility of any internal damage occurring during the insertion?

Yes, depending on various conditions and the manner/expertise with which the insertion is carried out, it is possible that some internal damage could occur. The device or the insertion could cause cervix perforation. However, this is known to occur only among a very small number of recipients. In the event of such an occurrence, it is important for a thorough assessment, and careful treatment to handle the perforation.

How effective is Copper IUD?

Boasting of one of the highest rates of efficacy, Copper IUD comes with an extremely low rate of failure of 0.8%. Failure rate may differ and change as per various conditions. For instance, women who use copper IUD for a longer period may end up with relatively lower effectiveness. This could dip to as much as 2.1% when the implant is in the body for a period of ten years.

A comparison of various forms of birth control clearly highlights the difference in efficacy. The failure rate of oral contraceptives is 7%, the rate of failure of barrier contraceptives is the highest at 13%, clearly indicating the IUDs have the lowest failure rate. Even when the devices are used for a longer period, the rate of failure is lower than the rate of failure of other options.

As mentioned earlier, IUDs also serve as an emergency birth control option, with 99.9% success in protecting women from conception as a result of unprotected sex. This could be exercised up to 120 hours after indulging in sex, making it a very convenient and proven option.

Under what circumstances can the device fail?

The device can fail if it is not positioned precisely. Similarly, if the device is not positioned in a manner so as to remain in place, the effectiveness ends up compromised.  Failure could also be the result of the IUD dislodging.  The best method to check if the IUD is in position is to check the strings attached to the plastic, which can clearly indicate if the device has moved. Strings that cannot be self-detected by women are an indication of the IUD moving, and this can only be fixed by a trained healthcare provider.  The intervening period between detection of the dislodged IUD and its repositioning could remove the expose the woman to the risk of pregnancy from unprotected sex. Alternative emergency contraceptive methods are to be followed for complete protection.

Can Copper IUDs prevent disease transmission like barrier methods?

Barrier methods such as condoms offer protection from sexually transmitted diseases. However, Coper IUDs do not offer any kind of protection from diseases that may be sexually transmitted.  Couples who indulge in oral sex are advised to choose dental dams to prevent contracting of sexually transmitted diseases. Similarly, condoms are the best bet for prevention of such diseases; however, it is also necessary to remember that a damaged condom can neither protect the couple from disease or pregnancy.

What undesirable effects should one look out for, when using IUDs?

Heavy bleeding after the insertion is a possibility, while some women may experience irregular bleeding. The possibility of intense or heavier periods cannot be ruled out, and this is effectively the primary reason for removal or discontinuation of the option after it has been initially inserted. Women who have borne children earlier may experience lesser undesirable effects when compared with women who have not delivered. Periods may be more painful post insertion, while some women may experience backache and cramps in the period immediately after the insertion.

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