MISSING INTRAUTERINE DEVICES (IUDs) Part 2

Last week, we started a topic on intrauterine devices, discussing the functions, types and who needs an IUD. The process of insertion and removal of IUDs were also mentioned. This week, we will be concluding with the benefits, risks and side effects of IUDs and also reasons for missing IUDs.

BENEFITS OF IUDs

• An IUD is more than 99% effective in preventing pregnancy.
• It can last up to 10 years and works straight away after inserted properly.
• It does not disturb or interrupt sexual activities.
• They are safe and it can be used when breastfeeding.
• Medications cannot alter the function of an IUD.
• The chances of getting pregnant are back to normal after removal.
• It can be removed at any time by an appropriate health care professional.
• Almost all women can use an IUD including those who have never gotten pregnant.

SIDE EFFECTS OF USING IUDs

These varies depending on the type of IUD one decides to use. Hormonal IUDs may cause the following side effects:
• Reduced or absent menstrual periods
• Acne
• Head ache
• Breast pain
• Mood swing
• Irregular bleeding
• Weight gain
• Pelvic pain and cramping
• Ovarian cyst

The Copper IUD called ParaGard may cause the following side effects:

• Anemia
• Backache
• Bleeding between periods
• Cramping
• Vaginitis
• Painful sex
• Severe menstrual pain
• Heavy bleeding
• Vaginal discharge

RISKS AND COMPLICATIONS OF IUDs

• An IUD may be difficult to insert with women having uterine challenges such as fibroids.
• Women with serious complications such as sexually transmitted infection, pelvic inflammatory diseases, unexplained vaginal bleeding or any complication that may prevent a woman from getting pregnant in the future may be advised to not use IUD.
• Getting pregnant with an IUD is not advisable as 50% of such pregnancies end in miscarriage. Any woman with an IUD who has a positive pregnancy result should see her doctor immediately.
• Also, with the Hormonal IUDs (progesterone-releasing IUDs), reduction in menstrual flow and a decrease in painful menstrual period are often observed with continued use. This is because the progesterone hormone present can cause the endometrium (lining of the uterus) to be thin thereby reducing the occurrence of cramps. These menstrual changes are not dangerous in any way and do not mean that the contraceptive action of the IUD is diminished.

CAUSES OF MISSING/DISPLACED IUDs

When an IUD is inserted, these are the common reasons the IUD strings might appear to be missing:
• The strings from the IUD sometimes curl themselves up resting against the cervix, thereby, making it impossible to feel it.
• The IUD may have fallen out of the cervix completely or partially; although it’s not very common.
• On rare occasions the IUD may have punctured the cervix or the uterus. This can cause severe pelvic pain, pain during sex and bleeding.

SIGNS AND SYMPTOMS OF A DISPLACED IUDs

If there is a slight shift in the position of the IUD, there may likely be no noticeable signs. However, if the IUD gets displaced or lost, the following signs and symptoms may arise:
• Unable to feel the strings of the IUD with your fingers.
• Feeling uncomfortable because the plastic of the IUD is being felt.
• Your partner may feel the IUD during sexual activities.
• One may experience intra-menstrual bleeding i.e. there may be bleeding in between periods.
• Having abnormal heavy vaginal bleeding.
• Having intense cramps beyond what is usually experience during normal period.
• Experiencing soreness or pain in the lower abdomen.
• Having unusual/abnormal vaginal discharge.
• Experiencing or having random infections.

DIAGNOSIS OF A MISSING IUD

The missing IUDs may be symptomatic or asymptomatic. A simple examination of the vagina will confirm the diagnosis while it can be detected by Hysteroscopy, Uterine ultrasound, Abdominopelvic ultrasound, Hysterosalpinogram (HSG), Laparoscopy, Spencer well’s forceps, sponge holding forceps and plain abnormal X-ray with a marker in the uterus.

TREATMENT OF MISSING IUDs

• If pregnant with IUD, it can be treated with sonographic guided IUD removal.
• If there is an infection such as E. coli with an IUD in place, the device is removed and drainage of abscess if needed. Antibiotics can be used to fight infections.
• If an IUD is perforated, it should be removed laparoscopically.
• If there is either chlamydia or gonorrhea at the time of IUD insertion, it can be treated without removing the IUD.

CONCLUSION

Intrauterine devices (IUDs) are effective and safe form of birth control. However, the IUD can move from its position leading to an increase in the risk of one getting pregnant and other complications. If you feel the IUD may have moved from its original position or you can’t feel it at all, kindly book appointment with your health care professional. Never try to place it back by yourself.
It is worthy of note that IUDs does not protect against HIV or other sexually communicable diseases and the side effects often diminish over time.