Summary

In this study session, you have learned that:

• Three different types of common IUCDs are copper-bearing IUCDs (TCu-380A and MLCu-375), hormone-releasing IUDs (LNG-20 and Progestasert), and inert, or unmediated IUCDs (Lippes Loop). Copper T 380A is one of the most widely available IUCDs in many countries, including Ethiopia.
• Using an IUCD can be as effective as female surgical sterilisation in preventing pregnancy, but unlike sterilisation, it is a completely reversible family planning method.
• Although IUCD insertion and removal procedures are relatively straightforward, there are several separate steps to be performed in a specific sequence by a trained practitioner. These steps must be integrated with the appropriate infection prevention and counselling measures, to help ensure the safety and wellbeing of the woman.
• It is recommended that women check their IUCD after each period. A shorter than normal string can be a warning sign of an embedded IUCD. Missing strings may mean that the IUCD has been expelled.
• The main advantage of IUCDs is that they are a highly effective, long-acting, safe and cost-effective contraceptive method, and the client need make only a single decision to use an IUCD, compared with the daily decisions needed to take oral contraceptives.
• An IUCD is also a good option for those who have medical precautions in response to hormonal methods, as there are no hormonal side effects with copper-bearing or inert IUCDs. They do not interact with any medicine the client may be taking.
• Common disadvantages of IUCDs are that they require trained health personnel to insert and remove them. Also, the client needs to have a number of laboratory tests and pelvic examinations to rule out STIs, including an HIV test and a test for PID.
• IUCDs are absolutely not recommended for women who have the following health problems:
  • Current pelvic inflammatory disease
  • Known or suspected pregnancy
  • Undiagnosed irregular genital tract bleeding
  • Known allergy to any constituent of the device.
• One potential, though uncommon, complication of IUCD use is device expulsion. Expulsion occurs most often in the first few months after insertion, and it is most common in young women and women who have never given birth.
• Counselling women about common side-effects and possible complications of IUCD, either at the time of insertion or at subsequent follow-up visits, can ensure client satisfaction with the method.