Choosing a contraceptive method may not be an easy task. 71.1% of the population uses some system to prevent pregnancy, indicates the latest Contraception Survey of the Spanish Conception Society. A figure that has increased since 1997 (the year in which the first consultation was carried out in Spain) when more than half of those surveyed did not apply any barrier.
According to the Spanish Contraception Society, condoms and the pill are the most used with 37.3% and 17.9%. 6.9% resort to the IUD, a long-term system that is inserted into the uterus and they are usually women over 35 years old.
The IUD does not protect against sexually transmitted diseases. But if what you are looking for is to avoid pregnancy, it can be one of the most effective tools, since it does not require a daily dose like the pill, nor the section that requires a condom.
“Currently all scientific societies and gynecologists are committed to the so-called LARC (long-acting reversible contraceptives), such as IUDs. The effectiveness of contraception depends on how well or poorly patients use it, on adherence to treatment,” indicates Dr. Ignacio Cristóbal, head of the Obstetrics and Gynecology Service at the Sanitas La Zarzuela University Hospital.
In the case of the IUD, this adherence is easier: the gynecologist inserts the IUD and the user will be well protected against unwanted pregnancy for three to five years, depending on the model chosen.
“It used to be said that adolescents or childless women were not candidates for the use of IUDs because they had a smaller uterus or a narrower cervix that would make its introduction difficult. Nowadays there is a general consensus that any woman is entitled to use an IUD, as long as she wants it. There is no age limit, parity (previous births)… and they hardly have any medical contraindications,” she clarifies.
Ignacio CristóbalHead of the Obstetrics and Gynecology Service of the Sanitas La Zarzuela University Hospital
Which is the best for me
There are several types of IUDs: inert ones, which according to the expert are no longer used, and medicalized ones. The latter include copper and hormonal ones.
“Copper and hormonal drugs differ in the material they are covered with and which interacts with the patient’s uterus to produce their effects (copper versus levonorgestrel, the hormone contained in hormonal drugs). The big difference is that hormonal drugs tend to cause the endometrium (the innermost layer of the uterus) to atrophy (become narrower) and thus reduce menstrual bleeding,” says the doctor.
Therefore, when it comes to choosing, one of the factors to take into account is the amount of blood expelled with the period, as it can be tempting for this to decrease noticeably in women with a heavy flow.
The Spanish Society of Gynecology and Obstetrics considers the hormonal IUD as the first treatment option in women with heavy menstrual bleeding. “Therefore, if we have a woman with a heavy period who wants contraception, we can offer her other methods if she wants it, but our first proposal will always be the hormonal IUD.”
How it works
In the case of hormonal, levonorgestrel, a form of progestin, is released: “It acts by thinning the lining of the uterus (womb) to prevent a pregnancy from developing, thickening the mucus of the cervix (the entrance to the uterus) to prevent the entry of the sperm and their survival in the uterus,” reports the US National Library of Medicine.
This variety acts at the local level. There is a small proportion of the hormone that passes into the bloodstream, although as the specialist indicates: “It is so insignificant that it does not produce any hormonal alteration. With both types of IUDs, ovulation and the ovarian cycle remain normal.” As it is a local action, the desirable effects of hormones such as the reduction of premenstrual syndrome are also limited.
Pros and cons
The greatest risk of this method is sexually transmitted infections, as it does not protect against them. “In the case of unstable couples, sporadic relationships, risky relationships… a condom should be combined,” the doctor recommends. Likewise, he adds that on rare occasions some complications may occur during insertion. “Copper can sometimes cause somewhat heavier bleeding than normal during menstruation,” he adds.
Its great effectiveness and comfort are two of the most valued aspects of the IUD, which means that its users have more continuity in the method. Furthermore, “its limited contraindications and side effects make it a safe method.”
If once you decide that the time has come to be a mother, you can ask your doctor to remove it at any time. The essential thing before starting treatment is to consult with the specialist.
