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I am thinking about getting an IUD. Do I just make an appointment with the doctor to insert one, or are there tests that need to be done first?
June 18, 2001 -- The insertion of an intrauterine device, or IUD, is a two-step process. The steps are usually accomplished in two separate office visits, though some physicians may make exceptions to this rule. When making your appointment, ask if your doctor inserts IUDs (not all providers do) or can refer you to someone who does.
The first step in obtaining an IUD involves meeting with your doctor to jointly determine if it's the most appropriate contraceptive method for you. You and your doctor can review your contraceptive options and make sure you don't have any characteristics that might make an IUD unsafe. For example, having a sexually transmitted disease, presently or previously, increases your risk of developing an infection or other complications while using an IUD. Other possible reasons not to use an IUD include:
Multiple sexual partners (yours or your partner's)
An untreated infection of the vagina or cervix
Pelvic inflammatory disease, past or present
Increased susceptibility to infection, e.g., diabetes or HIV
Abnormal genital bleeding
Pregnancy, or infection after childbirth or an abortion
A very large or small uterus, abnormal Pap smear, or cancer
Once you and your doctor decide to opt for an IUD, she or he may examine your pelvic organs and perform a Pap smear. Your provider may also order screening tests for chlamydia, gonorrhea, or other sexually transmitted diseases.
After completion of counseling and screening, the second step is getting an IUD actually inserted into your uterus. This may be done during your period or any time during the month as long as you and your doctor are completely certain you're not pregnant.
After placement of the small, plastic device into the uterus, some women may experience cramping or bleeding. Get instructions from your provider about what to do should this occur. You'll usually get advice about using a backup method of birth control for the first month after insertion, and checking to make sure you can feel the IUD string after your first, and each subsequent, menstrual period.
While IUDs have several advantages and disadvantages, most problems arise when they're used in inappropriately selected women. Studies have shown that IUDs effectively prevent fertilization, achieve high satisfaction rates, and are cost-effective. On the other hand, they're associated with an increased risk of pelvic infections, infertility, heavier periods, and menstrual cramps.
Talk over your personal healthcare needs with your physician so that, together, you can select the best type of contraception for you.
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