Disadvantages of Intrauterine device (IUD)

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An IUD does not prevent against sexual transmitted infections (STIs). Only barrier methods of contraception, such as condoms, protect against STIs.

For this reason, the IUD is most appropriate for use by women with one long-term partner, who they are confident does not have any STIs. If you or your partner is unsure, you can go to your GP or sexual health clinic to be tested for STIs.

Most complications with IUDs occur in the first year after it has been fitted.

Pelvic infections may occur in the first 20 days after the IUD is fitted. The risk of infection from an IUD is extremely small but a doctor will usually recommend an internal examination before fitting it to be sure that there are no existing infections. If you experience any pain in your lower abdomen or have a temperature or smelly discharge in the first three weeks after your IUD is fitted you should see your GP immediately. Pelvic inflammatory disease (PID) can lead to infertility.

Very rarely an IUD can go through the womb (perforation) or be rejected by the womb (expulsion). This could damage the womb and potentially lead to infertility. Your GP or nurse will show you how to check your IUD threads every month after each period (this is the time it is most likely to fall out). If you can feel the IUD or you cannot feel the threads you should see your GP as soon as possible. You should also use a barrier method of contraception, such as a condom until the problem has been identified. If perforation occurs a simple surgical procedure will be needed to remove the device.

An uncommon side effect of the IUD is the appearance of small cysts on the ovaries. These are not dangerous and will not usually need to be treated.

There is a slightly higher risk of ectopic pregnancy occurring if a woman becomes pregnant while using an IUD. You should have your IUD removed as soon as possible if you are continuing with the pregnancy.

Longer or heavier periods can also be a side effect of the IUD (particularly if you have always had heavy periods). For some people this eases within a few months, but others continue to have longer and heavier periods. Some women may find that certain brands of IUD cause lighter periods, or no periods at all.

After having an IUD removed, there can be a delay before periods and fertility return for some women.