IUCD (IUD): Types, Uses, Duration, Generations & PPIUCD
Introduction
Intrauterine Contraceptive Devices (IUCDs), also known as IUDs, are among the most effective, reversible, and long-acting contraceptive methods available. These small, T-shaped devices are inserted into the uterus to prevent pregnancy and have been widely used by millions of women globally due to their high efficacy, safety, and convenience.
This article provides an in-depth look at IUCDs, their types, uses, time durations, generations, and the concept of PPIUCD (Postpartum IUCD). Whether you’re a healthcare provider, a student, or someone considering birth control options, this guide will help you understand everything about IUCDs.
What is an IUCD or IUD?
An Intrauterine Contraceptive Device (IUCD) or Intrauterine Device (IUD) is a small, flexible, T-shaped device inserted into a woman’s uterus to prevent pregnancy. It is a long-acting reversible contraceptive (LARC) method that can provide protection from pregnancy for 3 to 10 years, depending on the type.
How Does an IUCD Work?
IUCDs primarily work by:
• Preventing fertilization of the egg by sperm.
• Altering the cervical mucus to hinder sperm movement.
• Creating an environment in the uterus that is hostile to both sperm and implantation (especially copper IUDs).
• Hormonal IUCDs also thin the endometrial lining and suppress ovulation in some women.
Uses of IUCDs
• IUCDs are primarily used for birth control, but they also offer several additional benefits:
• Long-term pregnancy prevention (3 to 10 years).
• Immediate reversibility—fertility returns quickly after removal.
Non-interference with sexual activity.
• Hormonal IUCDs help in reducing heavy menstrual bleeding and dysmenorrhea (painful periods).
• Emergency contraception (Copper IUDs when inserted within 5 days of unprotected intercourse).
What is PPIUCD?
Definition:
PPIUCD (Postpartum Intrauterine Contraceptive Device) refers to the insertion of an IUD within 48 hours of delivery, either immediately after placenta delivery or during cesarean section.
Timing of PPIUCD Insertion:
1. Postplacental Insertion – within 10 minutes after expulsion of the placenta.
2. Intra-cesarean Insertion – during cesarean delivery after removal of the placenta.
3. Within 48 hours Postpartum – vaginal insertion within 48 hours of childbirth.
Advantages of PPIUCD:
• Convenient for women already in a health facility.
• Ensures immediate postpartum contraception.
• Eliminates the need for a return visit for contraception.
• Safe, effective, and reversible.
Types of IUCDs
IUCDs are broadly classified into two main types:
1. Copper IUCDs (Non-Hormonal):
These release copper ions that are toxic to sperm and prevent fertilization.
Examples: Copper T 380A, Copper T 375, Multiload Cu-375, TCu-380Ag.
2. Hormonal IUCDs:
These release a synthetic progestin hormone (levonorgestrel) to thicken cervical mucus, inhibit sperm movement, and thin the endometrium.
Examples: Mirena, Kyleena, Skyla, Liletta.
Time Duration of IUCDs
Each IUCD has a specific lifespan, depending on the type and brand.
Type of IUCD Brand Name Duration of Action
• Copper T 380A Paragard Up to 10 years
• Multiload Cu 375 – 5 years
• TCu 380Ag – 10 years
• LNG-IUS (Levonorgestrel) Mirena 5-7 years
• LNG-IUS Kyleena 5 years
• LNG-IUS Skyla 3 years
• LNG-IUS Liletta 4-6 years
Note: Actual effective duration can vary slightly by regulatory approval in different countries.
Generations of IUCD
IUCDs have evolved significantly over time. They are classified into three generations based on materials and mechanism:
First Generation IUCDs (Non-Medicated):
• Made of inert materials like stainless steel or plastic.
Examples: Lippes Loop, Margulies Spiral.
• No longer in use due to low efficacy and higher complication rates.
• Second Generation IUCDs (Copper-Based):
• Added copper to improve effectiveness.
• Copper enhances spermicidal action and increases duration of protection.
Examples: Copper T 380A, TCu 200, Cu 375.
• Most commonly used type today.
• Third Generation IUCDs (Hormonal IUDs):
• Release hormones (levonorgestrel) gradually.
• Offer both contraceptive and therapeutic benefits.
Examples: Mirena, Skyla, Liletta, Kyleena.
Insertion and Removal Procedure
Insertion:
• Performed by trained healthcare professionals.
• Can be done anytime during the menstrual cycle, preferably when not pregnant.
• Postpartum and post-abortion insertion possible.
Removal:
• Done by gently pulling the IUD string.
• Can be removed anytime by a trained provider.
• Fertility usually returns immediately after removal.
Benefits of IUCDs
1. Long-term protection without daily attention.
2. Highly effective (over 99% efficacy).
3. Cost-effective in the long run.
4. Reversible – fertility returns quickly.
5. Minimal systemic side effects.
6. Safe for breastfeeding mothers (especially copper IUCDs).
7. Hormonal IUDs offer additional benefits like:
• Reduced menstrual bleeding.
• Relief from menstrual cramps.
• Management of endometriosis and adenomyosis.
Disadvantages and Side Effects
• While IUCDs are generally safe, some users may experience:
• Cramping and discomfort during insertion.
• Irregular bleeding or spotting (especially in the first few months).
• Heavier periods (common with copper IUDs).
• Risk of expulsion or displacement.
• Rarely, perforation of the uterus.
• Increased risk of pelvic infection in the first few weeks post-insertion.
Note: Regular follow-ups and checking the string position can help ensure the IUD is in place.
Contraindications for IUCD Use
• IUCDs should be avoided in certain conditions:
• Active pelvic infections or STIs.
• Unexplained vaginal bleeding.
• Uterine abnormalities or fibroids distorting the cavity.
• Allergy to copper (for copper IUDs).
• Current pregnancy.
Comparison: Copper IUD vs Hormonal IUD
Feature Copper IUD Hormonal IUD
Hormones No Yes (Levonorgestrel)
Effect on periods Heavier, longer periods Lighter, shorter periods
Duration 5–10 years 3–7 years
Use in heavy bleeding Not recommended Recommended
Additional benefits Emergency contraception Menstrual regulation
Cost Lower Higher
IUCD Myths and Facts
• Myth: IUCD causes infertility.
Fact: Fertility returns quickly after removal.
• Myth: IUCD can travel to other parts of the body.
• Fact: IUCD remains in the uterus. Rarely, it may perforate the uterine wall if not inserted correctly.
• Myth: IUCD is only for women who have had children.
• Fact: Many IUDs are safe for women who have not had children.
Conclusion
IUCDs or IUDs are a safe, highly effective, long-acting, and reversible method of contraception. With various types—copper and hormonal—and generations to choose from, women can find an option that suits their body and lifestyle. PPIUCDs offer a great opportunity for immediate postpartum contraception, especially in countries with limited access to healthcare.
Whether you are looking for long-term birth control or wish to delay your next pregnancy, IUCDs remain one of the most reliable contraceptive options available today. Speak to your healthcare provider to determine which type is best suited for your needs.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group)