There are various
known side-effects of the I.U.D. also. It is not
100 per cent
effective. In some, infections are possible, and these may continue.
Some cases of sterility have been reported in women who have
subsequently desired to become pregnant.
There have been
several cases in which the I.U.D. has bored its way through the wall
of the uterus, to become lodged in some other part of the pelvis or
abdomen. In this way of course, the protective function lapses, and
it could cause damage to intra-abdominal structures.
There is also an
increase in the chance of an "ectopic pregnancy" occurring. This
means fertilization and early development of the embryo occurs in
the Fallopian tube. This must cause problems,
development must occur in the uterus. A surgical emergency may
ultimately occur as the tube bursts with the increase in size of the
The I.U.D. has a
checking device which will let the woman know that it is still in
the right place. This is the "tail," which hangs from the outer
cervix and may be felt with the examining finger
precaution advised by the doctors as a regular issue. If it is
missing, it means the I.U.D. may have gone astray and a medical
check may be advisable. If you do not know what to look for, discuss
this with the doctor and a little instruction will soon show you how
to check. Most doctors instruct the patient at the time of insertion
what to seek and how to go about this. In the older, larger models,
before the copper versions became available, side-effects were
common. These were chiefly cramps, backache, local pelvic
pain, heavy bleeding and discharges. With the advent of the
mini-models these are far less common. Infections can occur, and
discharges are often the sign of this. In any case, if there is any
abnormality, it is wise to check with the doctor, and a pelvic
examination will indicate if it is serious or not. In some cases it
may be necessary to remove the I.U.D. Incidentally, copper models
must be replaced at least two-yearly for continuing protection, as
the copper becomes exhausted after this period of time.
Variants of the
copper device are currently being assessed. One released a gestogen
hormone regularly and is claimed to be highly protective. No doubt
other types will flood the market in due course, just as the Pill
variations exploded in the earlier years. After all, it is such an
attractive market that many major commercial companies just cannot
resist the temptation.
doctors currently do not favor any sort of I.U.D. Low-grade
infections may occur, and it seems these may impair later fertility.
Although they are popular, their track record is not good, and some
gynaecologists simply refuse to fit them. If they do, they are often
inserted under a general anaesthetic in hospital.
One device called
the Dalkon Shield was popular for a while, but it seemed to be
associated with many infections, several occurring during
pregnancy, causing "septic mid-trimester abortions." This has since
been removed from the market.
Many women ask
what should be done if pregnancy occurs during the use of the I.U.D.
The recommendation is to see your gynaecologist at once. Advice
currently varies, but at time of writing, the British journals were
recommending legal termination of pregnancy,
There have been a
few reported cases of congenital malformations in babies born with
I.U.D.s in situ, and this has probably influenced this
opinion. But, go and see your doctor at once if pregnancy is
short, if you miss a period. If periods are very heavy, or light, or
if any unusual symptoms take place, of any nature, the same
principle holds. Visit the doctor for a complete examination.
Some women still
use the diaphragm.
This is a round
spring, covered with a thin sheet of rubber. When inserted high into
the vaginal tract, it is hoped to seal off the cervix mechanically
and so prevent the penetration of sperms. Often this is used in
conjunction with a spermicidal cream or jelly, or aerosol foam.
Alternatively, the spermicidals may be used on their own. The
protection that these offer is not as effective as the methods
already discussed, but some older women still use them
A high degree of
motivation must be present, and
in the pre-Pill,
about all that
was available. However, they are now nowhere near as popular as in a