Sex questions answered: How well does an IUD work?

Sunday Times sex therapist Dr Tlaleng Mofokeng sheds some light on intrauterine devices (IUD) and its success rate in preventing pregnancy

Q: Are IUDs less effective than other forms of contraceptive?

A: An intrauterine device is a small, T-shaped device that either contains hormones (the Mirena, for example) or is wrapped in copper (the copper T) and is inserted into the uterus to provide continuous, highly effective fertility planning.

The hormonal IUD prevents fertilisation by making the mucus in the cervix thick and sticky, so sperm can't get through to the uterus. It also prevents the thickening of the lining of the uterus. These physical changes to the uterus make it an unfavourable place for a fertilised egg to implant and grow.

The copper IUD, on the other hand, causes the uterus and fallopian tubes to produce a fluid that kills sperm. This fluid contains white blood cells, enzymes and prostaglandins.

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Many studies have been done looking at the effectiveness of pregnancy prevention using the hormonal or copper IUD. They have concluded that IUDs are at least 99% effective, which means that on average, if 100 women use a copper IUD for one year, one of them could become pregnant while using it.

The IUD is a highly effective method of birth control. However, it does not protect against HIV or STDs, so it is advised that you use a condom every time you have sex.

Advantages of IUDs include cost-effectiveness over time, ease of use, lower risk of ectopic pregnancy and long-term reliability and reversibility.

The Mirena is reliable for up to five years and the copper T works for up to 10 years.

Each contraception method has recognised and common side-effects. It is through contraceptive counselling that you are able to make an informed choice. In the case of an IUD, there are risks associated with the insertion. For this reason it is only available by prescription and should be inserted by a health professional with experience.

Talk to your healthcare provider to discuss whether an IUD could be the right choice for you.

• Dr Tlaleng Mofokeng (MBChB), Sexual & Reproductive Health, DISA Clinic, Sandton, 011-886-2286 or visit www.safersex.co.za

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