IUD (Intrauterine Device) for Long Term Contraception

What Is IUD (Intrauterine Device?)

IUD stands for an intrauterine device that is classified as a long term reversible contraception.

It works by acting on sperm function and prevents the fertilisation of the ovum by the sperm.

The IUD is an excellent choice for women who are planning on reversible birth control and is 99% effective in preventing pregnancy and does not require compliance, which makes it better than contraception pills and helps reduce human error involved in using one.

An IUD insertion can be done in an office setting and only takes about 15 minutes. Once inserted, it helps prevent pregnancy from 3 to 5 years, depending on the type of IUD you choose. It is also easily removed.

What are the Different Types of IUD?

There are 2 types of IUD available in Malaysia:

a. Hormonal IUD

b. Non-hormonal/ copper IUD


  • Hormonal IUDs (MIRENA) acts by releasing a small amount of progesterone hormone into the walls of the uterus.
  • It can be used for a span of 5 years.
  • You do not have to worry about hormone factors, as the IUD only releases a small amount within the uterus and the amount of hormone that circulates in your system is significantly lower than the pills.


  • Copper IUDs has a tiny piece of copper wire wrapped around it and comes without the artificial hormones.
  • It stays in the uterus and functions up until 30 months. It can also be used as emergency contraception if you had unprotected sex.

What about Insertion and Removal

First, the woman would have to make a pre-insertion visit to the clinic for pre-testing and discussion about the more suitable type of IUD for her.

Pre insertion testing includes a breast and pelvic examination, pap-smear, pregnancy test and STD screening.

The insertion of an IUD is done by the doctor via an aseptic technique to minimise the risk of infection and only requires approximately 15 minutes for the procedure to be completed.

After an IUD insertion, there is a very small chance that the IUD may slip out of place for the first 3 months. The patient should check for the presence of the thread for the first 2 periods to ensure that the IUD is in place, or should immediately visit the doctor as you are not protected from getting pregnant.

When a woman decides that she wants to become pregnant, she can easily remove the IUD by a simple and painless procedure conducted by the doctor.

IUD as an emergency contraception

You can prevent pregnancy after unprotected sex by a copper IUD insertion within 1 week of the unprotected sex. The mechanism of actions works the same in preventing fertilisation of the ovum.

Frequently Asked Questions (FAQs)

1. How is an IUD put in?

After getting some history and a complete examination is done, including STD screening, the IUD insertion is done by introducing a speculum into your vagina, and using a special insert to push the IUD through the cervix and into the uterus.

2. Is an IUD insertion painful?

Some women barely feel it when others may find the insertion quite painful. For most, it is somewhere in between. Usually, any pain lasts only a few minutes. You may ask for painkillers prior to the procedure.

You might feel sore for a few hours after the insertion of an IUD, but it will go away.

3. Can I have an IUD inserted during my period?

An IUD can be safely inserted at any point of your menstrual cycle. During menses, the is believed to be dilated, making it easier for the IUD introduction.

4. How soon after an IUD insertion can I have sex?

As soon as you want, however, you may want to use another type of birth control (condoms) until the IUD starts to work.

The copper IUD works immediately after insertion, whereas the hormonal IUDs like Mirena works only if they are put within the first 7 days of the menstrual cycle., otherwise they start having effect post 7 days of insertion.

5. What should I expect after an IUD contraception procedure?

You may have cramping and backaches after IUD insertion but it should go away after 3-6 months.

A heavier period flow is expected when a copper IUD is used, whereas hormonal IUDs as a contraception may cause lighter period flow and less backache, or even complete stop of menses.

Contraception All in All

Women with IUDs as contraception almost never get pregnant as it is 99% effective. But if they do, there is a danger of a serious, fast-spreading pelvic infection and the IUD should be removed for the woman’s safety.

If a woman gets a pelvic infection (example: chlamydia, gonorrhoea) with the IUD in place, it is important that the infection is treated as soon as possible. If the treatment is successful, the IUD can usually stay in the uterus.

An ectopic pregnancy (growing outside the uterus) can be life threatening for a woman if it’s not caught early enough. The IUD doesn’t cause these but if you become pregnant during use, there is a high chance that the pregnancy is ectopic. If you have any signs of pregnancy, it is important to get a pregnancy test as soon as possible.

Very rarely during insertion, the IUD can cause uterine perforation. If this happens, the IUD is removed, and typically the uterus heals with time. If the IUD moves into the abdominal cavity or becomes embedded in the wall of the uterus after perforation in rare occasions; it would then have to be removed surgically.

Almost all group of women are a candidate for an IUD, with a few exceptions, such as women who are already pregnant, has pelvic inflammatory diseases, or has existing cervical/uterine cancer.

It is a common myth that IUD interrupts an implanted pregnancy and causes abortion. The IUD works by preventing fertilisation to take in the first place.

Different women experience different side effects after an IUD insertion, and most often home remedies and medical treatment can help. If the symptoms start to become bothersome, you can always opt to remove the IUD.

Getting an IUD insertion can be a little scary due to the frequent buzz of IUD horror stories on the internet.

However, this can be avoided by visiting a qualified doctor to explain and guide you on choosing the perfect method of birth control most suitable for you and your lifestyle.

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