Transcript Session I: Characteristics of IUDs

Copper-Bearing Intrauterine
Devices (IUDs)
Session I:
Characteristics of IUDs
Copper T 380A
Session I, Slide 1
Copper IUDs:
Objectives
Participants will:
• Describe the characteristics
of copper IUDs in a manner
that clients can understand
• Demonstrate how to screen
clients for eligibility to use
the copper IUD
• Describe when to start the
use of the copper IUD
• Explain to clients insertion
and follow-up procedures,
and when to return
• Explain how to manage side
effects
• Address common concerns,
misconceptions, and myths
• Identify clients in need of
referral for IUD-related
complications.
• Demonstrate how to insert
and remove the IUD on an
anatomical model.
Session I, Slide # 2
Copper IUD
IUDs: Key Points for Providers and
Clients
Small plastic device
inserted through the
vagina and cervix
into the uterus.
• Works mainly by stopping sperm and egg from
meeting.
• Requires no user action.
• Requires a clinically trained provider to properly
insert and remove.
• Most women can use IUDs, including women who
have never been pregnant.
Very effective
• Very effective, with little to remember.
• A woman can soon become pregnant when IUD is
taken out.
Long acting
• Long acting – up to 12 years – depending on type of
device.
• Can be removed whenever woman wants.
• For older women: should be removed 1 year after last
menstrual period (menopause).
Session I, Slide #3
Copper IUD
IUDs: Key Points for Providers and
Clients
Very safe
Copper-bearing IUDs act locally on the reproductive
tract and have no systemic effects. For this reason,
copper IUDs can be used safely by breastfeeding
women and by women who cannot use hormonal
contraceptives.
IUDs do not:
• Leave the womb and move around the body.
• Get in the way during intercourse, although
sometimes the man may feel the strings.
• Rust inside the body, even after many years.
Some women have
side-effects
• Side-effects usually get better after first 3 months.
• Side-effects include increase in menstrual bleeding or
cramps.
No protection against • For STI/HIV and AIDS protection, also use
condoms.
STIS or HIV/AIDS
Session I, Slide #4
Copper IUDs
• Copper IUDs have a small plastic frame
with copper sleeves or wire around it
– TCu-380A, “Copper T” is most widely
used copper IUD
– Multiload 375 is another copper IUD
commonly available in some
countries
Copper T-380A
Multiload 375
Session I, Slide # 5
Effectiveness of IUDs
In this progression of effectiveness, where would
you place copper intrauterine devices (IUDs)?
More
effective
Implants
Male Sterilization
Female Sterilization
Copper IUDs
Progestin-only Injectables
Combined Oral Contraceptives
Male Condoms
Standard Days Method
Less
effective
Female Condoms
Spermicides
Session I, Slide # 6
Relative Effectiveness of
Family Planning Methods
Method
# of unintended pregnancies among
1,000 women in 1st year of typical use
No method
850
Withdrawal
220
Female condom
210
Male condom
180
Pill
90
Injectable
60
IUD (CU-T 380A / LNG-IUS)
Female sterilization
8/2
5
Vasectomy
1.5
Implant
0.5
Source: Trussell J., Contraceptive Failure in the United States, Contraception 83 (2011) 397- 404,
Elsevier Inc.
Session I, Slide #7
IUDs: Mechanism of Action
Prevents fertilization by:
• Impairing the viability of
the sperm
• Interfering with
movement of the sperm
Source: Ortiz, 1996
Session I, Slide # 8
Copper IUDs: Characteristics
• Safe and highly effective • Trained provider needed to
insert and remove
• Require no user action
• Require pelvic exam
• Long-acting (up to 12
• Possible pain or discomfort
years)
during insertion
• Rapid return to fertility
• Have potential side effects
• No systemic effects
• Complications are rare, but
• Have health benefits
may occur
• Do not protect against
STIs/HIV
Source: CCP and WHO, 2011.
Session I, Slide # 9
Copper IUDs: Health Benefits
IUDs are known to:
• Prevent risks of pregnancy
• Reduce risk of ectopic pregnancy
– Rate in IUD users is 12 in 10,000 (2 in 10,000 for
Copper T380A)
– Rate in women using no contraception is
65 in 10,000
• Help protect against endometrial cancer
Session I, Slide # 10
Copper IUD
Possible Side-Effects
If a woman chooses this method, she may have some side-effects.
They are not usually signs of illness.
After insertion:
Other common side-effects:
Some cramps
for several days
Longer and
heavier periods
Some spotting
for a few weeks
Bleeding or spotting
between periods
More cramps or
pain during periods
May get less after a few months
Session I, Slide # 11
Copper IUDs:
Counseling about Side Effects
• Before insertion, describe common side effects:
– Heavier and/or prolonged menstrual bleeding
– Menstrual cramping
– Spotting between periods
• Explain that side effects:
– Are not signs of illness
– Usually become less within the first 3–6 months
• Encourage to come back with questions or concerns
• If client cannot tolerate side effects, treatment or
discontinuation may be necessary
Session I, Slide # 12