IUDs: The Truth Revealed About Them

iuds not just for contraception anymore welcome to talking with docs I'm Dr Paul zalza I'm Dr Brad weening and I'm Dr Sandy Anderson Dr Andrew Getty is an obstetrician gynecologist who's joined us here and thank you so much because I think if Dr weenie and I tried to tackle the topic of iuds on our own I don't think we would do it justice right so what we're going to talk about today is the history of IEDs and what they're used for and historically they were used to prevent pregnancy but they have many many uses to help women through many complicated problems so let's start at the beginning what is an iodine thanks for joining us what does this stand for uh intrauterine device we actually now change it to intrauterine system because it sounds a little bit sexier than intrudering device IUS so IUS is a system but it started out as just an IUD and the the one that got the the worst rap was the dalcon shield it kind of looked like a a little spider and the reason it got a bad rap is because there's a lot of infections right it's a device problem right right they said the string had too many filaments and bacteria can migrate from the outside right inside right so they changed that and then rebranded remarketed and we IUD has been used internationally for years and years as a great way to prevent pregnancy okay so let's start with pregnancy are they effective yes how effective so really effective there's two kinds there's ones that are copper very effective but a little bit less than the medicated ones which have progesterone in them what are the numbers here we're talking about like eighty percent ninety percent ninety percent more than nine yeah approaching 99 like I can think of three pregnancies in my 20 years okay so I think that's a useful piece of information so not 100 so you may you may want to consider a second option as well but very very highly effective okay so you mentioned that there are two types and it doesn't protect against STIs right okay so that's the other thing sexually transmitted infections you won't be protected from one of those using an IUD important to right so people think that it would protect you but it doesn't okay so what's the difference in the way that they work so you said that there's a cop for one that there's a medicated one how do they work differently so copper just makes a tremendous inflammatory reaction which is cover years hostile to the sperm okay hostile to the sperm and just prevents implantation is this main reason and the other one works by changing the mucus a little bit and making the lining of the uterus super thin okay so the copper ones not unlike the copper bracelets that people wear in our office that's right different different ideas copper yeah but reduces inflammation yours reduces causes inflammation yeah interesting okay so first one is to produce pregnant reduce pregnancy what's the second reason that someone would consider having an IUD um a big one is emergency contraception so if you find yourself having a unplanned undesired pregnancy and your contraception failed or you didn't use it we can use iuds for up to five days the copper one's only not the medicated ones okay here's a five day limit on that one Beyond five days sometimes up to seven well even depends on who you the further out you get the less effective but because be useful when things like Plan B no longer work okay plan C here plan C exactly okay so number two is unplanned pregnancy number three heavy periods correct yes and this is a very common problem huge and that's why we're calling it an intrauterine system because we want people to know that it's not just for contraception and people almost back off immediately they say well I don't want anything in my uterus I don't want that but I'd like you to help solve my problem of flooding and really heavy periods and sometimes even that the tissue can change that can if left um untreated can lead to a cancer so we use it for something called hyperplasia um it's great for that because it can help reverse that with that little bit of progesterone so the progesterone is delivered locally as opposed to going through your bloodstream and traveling I call it the Costco of Delivery Systems straight to the consumer so it's a consumer nice remove the middle remove the middle which is their liver right yeah you remove your liver so the IUD now known as IUS as everyone commonly thought it was to reduce the risk of pregnancy but now also we're talking about uh reducing heavy Menzies and even possibly risk of cancer in these settings exactly yes we use it to reverse something called hyperplasia which we traditionally used to give people oral progesterone so now we can just deliver it okay and then we're also using it for hormone therapy so a lot of women who have terrible hot flashes that can't manage without estrogen rather than taking estrogen and progestin by mouth so we're reducing our hormone we always want to reduce exposure to hormones and achieve the highest benefit right so one way of doing that is we can put the IUS in the uterus and just give them the estrogen by mouth and then we're cutting out you know exposure of hormones and and people are hormone averse for good reason there's lots of media attention but hormones are great when we need them because they help manage our symptoms okay now we talked about the device itself how does someone go about getting one of these so third party insurance if they're medicated if they're not non-medicated they don't have that drug identification number so you have to pay for them so you mean the copper ones you have to pay for correct and they run about a hundred dollars and there's different kinds there's some for people who've never had a baby or the null of one there's some that are five years then there are some that are 10 years so 10 years are a really good return on your investment because it's 100 bucks for 10 years that's pretty pretty reasonable yeah and then the um the IUS there's two in Canada now there's one called kyleena which is a little bit smaller good for five years and that's usually what we use for women who've never had a baby are like adolescent population um and then there's one that's called Marina which is last um off Market or on label five years but off labels seven years and we've been telling patients for a long time that it's good for seven years off label and with covid the Society of Obstetricians actually endorsed us now that says we can tell them seven years some of the data says eight years wow and on the costs like everything in healthcare and every time we talk about costs related to healthcare it varies with with your region okay these are sort of the local costs in our area by where you live it might be more expensive might be less expensive might be covered by your insurance may not be covered by Insurance exactly where is this done where is this inserted what's involved in the process itself so it's mostly done in doctors offices by health care providers so either family doctors some midwives are training it doesn't have to be an obstetrician sexual health clinics lots of places and if you do a lot of them it's pretty simple how long does it take uh takes about well it depends on the person doing it the provider takes about three minutes okay so it's relatively quick done in my office is it uncomfortable it can be uncomfortable so I have everybody take Advil or Tylenol before okay if they're not allergic and then they just get up they walk home yeah sometimes the recommendations are to wait 15 minutes in the doctor's office most of my patients are like I got a bail can I go and I say sure um but yeah it's pretty quick some places do it in the hospital some of my colleagues do it only in hospital okay wow that is so that's a summary of it man that's everything you want to know about IUD now known as IUS the multiple uses how you get it how you get one implanted it's really like a Swiss army knife lots of different uses yeah and it's not something that has to stay in the whole five years that's the only thing if you hate it we pull it out right because there's a little string attached to this device so people think it's you know I don't want this in my body I don't it's not like a filling you know you don't need a drill you just pull a little string and out it comes every treatment we do has a chance of risks and complications what are some of the risks associated with an intrauterine system so the risks are it can cause some irregular bleeding for up to three to four months while it's settling in some people up to five months even though it's a treatment for bleeding ironically right just like the birth control pill we use as a treatment for bleeding but it doesn't work straight away it takes a time just for the process just to start thinning out the lining there's always a risk of infection whenever we do anything risk of expulsion which means you can spit it out or your body can reject it right I say that's kind of like a contact you know your contact can go flying out sometimes um and there's a risk of pregnancy those are the four big ones um perforation is the other tiny little risk which is during insertion theoretically that thin little device could go through the wall of your uterus yeah now in in on in the field of contraception competing with condoms competing with uh the pill where does where does the intrauterine system find itself is it becoming more commonly used than the pill less commonly used you know it's definitely becoming more commonly used um sometimes it's just trying to educate people about what it's about um but it's much more commonly used from a cost benefit ratio it's much much higher from uh loss of menstrual flow like people are saving lots of money just on tampons and pads alone because they almost have no periods right um and people are becoming more hormone aware or hormone-averse and don't want to take pills that can't remember they have busy lives so the whole set it and forget it is an amazing thing like I have people who forget they have it in and they're coming in at 10 years and say can you just check and see when you put that IUD in because they're not having any periods or very light periods and they love it right so you think it's gaining popularity for sure absolutely yes I have two more questions one there's a myth that it can cause infertility can we debunk that yes 100 so if you have an infection so if you have um unprotected intercourse unexposure to STi for sure right we don't even take out an IUD anymore if you're positive for chlamydia we just treat the chlamydia or gonorrhea which are very common infections right um we we used in the old days immediately retrieve it we don't do that anymore right okay and then the second one is how do you know when it's not working anymore so even if it's there right it's in the proper position the last thing you want us to get pregnant say oh yeah I guess your ID kind of had worn out or whatever I think that's your clue Dr Williams I know but I know but how does someone know before prevention so we're talking about prevention so someone's like listen I'm I'm nervous or I have a business for whatever reason I don't want to get pregnant and I've had it in for four and a half years how do I know how maybe like to get so if it's the progesterone one you'll start bleeding so everybody wears out a medication quicker if it's worried about movement or expulsion we always teach people to put two fingers in their vagina and feel for their cervix your cervix feels like your tip of your nose and I say feel for the opening like a nostril and you should feel two little wires like a fishing wire right when I insert it I actually give them the fishing wire ends that I cut so they can so they can know what they're feeling that's a good idea yeah wow we've learned a lot this morning and it is early still yeah I don't think we could have covered this on our own I don't think so yeah that was wise to bring in an expert for us first year thanks so much for joining us thank you thanks for having me guys video please like it subscribe to our Channel please your leave your leave your experience with an eye contraception or any thoughts about the video and thank you so much for joining us of course I'm really that's the point of this channel is to talk about things that for various reasons for a variety of reasons you can't access a healthcare professional to talk about here we have a professional and you just heard everything you want to know about the intrauterine system you are in charge of your own health see you next time thank you

Channel: Talking With Docs

Views: 38,952

Keywords: intrauterine device, iud, contraception, children's mercy, kansas city, cm, cmh, gynecology, levonorgestrel, birth control, iud process, iud placement, iud questions, iud answers, missouri, kansas, kc, iud insertion, 3d, medical, animation, reproductive, vagina, egg, sex, intercourse, uterus, cervix, family planning, sperm, ovulation, copper, hormonal, intrauterine devices, intrauterine device (medical device), intrauterine, women's health, reproduction

Id: KHhO1-2iHgY

Length: 11min 10sec (670 seconds)

Published: Mon Jun 05 2023