An intrauterine device (IUD) is a small, T-shaped device inserted into the uterus to prevent pregnancy. There are two common types: the copper IUD and the hormonal IUD. According to Specialist Doctor Level I Nguyen Thi Kieu Phuong from the Obstetrics and Gynecology Unit at Tam Anh Cau Giay General Clinic, this method offers approximately 90% contraceptive effectiveness, lasting from a few years to 10 years depending on the specific type.

A doctor advises a woman on contraception. Photo: Tam Anh Cau Giay General Clinic

While intrauterine device placement suits many women, doctors emphasize the importance of a thorough examination beforehand. This assessment helps rule out contraindications or identify cases requiring careful consideration.

Pregnant women or those with suspected pregnancy should not undergo intrauterine device placement, as this is an absolute contraindication. Prior to the procedure, doctors evaluate a woman's menstrual cycle, sexual history, signs of delayed menstruation, or may order a pregnancy test.

Women with active genital infections, pelvic inflammatory disease, or a high risk of sexually transmitted infections are not candidates for immediate intrauterine device insertion. Placing an IUD during an infection risks deeper bacterial spread, potentially leading to severe inflammation and impacting future fertility. Doctor Phuong advises that women who have experienced uterine lining inflammation after childbirth or abortion should postpone placement for at least three months.

Before considering an intrauterine device, women experiencing abnormal uterine bleeding of unknown origin must have the cause identified. Mid-cycle bleeding, prolonged heavy periods, or irregular bleeding may indicate polyps, uterine fibroids, hormonal imbalances, or malignant lesions. Inserting an IUD without a clear diagnosis could exacerbate symptoms and delay proper medical assessment.

Women diagnosed with cervical cancer, endometrial cancer, or other malignant reproductive tract diseases should not use an intrauterine device. The primary focus for these patients is treating their underlying condition, and doctors will recommend alternative, more appropriate contraceptive methods.

Intrauterine device placement is also contraindicated for women with uterine cavity abnormalities, including uterine malformations, fibroids that distort the uterine lining, or large polyps. These conditions increase the risk of device displacement, which reduces contraceptive effectiveness and raises the likelihood of abdominal pain, prolonged bleeding, and IUD expulsion.

Beyond these general contraindications, specific types of intrauterine devices have additional considerations. For copper IUDs, individuals with copper allergies, Wilson's disease, bleeding disorders, or heavy menstrual bleeding require particular caution. Hormonal IUDs are generally unsuitable for women with a history of breast cancer.

While not absolute contraindications, conditions such as a history of ectopic pregnancy, previous fallopian tube surgery, heart valve disease, pelvic organ prolapse, or anticipated difficulty with follow-up appointments necessitate careful doctor evaluation before intrauterine device placement. Additionally, women who have not given birth should seek specialist advice to select an IUD type appropriate for their uterine size and future reproductive plans.

Doctor Phuong emphasizes that an intrauterine device is an effective and convenient contraceptive method when prescribed for the appropriate individual at the correct time. Women should undergo a specialist examination at a hospital to determine the most suitable IUD type.

Van Anh