8 preconceived ideas
on IUDs

There are many preconceived ideas about IUDs (Intrauterine Contraceptive Devices). They mostly come from the time when this method of contraception had not yet been significantly studied, as is the case today.

In addition, certain prejudices, such as “not to insert an IUD in nulliparous women”, are specifically French. In other countries such as Belgium, for example, this practice is in common use. It is therefore important to clarify certain beliefs. Since 2017, the French Health Authority has been recommending copper IUDs as first-line treatment, including for nulliparous women.

1Does the IUD makes sterile?
FALSE – The IUD is a completely reversible contraception. The time it takes for fertility to recover after IUD removal is comparable to that observed for oral contraception, i.e. immediate.
2IUD in the Nulliparous?
TRUE– The IUD is a contraception recommended as a first line of treatment by the French Health Authority. The most suitable model for nulliparous women is the 7 MED 380 USHA or NSHA (short size). This optimizes the often poor compliance of young nulliparous women (on the pill).
In nulliparous women, the expected benefits must be weighed against the possible therapeutic risks. For young women, the main risk is related to Sexually Transmitted Infections, especially in the case of multiple partners. Only the condom protects against this risk.
3NSAIDs and decreased efficacy?
FALSE – No decrease in effectiveness with anti-inflammatory drugs and any other medication. It is perfectly legitimate to prescribe an anti-inflammatory drug to a woman with an IUD (whether copper or levonorgestrel) (Study Thonneau, Human reproduction 2006).
On the other hand, non-steroidal anti-inflammatory drugs can only be used as a short treatment. In short treatment, they do not influence the contraceptive effectiveness of IUDs.
4Emergency contraception?
TRUE – The IUD works better than the pill within 5 days of insertion.
NB: Only copper IUDs must be inserted in this context, hormonal IUDs (with Levonorgestrel) do not have this indication.
5Ectopic pregnancy?
FALSE – The rate of ectopic pregnancy with the IUD is 0.02% per year. It is significantly lower than that of women not using contraception.
6IUD: Is the size of the IUD uncomfortable?
FALSE – The IUD is an effective contraceptive but its supposedly large size makes patients reluctant?! See for yourself…
7Does the IUD ever interfere with the partner?
FALSE – This is often a subjective feeling because penile sensitivity is relatively low. The thread connected to the IUD is cut short enough (2 to 3 cm from the outer orifice of the cervix) so as not to bother the partner.
8Does smoking prohibit certain contraceptive methods?

TRUE – But not IUD insertion: However, the combination of tobacco and hormones (the pill) should be systematically avoided in view of the greatly increased cardiovascular risk.