The IUD:
a reliable method of contraception
up to the menopause

Women aged 40 and over still need reliable methods of contraception, because although fertility declines, it does not disappear. The IUD – intrauterine contraceptive device – recommended by the World Health Organization (WHO), is a long-term contraceptive method, particularly suitable for mature women with or without children. Once applied, it can be completely forgotten, while guaranteeing maximum safety, comfort and freedom until the menopause. It is the method of contraception of first intention recommended by the High Authority of Health in France, for all women.
What is the principle of the IUD?

An IUD is a small device, usually T-shaped, made of flexible plastic and extended by one or two withdrawal threads. It can be fitted with a copper wire (copper IUD) or a kind of small reservoir (hormonal IUD) in the central part. It is available in different sizes to best fit each woman’s anatomy. To be effective, the IUD must be positioned at the bottom of the uterus.
Are there different types of IUDs?

Are there different types of IUDs?
Two types of IUDs are now available. Copper IUDs have a copper wire fixed around the central axis. Some models are also equipped with copper at the arms of the device. These devices, completely free of hormones, accompany women serenely and unconstrained until the menopause.

Hormonal or progestin-only IUDs, on the other hand, have a reservoir located on the longitudinal side. The progestogen hormone (levonorgestrel) it contains is delivered slowly and in very small quantities throughout the duration of insertion (from 3 to 5 years depending on the model).

Les stérilets hormonaux ou progestatifs, disposent quant à eux, d’un réservoir situé sur la partie longitudinale. L’hormone progestative (lévonorgestrel) qu’il contient est délivrée lentement et en toute petite quantité durant toute la durée de pose (de 3 à 5 ans selon les modèles).

What are the advantages and disadvantages of the IUD?

The advantages of the IUD are numerous. As it is a long-term contraceptive:

  • It makes it possible to avoid daily oral contraception and does not require regular gynaecological monitoring as with the pill
  • Copper IUDs allow a more natural contraception, i.e. without progestin hormone. This is an undeniable advantage for all women who do not want or tolerate estro-progestogen contraception

As for the hormonal IUD, it allows:

  • Soothe and regulate painful and intense menstruation
  • As the dose of hormones released is low, they do not cause the main side effects of the same nature as the pill; such as migraines, lumbago etc

Finally, an IUD, whether copper or hormonal, is completely reversible. It is very easy to insert and remove, painless and is mostly well supported.

On the inconvenience side, the insertion of an IUD can sometimes cause temporary abdominal pain in the hours following the insertion. Copper devices can sometimes make menstruation longer and more abundant.

After the age of 40, can a woman who has never worn an IUD have one inserted?

Yes, a woman can wear her first IUD after the age of 40, whether or not she has had children, because an IUD can be inserted at any age in her fertile life. IUDs are now available in different sizes so that they can be perfectly adapted to the anatomy of each woman’s uterus. There is no particular risk of infection, and since it is a long-term contraceptive, the IUD allows you to stop worrying about contraception, sometimes even up to the menopause.

Until what age can an IUD be used?

An IUD can be worn until the menopause, i.e. until the hormonal functioning of the ovary stops. It is customary to wait a year after the end of menstruation before talking about menopause.

How long does an IUD last?

An IUD is a long-term method of contraception. This means that once it has been inserted into the uterus, it can remain in place for between 5 and 10 years, depending on the model chosen.

Copper IUDs offer the longest lifespan: between 5 and 10 years depending on the model.

Progestin-only IUDs can remain in place for between 3 and 5 years, depending on the model. It is important not to exceed the date indicated because the hormone in the reservoir is intended to be released over a given period of time and not beyond.

Can an IUD be inserted and removed easily?

An IUD can be inserted and removed in a few minutes, very simply. The insertion is done by a healthcare professional who, after inserting a speculum, introduces the IUD insert and simply slides the device into the bottom of the uterus. He then verifies that the withdrawal wire is in place.
The IUD can be removed at any time by a doctor or midwife. All they have to do is pull on the thread to retrieve the device.

Does the copper IUD have an effect on the libido?

The copper IUD does not alter libido and does not cause vaginal dryness. It may even encourage the return of sexual desire in many women who were previously on oral progestin-only contraception. As for hormonal IUDs, a drop in libido is one of the frequent conditions encountered in women who have this device.

Who should I contact to have an IUD inserted?

Only health professionals: gynaecologists, general practitioners and midwives are authorised to prescribe, insert and remove an IUD.

En savoir plus : The IUD: a contraceptive response adapted to young women