Dear doctor;

I started using intrauterine device in January but ever since, my periods come with a lot of pain. My stomach usually pains for like two days before my menses set off and then subside after the last day. Could something be wrong with the setting? Joan, 28.

Dear Joan,

Intrauterine device (IUD), once inserted, is a safe and convenient way of birth control. It also reduces endometriosis and prevents ectopic pregnancy. With a non hormonal IUD, one avoids the side effects of hormonal pills. But along with advantages it also has side effects. It can augment menstrual cramps(particularly the copper IUD). If some infection occurs due to the IUD, one may get chronic pelvic pain with or without discharge. Hormonal IUDs carry risk of hormonal pills also like breast tenderness, swelling over feet, among others. In one out of 1,000 women, the intrauterine device may perforate or puncture the uterus causing chronic pelvic pain which can be severe also depending on the severity of perforation. If the pain is persistent, it is better you get the IUD checked for its placement and if infected, get it changed. A complete course of suitable antibiotics would help to control the infection.