Dear doctor;

After my first born five years ago, I put IUD but it had to be removed within two weeks because of several effects. I would later suffer a miscarriage that I blame for the IUD. But I later went to another hospital and I was convinced IUD could work., only to end up with ovarian cyst. A gynaecologist said I was playing with my life. Could it be that intrauterine device does not work for some women?

Flo, Remera.

Dear Flo,

Intrauterine device (IUD) is very effective for contraception, i.e. preventing unwanted pregnancy. It has many benefits. There are different types of IUDs available, made  of copper, plastic. hormone coated, They act similarly with some differences. IUDs, can reduce menstrual pain,  reduce menstrual cramps, prevent ectopic pregnancy,  can reduce endometrial hyperplasia and  endometrial cancer, prevent  weight gain, side effects of hormonal pills are avoided by using copper IUDs.   It  is also  cost  effective. But like any other invasive device it is not free from side effects. Most common side effect that can occur is a pelvic infection, particularly if due sterile precautions are not observed during its insertion. It can also perforate the uterus. It can be expelled particularly if inserted right after a child birth or if one has not conceived, thus making one vulnerable to pregnancy. Risk of ectopic pregnancy, i.e. pregnancy occurring at another site than inner wall of uterus is increased with IUD.  If one becomes pregnant after insertion of IUD, there is high risk of abortion or miscarriage.

The plastic coated IUDS are currently very popular, they reduce risk of heavy menstrual bleeding, reduce menstrual pain, are useful to treat endometriosis, but they also carry risk of formation of ovarian cysts. Cysts are fluid filled sacs that form over surface of ovary. Some cysts occur around menstruation,  can rupture spontaneously and heal . These are called functional cysts. But some continue to grow, causing pain and discomfort.  They may cause painful intercourse, painful defecation, nausea, severe menstrual cramps. If these cysts rupture due to trauma, lifting heavy weights, bending forwards, e.t.c., there can be severe abdominal pain with shock which can be fatal. Treatment of these cysts is surgical excision. Best option for you is to get the IUD removed, get the cyst  operated and adopt another method of family planning.