I happen to sometimes forget to take my contraceptive pill. As I do not like the idea of injections, I’ve been thinking that a an intrauterine device (IUD) could be the solution for me. However, a friend of mine told me she was councelled against it’s use as a contraceptive device due to the risk of infection that can cause sterility. Is this risk real?
Although the IUD has been associated with certain infections such as pelvic inflammatory disease (PID) and endometritis, it is important to understand that it is not always really the direct cause. In reality, in the vast majority of cases, it is more so associated with the acceleration of the evolution of the disease, often a bacterial STI such as chlamydia or gonorrhea. Normally, when a woman contracts these infections, following unprotected intercourse, the bacteria gradually progresses moving up the vaginal canal towards the uterus proper. Following this, if left untreated it may pursue its course into the fallopian tubes where the infection can degenerate into a PID and could, at that stage, impact fertility. This process can take many months.
When a woman wears an IUD, the small wire that is used to insert and remove the device acts as a transport for the bacteria to move swiftly into the uterus and thus attack the fallopian tubes much more rapidly. As it can take some time for the disease to be detected the risks of serious infection are thus more important.
Although STI’s are the main cause of important infections, one may none the less develop an endometritis or PID without any other reason but the use of a IUD itself.
For these reasons, doctors typically will not prescribe the use of an IUD in women who have not yet had children. Additionally, many will indeed frown this method of contraception for women who are not in a stable relationship due to the augmented risk of STI transmission.
In conclusion, the risks of IUD’s are real however their risk is greatly reduced when STI’s are not a concern. STI protection and detection remains always important but becomes even more so in women using IUD’s!