Intrauterine contraceptive devices

Although the ideal contraceptive has not been found, intrauterine contraceptive devices offer distinct advantages and provide adequate contraception. Unfortunately, they have side-effects, complications and failures. Their use is contraindicated in pregnancy, abnormalities of the uterine cavity, uterine hypoplasia, infection and abnormal uterine bleeding. Patients who have had an ectopic pregnancy, who are prone to endocarditis, who have allergies to copper, or who are taking anticoagulants also should not use IUCDs, Insertion is best performed during menstruation, and the patient should be seen in follow up to assess placement and any side-effects, including cramps, bleeding, vaginal discharge, or discomfort during intercourse. Pregnancy may occur when the IUCD is in place, and prompt diagnosis is mandatory. Depending on the type of IUCD used, replacement time varies from one to three years.