The Non-hormonal Copper IUD

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• 0:03Introduction
• 0:24How it works
• 1:09Advantages
• 2:17Disadvantages
• 4:14Insertion
• 5:47Removal

Full transcript

1. 0:03Introduction

   Hi, I'm Dr. Taz Varkey. Welcome back to GynoTalks. Today I want to teach you about the copper IUD. The copper IUD is a T-shaped device, and I point to my palm because it's about the size of my palm, and embedded on this T is copper, and this copper is an important part of how this IUD keeps you guys from getting pregnant.

2. 0:24How it works

   So the copper IUD works to prevent pregnancy in three different ways. One, it's a physical barrier sitting in the uterus to keep the sperm from getting through. But even if it gets through and it meets the egg, once the egg and the sperm meet, that embryo has nowhere to implant. And lastly, the copper that's on the actual T-shaped device on this IUD causes an irritation in the lining of the uterus, so even if the egg and the sperm meet and the embryo comes and tries to implant and gets past the physical barrier of the T-shape, the lining is so irritated that it can't implant.

3. 0:47

   So it's a very effective method of contraception, over 99.5% effective for preventing pregnancy.

4. 1:09Advantages

   Part of the reason it's so much more effective than things like the birth control pills is because there's no chance for error. There's no room for error. It's not like you have to remember to take a pill or put on a patch. Once it's put in, it's there for the duration. And here's one of the big advantages, it's good for ten years.

5. 1:31

   You can pull it out at any time and get pregnant right away, so it doesn't affect fertility. But if you want it to be, it'll be there for ten years and will keep you from getting pregnant that whole time. Other advantages, in addition to it being very effective, it's non-hormonal. So a big reason a lot of patients end up using the copper IUD is maybe they've tried other hormonal contraceptive methods and have side effects, or they have medical conditions that don't allow them to use hormones, such as a history of breast cancer or if they've had a very serious blood clot.

6. 1:54

   Sometimes they're not even comfortable taking progesterone, so then we'll do the copper IUD. And I think the ten-year part is a big advantage as well, how long it lasts. It lasts longer than any of the other methods out there that are reversible.

7. 2:17Disadvantages

   That is, of course, if you tie your tubes, that lasts forever. But any of the reversible methods, the copper IUD is the most effective. Now, disadvantages. So the disadvantages basically involve your period. Unfortunately it makes your periods heavier and more crampy almost always.

8. 2:40

   Every now and then I have a patient that comes in and says, "No, Dr. Varkey, I'm good, it hasn't changed anything," but that is a rare exception. Almost always it's gonna be heavier and more crampy. So why would anyone use it? Well, maybe they have to or they really want to because they don't want hormones. But if a woman inherently has very light periods, and I don't mean if you're on the pill, if you have light periods when you're off all hormones, and they're not painful, well, then maybe this copper IUD is gonna take you to maybe moderately heavy flow and moderate cramping.

9. 3:04

   So that might be a good option for someone like that. Or if someone's breastfeeding and they can't use estrogen methods, and maybe they can't remember to take a pill, they have a newborn and they're not gonna remember to take the pill, so then it's not going to work, and then the copper IUD is a good option because they usually don't get their period when they're breastfeeding, and so they're not going to have all the side effects involved with the period.

10. 3:28

    And even if you decide to choose this method, you should know that by about six months the heaviness and the irregular bleeding tend to calm down. It tends to get better every month, such that when I see women maybe a year, two years later though, they'll say, "Yeah, yeah, in the beginning it was tough, but now, Dr. Varkey, it's a little heavier but not that bad, and I love it." So for the right patient it can be wonderful.

11. 3:51

    In terms of effectiveness, I mentioned that it's over 99% effective, so that's a big bonus there. There is a chance after we put it in. And let's talk about that for a second, how we put it in. There is also something to understand in terms of how this is inserted, the copper IUD.

12. 4:14Insertion

    This is maybe one of the disadvantages, it can be uncomfortable when it's inserted. So the woman goes to her gynecologist, her feet go up in stirrups, and we put in a speculum, and then we gently open up the cervix and we insert the IUD through the cervix. And it's not in a T-shape when we're inserting it, the arms are folded down, and it's held in a little straw-like device, and then we push the straw through the cervix into the uterus, and then we're able to kind of open, release it, and the arms open up in the uterus.

13. 4:37

    That whole process should take about five minutes. You might feel what feels like a severe menstrual cramp for a minute or two, usually not even that long, and then it all comes down. Now, there are going to be people watching this that say, "No way, Dr. Varkey, I had it, I almost fainted or I had severe pain."

14. 5:01

    It happens sometimes. People react that way even to a blood draw, so some people are very sensitive, or they have difficult anatomy where it's difficult to insert it. It also matters who's inserting it. I've inserted over a thousand IUDs, I consider myself very skilled at it, I'm very gentle with it.

15. 5:25

    These things matter when you're having an IUD put in. So this is where you really have to ask your doctor how experienced they are with it and if they're comfortable inserting it and that kind of thing. So again, most people will find it uncomfortable but not severely painful. Every now and then there's an exception. But the great news is once it's inserted, if you don't like it right away or the next month or two years later, we can easily pull it out by just pulling the strings.

16. 5:47Removal

    It takes two seconds. It's really simple. It rarely ever hurts as much as insertion does. So it's super easily reversible, and you can get pregnant the month after it's removed. So even though this thing is good for ten years, if you want to get pregnant after two years of having it in, we can easily remove it and you're good to go.

17. 6:08

    So that's it. I hope this was helpful. Thank you for tuning in. Don't forget that this video doesn't substitute for regular medical advice from your doctor, so please go in and have a conversation with your own doctor, or with me if you're my patient. And don't forget to subscribe.