The intrauterine device (IUD) is one of the most effective and long-acting reversible contraceptive methods in the world, although its use in Georgia is low compared to many European countries — largely due to insufficient awareness.
Two main types
Copper IUD. Works without hormones — copper ions are toxic to sperm and prevent fertilization. Effective immediately after insertion, lasts 10 to 12 years (depending on the model), and is also useful for emergency contraception (inserted within 5 days of unprotected intercourse).
Hormonal IUD (e.g. Mirena, Kyleena). Releases a small dose of progestin locally, thickens cervical mucus, and thins the lining of the uterus. In some users, it either suppresses ovulation or stops menstruation altogether. Lasts for 3 to 8 years depending on the model.
Efficiency
Both types represent one of the most effective reversible methods — failure rates are less than 1%, virtually identical between ideal and typical use, because, unlike the pill, they do not require daily user intervention once inserted.
The staging process and expected sensations
The procedure is performed on an outpatient basis, in a gynecologist's office, and takes a few minutes. Intense, cramp-like pain is common during the procedure, especially at the time of cervical dilation — taking a painkiller beforehand (as recommended by your doctor) or using local anesthesia is often recommended, although practices vary by clinic. Mild cramping and unexpected bleeding are possible for the first few days or weeks — this is usually normal.
Common myth: "IUDs cause miscarriage"
According to medical consensus (as defined by ACOG and WHO), the IUD works primarily by preventing fertilization, not by terminating an already established pregnancy—an important distinction, as many misconceptions are based on a misunderstanding of this mechanism.
Common myth: "Only for those who have given birth"
Historically, IUD placement was often limited to women who have given birth, although modern guidelines (including those from ACOG and other international gynecological organizations) clearly support the safe use of IUDs in nulliparous women, regardless of age—selection is based on individual medical assessment, not automatically based on birth history.
Risks worth remembering
The IUD, like any medical intervention, is not without risks: uterine perforation during insertion is rare (less than 1 in 1,000 cases), expulsion of the IUD (spontaneous fallout, especially in the first year), and a small but present risk of pelvic inflammatory disease in the first weeks after insertion if an undetected infection was present at the time of insertion—which is why screening for sexually transmitted infections is often done before insertion.
Removal and restoration of fertility
Removing an IUD is as simple a procedure as inserting it, and fertility usually returns quickly after removal—one of the major advantages of long-term, yet reversible contraception over sterilization.
Which type to choose?
The choice between copper and hormonal IUDs depends on individual preferences: for those who want to avoid hormones (for example, due to contraindications to hormonal contraception), the copper IUD is suitable, although it often increases menstrual bleeding; hormonal IUDs often reduce or stop menstruation altogether, which is an additional advantage for many. The final decision should always be made in conjunction with a gynecologist, taking into account the individual's health history.