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When is it okay for your IUD to be removed?



Intrauterine devices – or IUDs, if you prefer the less intimidating nickname – are for one reason termed the "set it and forget it" form of birth control . Once one of these small T-shaped devices is implanted in your uterus, you are fairly insured in the birth control front for three to ten years, depending on what type you choose .

The funny thing is that just because you can use an IUD for a certain period of time does not mean that you have to have – but it still feels that way. This raises an important question: When is it OK to remove your IUD ? First, let's explain some basics that will help you better understand the answer.

How long IUDs take depends on the shape you receive. Overall, IUDs are one of the most effective methods of contraception that you can choose

. According to Research less than 1 percent of people with an IUD become pregnant within the first year of use. This makes IUDs more effective than contraceptive methods such as inner and outer condoms the pill the plaster, the vaginal ring and the dash. Much of it depends on the convenience. Your single IUD can last from a few years to a decade with the same level of efficiency, whichever you choose.

There are five major brands of IUDs in the US market. They occur in both hormonal and non-hormonal form. Here is a breakdown of each category:

Hormonal

These contain the hormone levonorgestrel, which causes the cervical mucus to thicken, making the sperm harder to wind around an egg. This hormone also dilutes your uterine lining, so any egg that could be fertilized has a harder implantation. (As a happy side effect of a thinner lining of the uterus, you may experience a lighter and less painful time .) Hormonal IUDs include:

  • Mirena recommended for five years
  • Liletta recommended for five years
  • Kyleena recommended for five years
  • Skyla recommended for three years

Non-hormonal

Only one IUD does not use hormones. Instead, ParaGard is copper that causes a toxic inflammatory reaction in your uterus that is toxic to sperm. While hormonal IUDs can be great for many reasons, ParaGard, which is recommended for up to 10 years, smokes other intrauterine devices in the longevity department.

Here are some reasons why you want to remove your IUD before the due date.

Just because you can have an IUD for three, five or ten years does not mean you have to do this. "You can get the IUD out at any time," says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive science at Yale Medical School, to SELF. Many people remove their IUDs prematurely for a variety of reasons.

The most obvious is the desire to become pregnant . "Fertility returns almost immediately after removal of the IUD, be it hormonal or non-hormonal," says Sarah Horvath, a family planning member at the American College of Obstetricians and Gynecologists (ACOG), told SELF.

Wonky periods are another reason why people want to accelerate the removal of IUD removal. In general, copper IUDs have the potential to make their periods harder and more painful, and hormonal IUDs can cause breakthrough bleeding . These effects can disappear over time. If they stand around, that may be enough to get some people to remove their IUDs earlier.

Much more often, people are dealing with the known perforation [1945959] that occurs when an IUD pierces the ICE uterine wall According to estimates by ACOG this is assumed to be only 1 of 1,000 people with IUD is the case. In the unusual case that a perforation occurs and is discovered, the IUD must be removed . Since the perforation usually occurs shortly after insertion, this could mean that your IUD needs to be removed well before the deadline.

That was obviously a lot of crazy information to digest. Remember, Dr. Minkin: "Overall, most [people] are good with their IUDs."

But there are a few things you should consider before removing your IUD.

As already mentioned, it is possible that you may become pregnant right after taking the IUD. So, if you decide to take your IUD out early, but do not want to get pregnant, you will need to use another method of contraception once the device has left the device

There are other things to consider when thinking about the idea Think about removing your IUD prematurely. The costs are big. According to the Birth Control Mandate Affordable Care Act most health insurance companies must cover at least one form of each type of birth control. However, they can set restrictions on how often they will pay for an IUD, says contraceptive researcher Michael Policar, MD, MPH, a professor at the University of California at San Francisco and a clinical staff member at the National Family Planning & Reproductive Health Association SELBST. While your insurance company may cover the initial initial and actual IUD costs, it may only cover a new IUD after a certain number of years have passed. Depending on the type and location, the actual intrauterine meter can cost around $ 1,000 without insurance, and this does not include the cost of insertion and follow-up.

This could lead to an IUD. In some cases, it can be really costly if you only get one for a few months before trying to get pregnant, but another after birth [LaurenStreicher Professor of Clinical Obstetrics and Gynecology at Northwestern University's Feinberg School of Medicine, tells SELF. In this case, depending on your insurance, it may be worth trying another form of birth control and then getting the IUD after birth. (It's worth noting that some health insurance plans allow exceptions if it's a child between the IUDs, but you and your doctor may need to go through some bureaucracy first.)

Then there's the discomfort factor. After the potential pain associated with the onset of an IUD, you might want to keep it as long as possible to get the buck for the uterus of your uterus. While removing an IUD is usually not as painful as inserting an IUD, your doctor still needs to use a tool to attach the strings that are in the IUD to your vagina, to stretch. Then pull the device past your cervix. If your IUD strings have wrapped around your cervix and are difficult to fish, your doctor may need to use an ultrasound machine and special tools to remove the IUD, Dr. Policar. While this does not happen often, it can be annoying, uncomfortable and costly, he notes.

This summarizes the advantages and disadvantages of premature removal of the IUD. But what if you remove it too late?

OK, but what happens if you leave your IUD alone too long?

There is some evidence that IUDs may indeed be effective beyond the recommended usage data. However, there are some major limitations, so do not celebrate yet.

If the Food and Drug Administration (FDA) approves an IUD for the market, they also recommend the maximum usage data given above. However, data has shown that some IUDs can be more effective in certain groups of people. Policar.

A 2016 study on the subject, published in Contraception examined 3,755 people with IUDs. The study participants were over 16 and under 40 years of age and had been at least 20 weeks pregnant at a given time, had a particular fetus with a specific weight or had children. The researchers found that IUDs containing 52 micrograms of levonorgestrel (this would be Mirena and Liletta – the others would contain less hormone) – were as effective at age seven as they were at three and five. Then there was a review from 2014 in Contraception which analyzed 12 articles on lifetimes of the IUD. The mean insertion age for people using copper IUDs in the various studies was 27-39, and ParaGard (approved for up to 10 years) could be used safely for a similar efficiency up to 12 years , They also found that individuals who were at least 35 years old at the time of introduction could use the copper IUD, apparently until menopause, with a minimum "theoretical" chance of pregnancy.

There is a reason for these discrepancies. Medical devices can not be released to the public in the US without FDA approval. However, this requires a "long and costly" process, Dr. Horvath. "Manufacturers choose an appropriate target duration and apply for approval," she explains. "[researchers] may continue to investigate the devices or drugs after they have been approved."

So you can get a device that says it's good for a certain number of years, but may work longer. "If more research is done to show that it works longer, the company can apply to the FDA for a change in the packaging label. If the FDA is convinced, they will do it, "says Dr. Policar. (This happened to Liletta, who was previously admitted for four years, but was approved for five in October 2018.)

Here, however, the most important fact in this discussion is: None This means that you should go beyond the FDA-recommended usage data for your IUD. The FDA guidelines will be introduced after thorough research and thorough testing to ensure that the recommendations are for the broadest possible population. While the data is promising for a longer life of the IUD, this is not an official recommendation for use outside the label.

If you prolong your IUD use for longer than the given time period, throw the cubes of pregnancy technically. Streicher. "It's reasonable to ask your doctor about it, but I would tell younger patients that we do not have enough data on whether an IUD stays longer, okay," she says.

This is because of the effectiveness of using your IUD Over the period, it seems to be largely dependent on factors such as your age and thus your fertility. In fact, both studies aimed to include only those who already had children or were pregnant, which means that on average they were older than those without children and thus had lower baseline fertility. In particular, the 2014 Contraception review stated that its extended use recommendations only applied to those aged 25 and over who had children, as the data is not yet available for wider use in other populations. While the later Contraception study did not provide age-related recommendations, the average age of trapped individuals was 30 years.

Dr. IUD removal and end a few days or weeks after the recommended timeline. This is different than leaving the IUD for years after you should.

Overall, the right time to remove your IUD may depend on a number of factors.

"[IUDs] is a good method for people who really want reliable contraception without having to think about it regularly," Dr. Minkin. But if you have an IUD and want it earlier than you thought, that's okay too. "The best reason to remove an IUD is your reason," Dr. Horvath.

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