Presentation on theme: "Session I: Characteristics of IUDs"— Presentation transcript:
1 Session I: Characteristics of IUDs Copper-Bearing Intrauterine Devices (IUDs)Session I: Characteristics of IUDsIllustration credit: Salim Khalaf/FHICopper T 380A
2 Copper IUDs: Objectives Participants will:Describe the characteristics of copper IUDs in a manner that clients can understandDemonstrate how to screen clients for eligibility to use the copper IUDDescribe when to start the use of the copper IUDExplain to clients insertion and follow-up procedures, and when to returnExplain how to manage side effectsAddress common concerns, misconceptions, and mythsIdentify clients in need of referral for IUD-related complications.Demonstrate how to insert and remove the IUD on an anatomical model.Suggested script:The learning objectives for this module are based on input from various stakeholders <insert who provided input: participants, supervisors, health officials>.The objectives of this module are as follows: By the end of this training session, participants will be able to: <click the mouse to advance through the objectives, reading each objective aloud >.
3 IUDs: Key Points for Providers and Clients Copper IUD5/25/2012Small plastic device inserted through the vagina and cervix into the uterus.Works mainly by stopping sperm and egg from meeting.Requires no user action.Requires a clinically trained provider to properly insert and remove.Most women can use IUDs, including women who have never been pregnant.Very effectiveVery effective, with little to remember.A woman can soon become pregnant when IUD is taken out.Long actingLong acting – up to 12 years – depending on type of device.Can be removed whenever woman wants.For older women: should be removed 1 year after last menstrual period (menopause).Adapted from WHO’s Decision-making tool for family planning clients and providers.
4 IUDs: Key Points for Providers and Clients Copper IUD5/25/2012Very safeCopper-bearing IUDs act locally on the reproductive tract and have no systemic effects. For this reason, copper IUDs can be used safely by breastfeeding women and by women who cannot use hormonal contraceptives.IUDs do not:Leave the womb and move around the body.Get in the way during intercourse, although sometimes the man may feel the strings.Rust inside the body, even after many years.Some women have side-effectsSide-effects usually get better after first 3 months.Side-effects include increase in menstrual bleeding or cramps.No protection against STIS or HIV/AIDSFor STI/HIV and AIDS protection, also use condoms.Adapted from WHO’s Decision-making tool for family planning clients and providers.
5 Copper IUDsCopper IUDs have a small plastic frame with copper sleeves or wire around itTCu-380A, “Copper T” is most widely used copper IUDMultiload 375 is another copper IUD commonly available in some countriesCopper T-380AMultiload 375
6 Effectiveness of IUDsIn this progression of effectiveness, where would you place copper intrauterine devices (IUDs)?ImplantsMale SterilizationFemale SterilizationProgestin-only InjectablesCombined Oral ContraceptivesMale CondomsStandard Days MethodFemale CondomsSpermicidesMore effectiveCopper IUDsLess effective
7 Relative Effectiveness of Family Planning Methods # of unintended pregnancies among1,000 women in 1st year of typical useNo method850Withdrawal220Female condom210Male condom180Pill90Injectable60IUD (CU-T 380A / LNG-IUS)8 / 2Female sterilization5Vasectomy1.5Implant0.5Source: Trussell J., Contraceptive Failure in the United States, Contraception 83 (2011) , Elsevier Inc.
8 IUDs: Mechanism of Action Prevents fertilization by:Impairing the viability of the spermInterfering with movement of the spermSource: Ortiz, 1996
9 Copper IUDs: Characteristics Safe and highly effectiveRequire no user actionLong-acting (up to 12 years)Rapid return to fertilityNo systemic effectsHave health benefitsTrained provider needed to insert and removeRequire pelvic examPossible pain or discomfort during insertionHave potential side effectsComplications are rare, but may occurDo not protect against STIs/HIVSource: CCP and WHO, 2011.
10 Copper IUDs: Health Benefits IUDs are known to:Prevent risks of pregnancyReduce risk of ectopic pregnancyRate in IUD users is 12 in 10,000 (2 in 10,000 for Copper T380A)Rate in women using no contraception is 65 in 10,000Help protect against endometrial cancer
11 Possible Side-Effects Copper IUDIf a woman chooses this method, she may have some side-effects. They are not usually signs of illness.After insertion:Other common side-effects:Some cramps for several daysLonger and heavier periodsBleeding or spotting between periodsSome spotting for a few weeksAdapted from WHO’s Decision-making tool for family planning clients and providers.More cramps or pain during periodsMay get less after a few months
12 Copper IUDs: Counseling about Side Effects Before insertion, describe common side effects:Heavier and/or prolonged menstrual bleedingMenstrual crampingSpotting between periodsExplain that side effects:Are not signs of illnessUsually become less within the first 3–6 monthsEncourage to come back with questions or concernsIf client cannot tolerate side effects, treatment or discontinuation may be necessary