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The 5 Kinds of IUD Birth Control and Their Side Effects

The five kinds all work roughly the same way: They thicken cervical mucus so
sperm cant enter the uterus to fertilize an egg. In the rare event that some
mighty swimmers do get past the cervix, the IUDs active ingredient (either
copper or synthetic progesterone) makes it more difficult for them to travel
through the uterus and tubes toward an egg.

Insertion is the same with all of them: not comfortable, exactly, but usually
manageable. But the devices have different amounts of hormones or none at
all and will change your periods in different ways. Among the hormonal IUDs,
the higher the hormone amount, the more likely it is that your period will stop
after six months to a year. Heres how they compare to each other.

ParaGard

Best for: Women who want to avoid hormones.

Skip if: You have heavy periods.

The Old Faithful of IUDs, ParaGard is a non-hormonal option where copper acts
as the sperm deterrent. Its approved for ten years, but studies say its actually
effective for 12. Some women love the idea of birth control without hormones, but
if you have naturally heavy periods or if your doctor says you have
endometriosis, getting a copper IUD might make an already bad situation worse.

Keep in mind, too, that you might not remember what your period is like sans
hormones if, say, youve been on the pill for a decade, says Laura MacIsaac,
MD, MPH, FACOG, director of family planning at Mount Sinai Health Systems
and associate professor of obstetrics and gynecology at the Icahn School of
Medicine. The first three periods after a new ParaGard insertion can be pretty
bad. Just heavier and crampier. And then, [with] most women, their period gets
back to their baseline, Dr. MacIsaac says. But she points out that a heavy flow
doesnt happen to every woman some might not notice a difference.

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Mirena

Best for: Women with heavy periods.

Skip if: You dont want your period to disappear entirely.

Mirena was initially approved for women whod already had children, but thats
just because those were the women recruited for the study submitted to the FDA.
Doctors prescribe it to women without kids all the time and, in fact, the American
College of Obstetricians and Gynecologists has recommended long-acting
reversible contraception as the first-line method for adolescents since 2012.

Where ParaGard can make periods worse, a hormonal IUD could help improve
painful periods in fact, Mirena is also FDA-approved for the treatment of heavy
menstrual bleeding, or menorrhagia. About 20 percentof women with a Mirena
see their period stop after a year, as do a third of women who use it longer.
Mirena is approved for five years but recent data says its effective for seven.

Liletta

Best for: Women on a budget.

Skip if: You dont want your period to disappear entirely.

This device is a pharmacologic equivalent to Mirena (it has the same total
amount of hormones), but was developed to be less expensive for women
visiting family planning clinics who are either on Medicaid or lack health
insurance. It costs providers $50 and they can pass on savings to their patients.
Its not technically a generic because it looks a little different and releases slightly
less hormone on a daily basis, though there is the same amount of hormone in
the device. Still, about the same number of women reported amenorrhea (no
periods) with Liletta as with Mirena (Lilettas rate is slightly higher after three
years).

Its currently approved for three years but the manufacturer will be
submitting five-year data to the FDA and will continue to study the same group of
women for seven years. Its possible that Liletta could last even longer than
Mirena since the daily release is lower, but only further research can prove that.

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Skyla

Best for: Women who like the idea of a smaller IUD.

Skip if: Youre looking for a long-term commitment.

This device is approved for three years and is specifically marketed to women
who havent had kids. Its smaller than Mirena, which makes it more appealing to
people who havent had their cervix dilated, but were talking about the difference
of a few millimeters, says Kristyn Brandi, MD, family planning fellow at Boston
Medical Center.

What is different is that it releases fewer hormones on a daily basis, meaning

more women keep getting their periods on Skyla versus with Mirena which is
appealing if you would prefer to keep your normal bodily function intact, Dr.
Brandi says. (Only about 6 percent of Skyla users stop getting their period after
one year; 12 percent of users stop after three years.) That, and its only approved
for three years. If you want contraception for longer, you should probably get a
different IUD.

Kyleena

Best for: Women who want more than three years of use, and want to keep
menstruating.
Skip if: You dont have the patience to fight with your insurance.

Bayer, which manufactures Mirena and Skyla, developed this newest IUD which
became available in October. Kyleena is approved for use in women regardless
of whether theyve had kids. It releases fewer hormones than Mirena, but more
than Skyla, though it lasts the same amount of time as Mirena.

This device might be a better option for women who want five years of pregnancy
prevention but would rather get their period than not. In the approval
studies, about 12 percent of women stopped getting their periods after one year,
and 20 percent did after three years.

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Heres a handy chart with the dosing and approval length for each IUD.

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*Additional studies show that the devices are effective even longer than
originally approved for: 12 years for ParaGard, seven years for Mirena,
and five years for Liletta.

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II. Patients Data
Name: Margie Blances Cordova, 22
y/old
Ward: 4
Birthdate: April 5, 1994

Birth Place: Caloocan City

Address: 975 Quezon Blvd. Sta. Cruz

Manila

Religion: Catholic

Husbands Name: Ronie Jabonillo, 24

y/old

Date admitted: February 5, 2017

Time of Admission: 8:55 PM

III.Admitting Diagnosis

G2P1 (1011) Pregnancy Uteri, 37 weeks

AOG, delivered vaginally an alive

Baby Girl (2635gms) Apgar Score 8,9

IV. Patients History/Past,Present Illness

Decemeber 2016 Abortion 3 months (12weeks

AOG) D & C at Jose Reyes Memorial Hospital

V. Laboratory Examination
VI. Diagnostic Procedure
Intrauterine device insertion is an outpatient procedure that should be
performed by trained healthcare professionals. Intrauterine devices
(IUDs) are an effective and increasingly popular form of reversible
contraception. The increase in popularity has been attributed to their
efficacy, ease of reversibility, and patient satisfaction, with minimal
effort required for long-term use. IUDs are equivalent to tubal
sterilization at preventing pregnancy

An IUD is inserted into your uterus by your doctor. The insertion

procedure takes only a few minutes and can be done in a doctor's
office. Sometimes a local anesthetic is injected into the area around
the cervix, but this is not always needed.

IUD insertion is easiest in women who have had a

vaginal childbirth in the past.

Your doctor may have you feel for the IUD string right after
insertion, to be sure you know what it feels like.

VII. Pharmacologic Study

Advantages of the hormonal IUD

The hormonal IUD:

Reduces heavy menstrual bleeding by an average of 90%

after the first few months of use.1

Reduces menstrual bleeding and cramps and, in many

women, eventually causes menstrual periods to stop
altogether. In this case, not menstruating is not harmful.

May prevent endometrial hyperplasia or endometrial cancer.

May effectively relieve endometriosis and is less likely to

cause side effects than high-dose progestin.4

Reduces the risk of ectopic pregnancy.

Does not cause weight gain.

Hormonal IUD. This IUD prevents fertilization by damaging or

killing sperm and making the mucus in the cervix thick and
sticky, so sperm can't get through to the uterus. It also keeps
the lining of the uterus (endometrium) from growing very
thick. This makes the lining a poor place for a fertilized egg to
implant and grow. The hormones in this IUD also reduce
menstrual bleeding and cramping.

Copper IUD. Copper is toxic to sperm. It makes the uterus and

fallopian tubes produce fluid that kills sperm. This fluid
contains white blood cells, copper ions, enzymes,
and prostaglandins

VIII. Plan of Care

You will be given more details when your IUD is put in. You should
return to the clinic for a check-up about six weeks after your IUD is put
in, to make sure it is still in the correct place.

Check your IUD threads after each period or at the beginning of

each calendar month. See a doctor if you have unusual pain,
bleeding or discharge, you think your IUD is coming out or has
come out (you may need emergency contraception) or you think
you may be pregnant.

If you are pregnant with an IUD in place you need to have a check
that the pregnancy is not ectopic (in the tubes). If you decide to
continue with the pregnancy the IUD needs to be removed to
decrease the risk of infection and miscarriage.

IX. Outcome/Evaluation

The IUD is most likely to work well for women who have been
pregnant before. Women who have never been pregnant are
more likely to have pain and cramping after the IUD is
 inserted. They are also more likely to expel the IUD. But they
can still use the IUD.

Pelvic inflammatory disease (PID) concerns have been linked

to the IUD for years. But it is now known that the IUD itself
does not cause PID. Instead, if you have a genital infection
when an IUD is inserted, the infection can be carried into your
uterus and fallopian tubes. If you are at risk for a sexually
transmitted infection (STI), your doctor will test you and treat
you if necessary, before you get an IUD.

Intrauterine devices reduce the risk of all pregnancies,

including ectopic (tubal) pregnancy. But if a pregnancy does
occur while an IUD is in place, it is a little more likely that the
pregnancy will be ectopic. Ectopic pregnancies require
medicine or surgery to remove the pregnancy. Sometimes the
fallopian tube on that side must be removed as well.

Table of Contents
I. Introduction
II. Patients Data
III. Admitting Diagnosis
IV. Patients History/Past, Present
Illness
V. Laboratory Examination
VI. Diagnostic Procedure
VII. Pharmacologic Study
VIII. Plan of Care
IX. Outcome/Evaluation
 Narrative
Report
In
Family
planning

Name: Marites M. Dela Rosa

BSM - 3