The document summarizes intrauterine devices (IUDs) which are small T-shaped devices inserted into the uterus to prevent pregnancy for 1-10 years. There are two main types - hormonal IUDs which release progestogen and prevent pregnancy through thickening cervical mucus and altering the uterus, and non-hormonal or copper IUDs which release copper ions that are toxic to sperm. IUDs have high effectiveness rates of 99.2-99.9% and can be used as long-term or emergency contraception. Risks include pelvic inflammatory disease and potential infertility if not properly inserted.

1. INTRAUTERINE DEVICE
[IUD]
PREPARED BY:
SIWANI DEVI
ASSISTED BY:
VIDHI JAIN
ASSOCIATED PROFESSOR
KOTA COLLEGE OF PHARMACY

2. INTRODUCTION
• IUD is a small piece of plastic in T-SHAPED, coated with copper inserted by a
clinican into the uterus to prevent pregnancy.
• It is approximately one an half(3 cm) in length.
• This can be left in the uterus for 1-10 years.
• IUD are 99.2-99.9% effective as birth control.
• IUD have attached with thread or tail, which project into vaginal after insertion

3. ADVANTAGES
• Highly effective in preventing pregnancy.
• Inexpensive.
• Does not interrupt during intercourse .
• Can be used for a long period of time.
• Can be used as an emergency method of birth control .
• IUD provide long-term contraception for 3to 5 years and is cost effective.
• Its failure rate is 1-2%.
• It does not disturb the hormonal cycle.
• A hormone releasing IUD(Mirena) is suitable for heavy menstural bleeding.

4. DISADVANTAGES
• A trained medical professional should only insert and remove it.
• IUD may develop pelvic inflammatory disease(PID) which may cause infertility in the users
within the first three weeks of insertion.
• In some cases IUD may perforate the uterus wall due to improper insertion.
• Some users undergo hormonal side effects like mood swings and breast tenderness.
• In the first 3-6 months the users undergoes longer ,heavier and sometime painful menstrual
bleeding occurs in between periods. This condition is however normal and reduces over time.
• Use of levonorgestrel mass results may results in predictable bleeding lasting for about 4
months of use.The menstrual flow reduces with increase in duration. In the initial first year
around 20% of women experience Amenorrhoea.

5. RISKS OF INTRAUTERINE DEVICES
Due to risks of serious health problems women with the following conditions should
not use the IUDs:
• Recent or repeated pelvic injection.
• Severe cervicitis
• Malignant lesions in the genital tract.
• Unexplained vaginal bleeding
• HIVs/AIDs
• History of ecotopic pregnancy.

7. TYPES OF INTRAUTERINE DEVICES
NON- HORMONAL IUDs / COPPER MEDICATED IUDs :
• These IUDs have polypropylene plastic support of Number 7 or Letter 7.
• The T-Shaped IUD is used popularly as it shape is somewhat similar to uterine
cavity.
• This IUDs which does not release hormone.
• In Non Hormonal IUD, sperm are kill.
• The device bears two flexible arms that favours insertion into the uterus.
• The surface area of exposed copper is 380 square mm.
• Effectiveness duration of the device is upto 12 years.

8. TYPES OF INTRAUTERINE DEVICES
ADVANTAGES OF NON-HORMONAL IUDs :
• It is safe being a non-hormonal device.
• It works immediately and id high effective,
• It produces a long term effect(for upto 10 years), thus the user does not have to
use a contraceptive regularly or at the time of intercourse.
• It is a cost-effective device.
• It is a reversible device i.e., fertility returns on its removal.

9. TYPES OF INTRAUTERINE DEVICE
DISADVANTAGES OF NON-HORMONAL IUDs :
• It should be inserted and removed only by trained clinicians.
• It may get expelled in the first year.
• Increase menstrual bleeding and cramping occurs in some users.
• It does not provide protection against STDs, including HIV.

10. NON-HORMONAL IUDS AND HORMONAL IUDS

11. TYPES OF INTRAUTERINE DEVICES
HORMONAL IUDs / PROGESTOGENS IUDs:
• It is also a T-Shaped device made up of Polyethylene frame measuring 32 mm in vertical and
horizontal directions.
• This device has silicon reservoir having levonorgestrol or progesterone dispersed on the vertical
stem.
• This stem is enclosed in an ethylene-vinyl acteate copolymer rate-controlling membrane.
• Pregnancy is avoided by this device for upto 5 years as it continuously releases progestogen
directly into the uterus.
• They work by thickening the mucus of cervical mucosa, thus preventing the entry of sperm in
uterus and alterating the uterus lining, thus making it unsuitable for pregnancy.

12. TYPES OF INTRAUTERINE DEVICES
ADVANTAGES OF HORMONAL IUDs:
• After 5 months of using the device, the users will have light periods.
• After 12 months of using the device, 20% of women will get no periods.
• It can be used for treating heavy menstrual bleeding.
• The pain associated with period is reduced with the use of this device.
• It is suitable for women approaching menopause as it provides effective
contraception and can be used as the progestrogen component for hormone
replacement therapy(HRT)

13. TYPES OF INTRAUTERINE DEVICES
DISADVANTAGES OF HORMONAL IUDs :
• It causes disturbed bleeding pattern in the initial stages.
• The users may experience weight gain.

14. MECHANISM OF INTRAUTERINE DEVICS
IUDs block fertilization, progestogen released by the hormonal IUDs prevents
Ovulation impartially. Progestogen also thickens the cervical mucus, thus
prohibiting the sperm from reaching the fallopian tubes. Copper IUDs have no
hormones, but release copper ions in cervical mucus. These ions are harmful to
sperm, uterus and fallopian tubes. Thus these devices produce a fluid containing
copper ions, WBCs, prostaglandin and enzymes. The Cu- releasing IUDs are highly
effective as emergency contraceptives as they avoid implanatation of the blastocyst
in uterus. In non-emergency use, inhibition of implanatation has no typical
mechanism of action.

15. DEVELOPMENT OF INTRAUTERINE DEVICES
• Development of IUDs began in the 1920s with the first generation of IUDs constructed
from silkworm gut and flexible metal wire. For eg- Grafenberg Star and Ota ring.
• Fell into disrepute because of the difficulty of insertion, the need for frequent removal
as a result of pain and bleeding.
• Various inert biocompatible polymeric material – such as polyethylene and silicone
elastomer- were widely used to construct IUDs.
• These devices cause more endometrial compression and myometrial distension
leading to uterine cramps, bleeding, explusion of IUDs.
• Researchers developed IUDs in least in 30 years with aim to add antifertility agents to
more

16. DEVELOPMENT OF INTRAUTERINE DEVICE
tolerated. Smaller devices such as the T-Shaped device, to enhance effectiveness;
or antifibrinolytic agents, such as e- aminocaproic acid and tranexamic acid to
larger IUDs to minimize the bleeding and pain.
• Tatum developed a T- shaped device to confirm to the better contours of uterus.
This reduced side effects significantly.
• Zipper 1986 added contraceptive metals (Cu) and Doyle and clewe developed
progestin- releasing IUDs.

17. APPLICATIONS
• Emergency contraception : the copper IUD can be inserted within 5 days after
unprotected intercourse.
• Treatment for heavy menstrual bleeding : The progesterone IUD( marketed as
Mirena) is used to reduce heavy menstrual bleeding. It is proved to be better than
oral progesterone pills.The IUD should be increased only when the other serious
causes heavy bleeding has been solved by clinician.It is an alternative therapy to
Hysterectomy.
• Menopausal hormone therapy : Mirena is an alternative method for delivering
progesterone of combined menopausal hormone replacement therapy.
• Treatment for Pelvic pain

18. REFERENCES:
• Y.W.Chein. Novel Drug Delivery System, 2nd edition, Marcel Decker, Page no.-
585-630.
• Remington-the Science & practice of pharmacy vol.1&2.
• ParaGard (copper IUD)’’Drug.com. 7 September 2019. Retrieved 3 December
2019.
• Internet sources