- In the vast majority of cases there are no serious complications associated with either the insertion or the retention of an IUD.
- Women however frequently experience heavier monthly bleeds although not to the extent of causing any change in a woman’s day to day activities or comfort. With a copper IUD, a woman’s menstrual cycle returns to normal since nothing interferes with her hormones. So with an IUD, a woman’s natural cycle may be more irregular than if she were taking the contraceptive pill.
Very rarely however some complications may arise:
- A copper allergy or an intolerance to the IUD can result in mild pain or light bleeding, which requires the removal of the IUD. These symptoms disappear when the IUD is removed.
- Infection of the uterus. Although the IUD itself is not a cause of infection, if an infection does invade the body, it can enter the uterine cavity more easily. This is one reason why the IUD as a form of contraception is targeted at older women who are less at risk of STD/STI (sexually transmitted diseases/infections).
- Displacement of the IUD into the endocervix, or even more rarely, IUD expulsion. Pregnancy becomes an immediate risk when the IUD is not in its correct position.
- Uterine perforation and migration of the IUD (these are extremely rare) in certain situations such as when the uterus is retroflexed or anteflexed or if there is cervical stenosis (a very narrow cervix). These are situations where it can be difficult or painful to position the IUD and the uterus wall may be perforated. The IUD may not stay in position and exit via the perforation through to the abdominal cavity. This is why an ultrasound scan is performed after a difficult IUD positioning or if during regular monitoring the IUD strings are no longer in position. If the IUD migrate to the abdomen then it has to be removed via a laparoscopy (see the section on cœlioscopy or laparoscomy)
- Pregnancy. A woman may fall pregnant even with a correctly positioned IUD. If pregnancy is suspected then an early ultrasound scan is strongly recommended in order to examine the interaction of the IUD with the gestational sac. In most cases should the pregnancy be allowed to develop further, the IUD can be found in the placenta after the baby is born. Some professionals suggest (though this is not done systematically) removal of the IUD if the strings are visible at the start of any pregnancy.