From The Straits Times    |


Contraception is an important part of being in a sexual relationship and women should be making their own decisions in this sphere. One of the most convenient and reliable contraception methods is having an intrauterine devices (IUDs) inserted. However, could sex feel different with this device in your body?

The first decision you should be making is whether or not you want to have an IUD. There are two types of IUDs – with and without hormones. The IUD without hormones is also referred to as the copper IUD. 

Dr Freda Khoo, consultant gynaecologist and obstetrician at Freda Khoo Clinic for Women, advises that if you are uncomfortable with having external hormones in your body, or are very sensitive to the side effects of hormonal medication, then the type with hormones might not be the one for you. 

“Having said that, because the IUD is located within the uterus, the hormones will mostly be localised to the uterine area, and thus the side effects of hormones (like weight gain, pimples and sore breasts) will be mild, and will only affect a small proportion of women,” she adds.

However, the IUD with hormones could have added benefits if you have other pre-existing menstrual-related problems, like heavy menses or painful menses, says Dr Khoo. The IUD with hormones also works to reduce the amount of blood loss as well as pain during menses. On the flip side, the IUD without hormones might at times cause the menses to be heavier and more painful.

One important point to note – because an IUD lasts for around five years, it wouldn’t be the ideal choice if you’re planning to conceive in the next year or two. If it’s the right choice for you, visit your gynaecologist to have a discussion, a checkup and an ultrasound to ensure that the IUD is suitable for you, says Dr Khoo. This is also to exclude any contraindications, rule out any gynaecological abnormalities and to treat any existing infections before insertion of any IUD. 

Will my IUD fall out during sex?

Once the IUD is inserted, you might feel slight discomfort or cramps in the lower abdomen area on the day itself or even the next day. Dr Khoo says that, once these cramps die down, you should be able to resume sexual activity. However, while the copper IUD is effective immediately, the hormonal IUD takes seven days to take effect so use an alternative form of contraception – such as condoms – in the first seven days after insertion of the hormone IUD. 

The IUD should have no effect on your sex drive and you should also not be able to feel it in any way. Will your partner be able to feel it during sex, though?

“Most of the time, no,” says Dr Khoo. “The strings are actually very soft and pliable which will curl up within the vagina. In the rare chance that your partner does feel the strings, you can always return to your gynaecologist and have the strings cut shorter. This way, your partner will not be able to feel the strings anymore.”

You should also not worry that having an IUD may limit the sexual positions you want to try – Dr Khoo says the chances of an IUD getting dislodged while having sex is very, very low. Why? Because sexual intercourse takes place in the vaginal area, whereas the IUD is placed within the uterine cavity.

“However, for some women who have very heavy menses, or have uteri which are enlarged by fibroids or adenomyosis, the IUD might be expelled at times,” she adds.

How to know your IUD is causing issues

Even though the IUD is a safe form of contraception, you might experience irregular spotting in the first three to six months of having a hormonal IUD inserted. This eventually will settle into a light, regular monthly bleed; some women might not experience any menses at all during the duration of having the IUD in place, says Dr Khoo.

Whichever type of IUD you’re using, you should see a doctor if you have any pain or issues that are bothering you. 

Dr Khoo states the following instances when you should make a doctor’s appointment:

  • If you experience sudden, intense abdominal pain – this might mean that the IUD has perforated through the uterine wall.
  • If you experience heavy uncontrollable bleeding, or prolonged bleeding, you should also see your doctor, as this form of contraception might not be suitable for you. 
  • If you experience any vaginal discharge, itch, lower abdominal pains or fever, this might mean an infection which needs to be treated. 
  • If you suspect that the IUD has been expelled, especially if you have had a heavy period which could possibly flush the IUD out together with the bleeding, then you should return to your doctor to check for the placement of the IUD.