Expulsion: Sometimes, the<unk> can be spontaneously expelled from the uterus. Expulsion rates can range from 2.2% to 11.4% of users from the first year to the 10th year. The TCu380A may have lower rates of expulsion than other models. Unusual vaginal discharge, cramping or pain, spotting between periods, postcoital (after sex) spotting, dyspareunia, or the absence or lengthening of the strings can be signs of a possible expulsion. If expulsion occurs, the woman is not protected against pregnancy. If an IUD with<unk>  is inserted after an expulsion has occurred, the risk of re-expulsion has been estimated in one study to be approximately one third of cases after one year. Magnetic resonance imaging (MRI) may cause dislocation of a<unk>  and it is therefore recommended to check the location of the IUD both before and after MRI. Transvaginal ultrasonography showing a perforated<unk> as a hyperechoic (rendered as bright) line at right, 3 centimeters away from the uterus at left. The IUD is surrounded by a hypoechoic (dark) foreign-body granuloma. Perforation: Very rarely, the IUD can move through the wall of the uterus. Risk of perforation is mostly determined by the skill of the practitioner performing the insertion. For experienced medical practitioners, the risk of perforation is 1 per 1,000 insertions or less. It is recommended to consult an obstetrician/gynecologist, who has the equipment to properly insert the IUD and check that it does not move during the months following insertion. Infection: The insertion of a<unk> poses a transient risk of pelvic inflammatory disease (PID) in the first 21 days after insertion. However, it is a small risk and is attributable to preexisting gonorrhea or chlamydia infection at the time of insertion, and not to the IUD itself. Proper infection prevention procedures have little or no effect on the course of gonorrhea or chlamydia infections but are important in helping protect both clients and providers from infection in general. Such infection prevention practices include washing hands and then putting on gloves, cleaning the cervix and vagina, making minimal contact with non-sterile surfaces (using a no-touch insertion technique), and, after the procedure, washing hands again and then processing instruments. The device itself carries no increased risk of PID beyond the time of insertion. Cramping: Some women can feel cramping during the IUD insertion process and immediately after as a result of cervix dilation during insertion. Taking NSAIDs before the procedure often reduces discomfort, as the use of a local anaesthetic. Misoprostol 6 to 12 hrs before insertion can help with cervical dilation. Some women may have cramps for 1 to 2 weeks following insertion. Heavier periods: The<unk> may increase the amount of blood flow during a woman's menstrual periods. On average, menstrual blood loss may increase by 20–50% after insertion of a<unk> -T IUD; This symptom may clear up for some women after 3 to 6 months. Irregular bleeding and spotting: For some women, the<unk> may cause spotting between periods during the first 3 to 6 months after insertion. Transvaginal ultrasonography visualizing an IUD with<unk>  in the optimal location within the uterus. Pregnancy: Although it’s rare, if pregnancy does occur with the<unk> in place there can be side effects. The risk of ectopic pregnancy to a woman using an IUD is lower than the risk of ectopic pregnancy to a woman using no form of birth control. However, of pregnancies that do occur during IUD use, a higher than expected percentage (3–4%) are ectopic. If pregnancy occurs with the IUD in place there is a higher risk of miscarriage or early delivery. If this occurs and the IUD strings are visible, the IUD should be removed immediately by a clinician. Although the Dalkon Shield IUD was associated with septic abortions (infections associated with miscarriage), other brands of IUD are not.<unk>  are also not associated with birth defects. Some barrier contraceptives protect against STIs. Hormonal contraceptives reduce the risk of developing pelvic inflammatory disease (PID), a serious complication of certain STIs.<unk> , by contrast, do not protect against STIs or PID.<unk>  Toxicity: There exists anecdotal evidence linking<unk>  to cases of<unk>  toxicity.
Copper IUDs
Hormonal IUDs
Progestogen-only pill
Vibegron
Extended cycle combined hormonal contraceptive
Progesterone vaginal ring
High-dose estrogen
Lipoidal estradiol