Family Planning

- New and wide range of contraceptives are available to meet needs of women of all ages. The decision to choose the right kind of contraceptive is taken after being explained about the pros and cons of each by expert. It includes- - Barrier methods, hormonal drugs, ring, patch, injectable, intrauterine device - Provision for sterilization/ tubal ligation surgery.

MIRENA (INTRAUTERINE SYSTEM)

The IUS is a small device made from plastic and contains progestogen hormone. Therefore, it is called an intrauterine system (IUS) and not just an intrauterine device (IUD). The IUS is put into a woman's uterus (womb) by a doctor. It works for five years before needing replacing. It works mainly by thickening the mucus made by the cervix which forms a 'mucus plug' in the cervix. This stops sperm getting through to the uterus (womb) to fertilise an egg. The progestogen also makes the lining of the uterus thinner. This makes it unlikely that a fertilised egg will be able to attach to the uterus. It may also have some effect on the ovary, and ovulation may not occur (the release of the egg each month). Side effect: Irregular bleeding - may occur for the first three months or so, but usually settles down. Expulsion - rarely the device may come out without you noticing. How is it inserted? You will need a vaginal examination, and the doctor or nurse will pass a small instrument into the uterus to check its size and position. An IUS is then fitted. You will be taught how to feel the threads of the device so you can check it is in place. It is best to check the threads regularly, for example, once a month just after a period.

NON CONTRACEPTIVE USE: HEAVY PERIODS (MENORRHAGIA)

• The IUS has become popular as a treatment for heavy periods (menorrhagia). In most treated women, bleeding becomes very light, or stops altogether, within 3-9 months. Also the size of fibroid has been found to decrease with its use. With thermal ablation it has emerged as an alternative to hysterectomy in women with heavy menstrual bleeding.