Intra-uterine contraceptive devices and ectopic pregnancy

This may sound like tortured logic but an intra-uterine contraceptive device does not cause ectopic pregnancy. Let me explain:

Whilst the device (or "coil", as many people call it) will not increase the risk of ectopic pregnancy, the family planning practitioner advising a client has to ensure this is a suitable method for her.

The "coil" is certainly unsuitable for a woman with multiple potential or real partners. This is because she is at risk of pelvic infection, which puts her at risk of ectopic pregnancy.

A "coil" protects against normal intra-uterine pregnancy, so the combined oral contraceptive pill will be a better option for such an individual. If a woman with multiple partners opts for a ‘coil’ and feels that she is then free to have unprotected sexual intercourse, she is likely to end up with a pelvic infection which, in turn, puts her at risk of ectopic pregnancy.

"Mirena®," (Levonegestrel hormone) device and ectopic pregnancy

This device is significantly different from other ‘standard’ intra-uterine contraceptive devices. The Mirena device or "intra-uterine system", as its manufacturers prefer to call it, is a special type of device that contains a reservoir of Levonegestrel, a progestogen hormone. The hormone is released at a steady controlled rate in minute amounts to act upon the wall of the uterus.

It is an extremely effective contraceptive, protecting against both intra-uterine and ectopic pregnancies.

It has an added bonus in that it reduces the menstrual loss to very low levels within about three months of insertion, and its effectiveness may last up to five years.

Symptoms of ectopic pregnancy

Symptoms vary quite widely.

· The most common symptom will be that of persistent and one-sided abdominal pain.

· The area will be tender to touch. This is usually - but by no means always - accompanied by

· Vaginal spotting, light bleeding or simply a brownish discharge.

The symptoms typically start one or two weeks after missing a period. Sometimes the symptoms may start so early that the woman may be unaware she is pregnant. A woman with such a clinical picture ought to seek immediate medical help.

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