Intrauterine Contraceptive Device (IUCD): What Africans Need to Know

By: Glory Udochukwu Maduka, MB.BS. DLHA Volunteer and Freelance Health Writer, Medically reviewed by: T. Oyetunji, MB. BS. FWACS (Family Medicine)

November 25, 2025

Portrait of a young African lady posing in a maroon coloured T-shirt. There is a potted plant behind her. The image is captioned, ”Intrauterine Contraceptive Device (IUCD): What Africans need to know”.

 

When Aisha got married at 23, she and her husband agreed they wanted children — but not right away. She had just started a new job, and the husband was still completing his degree. They agreed to wait until they were more financially stable.

She tried using pills at first for birth control, but remembering to take them every day became stressful. The injectable worked, but going back to the clinic every three months was inconvenient with her busy schedule.

One afternoon, during a routine hospital visit, her doctor mentioned a small device called an intrauterine contraceptive device (IUCD). It was a one-time procedure, required no daily attention, and could protect her from pregnancy for several years and she could remove it anytime she was ready to conceive.

A month later, Aisha had an intrauterine contraceptive device (IUCD) inserted. Five years on, she has built her career, travelled, and is now planning her first child on her own terms.

Just like Aisha, many African women are discovering that family planning doesn’t have to be stressful or complicated. One of the most reliable, reversible, and low-maintenance methods of family planning is the IUCD. Read on to learn more.

 

Introduction

Family planning is more than just avoiding pregnancy; it is really about making choices, having control, and shaping the future you want for yourself.

In Africa, we’re seeing more women take charge by using contraception to plan their families, chase their career goals, and prioritise their health. 

However, fears, uncertainty, and a lack of information still make it hard for many to go for one of the best family planning options available; the intrauterine contraceptive device (IUCD).

If you have ever heard of a micro device inserted into the womb to prevent pregnancy, then you already have an idea of what an Intrauterine Contraceptive Device (IUCD) is.

It is one of the safest and most reliable methods of contraception. And this knowledge is important for African women who want to have full control of their lives in marriage. 

So let's go into more details of what an IUCD is, how it works, and settle the fears and misconceptions you may have. 

 

What is an Intrauterine Contraceptive Device (IUCD)?

An intrauterine contraceptive device (IUCD) is a small, T-shaped device that a doctor or nurse places inside the uterus (womb) of a woman to prevent pregnancy. 

They are 99% effective in birth control and last up to 5 years. [1]

A medical illustration of a typical T-shaped intrauterine contraceptive device (IUCD) inside the uterus.

There are two types of IUCD: 

• Copper IUCD and
• Hormonal IUCD.

The copper IUCD

The copper IUCD is a small device made of copper and plastic. It does not contain hormones. 

Here’s how it works:  

• It makes it harder for sperm to reach and fertilize an egg.  
• It makes it tough for an egg to survive.  
• It changes the lining of the uterus, so if an egg is fertilized, it cannot implant.  

This IUCD is a good choice for those who prefer non-hormonal birth control. [2]

The hormonal IUCD

Hormonal IUCD is a small T-shaped device made of plastic that gradually releases a hormone called levonorgestrel. It is a popular choice for preventing pregnancy.

Here’s how it works:

• Thickens the mucus at the entrance of the uterus, which makes it difficult for sperm to pass through.
• Creates a tougher environment for sperm to reach and fertilize an egg.
• Helps prevent an egg from surviving in the uterus.
• Thins the lining of the uterus making it difficult for fertilized eggs to implant.
• In some cases, it even stops ovulation, which is when eggs are released from the ovaries.

In some countries including in Africa, you can find two brands of hormonal IUDs: Mirena and Kyleena. Kyleena has a lower dose of the hormone compared to Mirena, catering to different needs.

If you get a hormonal IUCD, you may need to use another form of contraception for the first 7 days afterwards, so it’s a good idea to check with your doctor or nurse about the best plan for you.

These IUCDs are effective for up to 5 years, making them a long-term option. [2]

 

IUCD vs other contraceptives 

The IUCD is one of the most effective choices of contraceptives for African women compared to other contraceptives like implants, pills, injectables, and condoms. 

It offers a long-term, reliable, and private way to manage reproductive health without the stress of daily or monthly upkeep. This makes it a great choice for many women looking to take control of their health and family planning.

 

How is IUCD inserted into and removed from the womb?

Intrauterine device insertion and removal are clinic (outpatient) procedures that should be performed by trained healthcare professionals after thorough examination and proper service setup to ensure that they are done correctly and safely. 

The procedures are performed according to protocols (steps) whose details are supplied here.

Both procedures should  normally take a few minutes (15 minutes or less) each, and some cramping, discomfort and dizziness may occur. In unusual cases, sweating, vomiting and fainting may occur during the insertion of IUCD.

 

Benefits of IUCD

I. Long-term and convenience

The IUCD works up to 5 years and above without daily pills, ideal for busy women.

2. Highly Effective

Over 99% effective, making it one of the best birth control options.

3. Cost-Effective

Though it might be a little more expensive at first but it is cheaper over time as it lasts for years.

4. Private and Discreet

Unnoticeable by partners, it allows for private reproductive choices.

5. Quick Return to Fertility

Pregnancy can occur almost immediately after removal.

6. Suitable for Many Women

Safe for most, including breastfeeding mothers, and can be inserted post-childbirth.

 

Side effects and possible risks of IUCD

Common side effects associated with the use of IUCD are irregular bleeding and cramps.

There are also risks associated with the use of IUCD. They are rare with < 1% occurrence [3] and include:

• Displacement or accidental removal especially during the first three months after insertion. [4]

• Perforation of the uterus (womb) during an IUCD insertion.

• High-risk pregnancy. While it is quite rare for individuals with an IUCD to become pregnant, it can occur in a small percentage of cases [2], with a high risk of ectopic pregnancy.

 

Contraindications of IUCD 

Universal contraindications for IUCD use include:

• Pregnancy or suspected pregnancy
• Current sexually transmitted infections (e.g., cervicitis, vaginitis)
• Congenital uterine abnormalities affecting shape
• Acute pelvic inflammatory disease
• History of pelvic inflammatory disease (unless a successful intrauterine pregnancy followed)
• Recent septic abortion or postpartum endometritis (within 3 months)
• Confirmed or suspected uterine or cervical cancer
• Unexplained abnormal uterine bleeding
• Conditions increasing pelvic infection risk
• History of an unremoved IUD
• Hypersensitivity to any device component.[2]

Specific contraindications for levonorgestrel-releasing IUDs:

• Confirmed or suspected breast cancer or other progestin-sensitive cancers
• Liver tumors (benign or malignant)
• Acute liver disease

Contraindications for the copper IUD:

• Wilson disease
• Sensitivity to copper

 

Accessibility and challenges of IUCD in Africa

Even though IUCDs are effective, many people in African countries do not use them. Some common challenges include:

• Limited availability: IUCD services may not be available at all healthcare centers, especially in rural areas.

• Cultural and religious beliefs: Some communities discourage the use of contraceptives altogether.

• Misinformation: Myths spread by peers, media, or traditional beliefs often discourage women from considering IUCDs.

 

Guidance for African women considering IUCD

If you are thinking about getting an IUCD, here are some steps to guide you:

1. Consult a Healthcare Provider: Start with a conversation about your medical history, lifestyle, and reproductive goals.

2. Undertake pre-Insertion Ccecks: You may need a pelvic exam or an STI test, including pregnancy test. These checks help ensure everything is safe for your IUCD.

3. Insertion: The insertion is done during a short visit to the clinic, usually taking under 10 minutes.  You will be on your way in no time!

4. Follow-Up: Don’t forget to schedule a follow-up appointment about 4–6 weeks later. It is a great way to make sure everything is working perfectly.

5. Ongoing Care: Take a moment each month to self-check your IUCD strings and be aware of any unusual symptoms. If something feels off, reach out to your healthcare provider.

 

Common myths and misconceptions about IUCD in Africa

Myth 1: IUCD causes infertility

Fact: Fertility returns quickly after removal. IUCDs do not cause infertility.

Myth 2: The device moves around your body

Fact: Once inserted correctly, the IUCD stays in the uterus. It does not travel to other parts of the body.

Myth 3: It’s only for older or married women

Fact: IUCDs are safe for most women, including young women and those who haven’t had children.

Myth 4: It’s painful and risky

Fact: Insertion is usually quick and only mildly uncomfortable. Most women return to normal activities the same day.

 

Conclusion

Empowerment starts with having the right information. IUCDs give African women a safe, effective, and reversible way to plan their families and manage their reproductive health

Myths and misinformation should not stop you from making choices that shape your future.

If you are considering an IUCD, speak with a qualified healthcare provider. Ask questions, explore your options, and choose what is best for you. 

Remember, when it comes to your body and your future, knowledge is power.

 

References

1. Farr G, Amatya R, Doh A, Ekwempu CC, Toppozada M, Ruminjo J. An evaluation of the Copper-T 380A IUD's safety and efficacy at three African centers, Contraception, 1996; 53(5)293-298. doi: 10.1016/S0010-7824(96)00063-7. Abstract available from here.

2. Lanzola EL, Auber M, Ketvertis K. Intrauterine Device Placement and Removal. [Updated 2025 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. [Cited 2025 Nov 18]. Available from here. 

3. Estevez E, Hem-Lee-Forsyth S, Viechweg N, John S, Menor SP. Advancing Pain Management Protocols for Intrauterine Device Insertion: Integrating Evidence-Based Strategies Into Clinical Practice. Cureus. 2024 Jun;16(6):e63125. Available from here..  

4. Aisien AO. Intrauterine contraceptive device (IUCD): acceptability and effectiveness in a tertiary institution. Afr J Med Med Sci. 2007 Sep;36(3):193-200. Abstract available from here. 

 

Related: IUCD insertion and removal: A simple guide for African women

 

Published: November 25, 2025

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