What is an IUD?
In this section
Everything you need to know about IUDs
Aside from birth control pills, intrauterine devices (IUDs) have gained significant popularity as a birth control option thanks to their high success rate, long-term effectiveness, and ease of use. In fact, IUDs are the most effective form of reversible birth control and emergency contraception.
What is an IUD?
An IUD is a small t-shaped device made of either copper or plastic and is inserted into the uterus opening (the cervix) by a healthcare professional.
There are two types of IUDs: hormonal and non-hormonal (copper). Even though they work a bit differently, both work by making it difficult for sperm to reach an egg. Hormonal IUDs thicken cervical mucus and thin the uterine lining, while copper IUDs create an environment that is safe for you, but toxic to sperm.
Hormonal IUDs
Hormonal IUDs, such as Mirena, Kyleena, Liletta, and Skyla release a progestin hormone called levonorgestrel (also found in birth control pills and morning-after pills like Julie and Plan B). This hormone thickens the cervical mucus, making it difficult for sperm to reach the egg, and thins the uterine lining, reducing the chances of implantation. Each of these IUDs contain different hormones, resulting in varying expiration dates:
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Mirena: 8 years
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Liletta: 8 years
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Kyleena: 5 years
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Skyla: 3 years
Research also has shown that Mirena and Liletta can reduce heavy menstrual bleeding and can reduce menstrual cramps and pain.
The Copper IUD
The copper IUD, known as ParaGard, is a hormone-free option. It is wrapped in copper wire, which creates an environment toxic to sperm, preventing fertilization. The copper IUD is highly effective and lasts up to 10 years. The copper IUD can also be used as emergency contraception if inserted within five days of unprotected sex.
IUDs are the most effective emergency contraceptive option
IUDs are over 99% effective at preventing pregnancy, making them the most effective birth control option for all people and body types. IUDs are also one of the most user-friendly methods of birth control; instead of having to remember to take a pill at the correct time each day, an IUD requires nothing after insertion. Here are some other reasons why IUDs are a popular contraceptive choice:
Weight does not impact effectiveness
While the effectiveness of some morning-after pills can decrease with higher BMIs, weight does not impact the efficacy of IUDs. IUDs are highly effective at preventing pregnancy for all body types.
Long-lasting effectiveness
Hormonal IUDs can provide contraception for up to 3 to 8 years, depending on the specific brand, while the copper IUD can protect against pregnancy for up to 10 years.
Low failure rates/No user error*
Once the IUD is inserted, you can effectively forget about it until it needs to be replaced. You don’t have to remember to take a pill at a certain time each day or change your patch every week. These situations are considered “user error” and are the main reason that other birth control methods aren’t as effective as the IUD. With the IUD, you completely eliminate user error and have the best chance of effective birth control for the longest period of time.
*IUDs are effective at preventing pregnancy, but they do not prevent STIs. Be sure to use an additional barrier method (ie. condom or dental dam) to prevent contracting or spreading STIs. For more about STIs, read this.
Side Effects of IUDs
As with other medications, including other forms of birth control, there is a possibility of side effects. Here are some of the most common side effects of the IUD:
Cramping and discomfort
Mild to moderate cramping and discomfort can occur after the insertion of an IUD. This is usually temporary and can be managed the same way menstrual cramps are managed: over-the-counter pain relievers, a heating pad, or warm bath.
Irregular menstrual bleeding
One of the most common side effects is irregular menstrual bleeding. This may include lighter or heavier periods, spotting between periods, or even the absence of menstruation altogether, also known as amenorrhea.
The copper IUD can make your menstrual cramps more intense and can also increase period bleeding, especially during the first few months after insertion. Periods generally return to normal thereafter.
Spotting and breakthrough bleeding
Spotting or breakthrough bleeding can occur 3 to 6 months after IUD insertion. This is a normal response to the presence of the device.
Additional side effects
While rare, some individuals may experience other side effects with IUD use, such as headaches, breast tenderness, mood changes, or acne. If any concerning side effects occur, it is recommended to consult with a healthcare provider.
The IUD Process: What to Expect
If you're considering getting an IUD, it's natural to have questions about the process. Here's a breakdown of what you can expect:
Consultation with a healthcare provider
Schedule a consultation with a healthcare provider. They’ll discuss the different types available and address any concerns or questions you may have.
Preparing for the insertion
Before the insertion procedure, your healthcare provider may advise you to take an OTC pain reliever, such as ibuprofen, to help manage potential discomfort. Your provider will also have you take a urine pregnancy test.
Insertion procedure
During the insertion, a healthcare provider will use a speculum to find the cervix and forceps to guide the IUD into the uterus. The procedure typically takes just a few minutes and may cause mild to moderate discomfort or cramping.
Post-insertion care and follow-up
After an IUD insertion, some people feel completely fine while some experience mild to intense pain for about 24 hours. If you can, take it easy the rest of the day. You might feel:
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Light-headed or dizzy
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Experience cramps or backaches
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Have light spotting or bleeding
Be sure to follow your healthcare provider's instructions for post-insertion care. This may include avoiding tampons and sexual intercourse for a specified period. Your doctor will likely schedule a follow-up appointment to ensure the IUD is properly in place.
Expulsion
To ensure the IUD remains in place, it’s recommended to check the strings attached to the device regularly. If you cannot feel the strings or suspect the IUD has moved, it is important to consult with a healthcare provider. This may be nothing to worry about, or it may be something called expulsion.
Expulsion is a rare occurrence that describes when the IUD is out of place. It may have completely fallen out of the uterus or just shifted significantly. If the IUD completely falls out, do not attempt to reinsert the IUD or move it back into place. If you’re concerned about expulsion, call your doctor ASAP.
Expulsion is more common for women:
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Who are under 20 years old
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Have never been pregnant
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Have heavy periods
Perforation
Although very rare (1 in 1000 insertions), there is a small risk of uterine perforation. That’s when the IUD perforates (pokes through) the wall of the uterus. Depending on the severity, treatment may require you to wait and avoid sexual activity while the uterus heals or surgery may be required.
IUD Removal: A Safe, Straightforward Process
When the IUD has completed or is about to complete its timeline of effectiveness, or if you want to stop using it for any reason, the IUD can be removed by a healthcare provider. Do not attempt to remove an IUD on your own. Here’s what to expect:
Consult with a healthcare provider
Schedule an appointment with your healthcare provider. If you’re at the end of your IUD’s efficacy timeline and want a new IUD, the insertion procedure will likely take place right after the removal of your old IUD.
Quick and relatively painless
IUD removal is typically a quick and relatively painless process. The healthcare provider will use forceps to gently pull on the strings, and the IUD will come out of the uterus. Like with insertion, you may feel some discomfort.
Fertility returns promptly
Once the IUD is removed, fertility generally returns quickly. For some, fertility returns immediately. For others, it returns with the next menstrual cycle.
Potential side effects
Similar to the insertion process, some individuals may experience mild cramping or discomfort during or after the removal procedure. These symptoms are usually temporary and can be managed with OTC pain relievers. Be sure to talk to your provider if side effects last beyond a week.
Consider future contraceptive options
If you’re removing your IUD because you want a different method of birth control, speak with your healthcare provider about your options. They can help you explore other methods that align with your reproductive goals and lifestyle, ensuring a smooth transition from one form of contraception to another.
Please note that this article is for informational purposes only and should not replace professional medical advice. If you have specific questions or concerns, it’s always best to consult with a healthcare professional.
