Intrauterine Device (IUD)

An intrauterine device (IUD) is a form of birth control. It prevents pregnancy either by damaging or killing a man’s sperm or blocking it from entering a woman’s uterus. An IUD is a small, T-shaped device with a string attached to the end. The purpose of the string is to help you or your doctor make sure that the IUD is still in place. It also is how a doctor removes the device.

There are 2 types of IUDs available in the United States: hormonal and non-hormonal. ParaGard is the non-hormonal option. It has copper rings, or coils, that alter the chemicals in your uterine fluid to kill sperm. You should not use ParaGard if you are allergic to copper. Hormonal options include Mirena, Kyleena, Liletta, and Skyla. These release progestin hormones to thicken your cervical mucus and stop ovulation.

Path to improved health

Your primary care or women’s doctor can insert an IUD. They can insert ParaGard at any time during your menstrual cycle. Hormonal IUDs should be inserted in the first 7 days of your cycle. The procedure is quick and done in the doctor’s office. The doctor puts a small plastic tube with the IUD into your vagina. You may have pain or cramping during this process. Discomfort can last several hours or days. Most doctors suggest that you have someone else drive you home from the appointment.

IUDs start working immediately. You can have sex, exercise, and use tampons. An IUD is effective for 3 to 12 years, depending on the type. Your doctor can remove it at any time.

Call your doctor right away if you have the following symptoms or problems. They will check your IUD and may remove or replace it.

• You can’t find the string
• You can feel the IUD
• Your IUD comes loose or falls out
• You have a fever or chills
• You have abnormal blood, fluid, or odor coming from your vagina

Things to consider

You should not use an IUD if you have abnormal vaginal bleeding. Cancer of the cervix or uterus or the AIDS infection prevent IUD use as well. You shouldn’t use an IUD if you are pregnant or want to become pregnant. You can, however, get an IUD immediately after giving birth. The best time for the doctor to insert it is after delivery of the baby and placenta.

IUDs do not protect you from sexually transmitted diseases or infections (STDs or STIs). To reduce your risk of getting an STD, use a condom when you have sex. IUDs can affect your menstrual cycle. At first, you may have pain, cramping, or spotting (light bleeding) between periods. This can last for 3 to 6 months. Hormonal IUDs can cause your periods to be irregular. They may also cause you to miss periods. Copper IUDs can cause worse cramps and bleeding during your period.

The benefits of IUDs include:

• Pregnancy prevention success rate of 99% when used properly
• Use of 3 to 12 years, depending on the type
• Can be removed by your doctor at any time
• Convenience
• Safe for women who just gave birth and/or are breastfeeding
• Cannot be felt during sex
• Low risk of side effects

Risks are uncommon, but include:

• Injury to the uterus when the IUD is being inserted
• Increased risk of pelvic inflammatory disease if you have an STD
• Chance of getting pregnant, in which case your doctor should remove the IUD (If you become pregnant, the risk of miscarriage and health problems for you and the baby increase.)
• Chance of an ectopic pregnancy (This occurs when an egg fertilizes outside of your uterus. It is rare but can be harmful for a woman.)

Questions to ask your doctor

• How do I know which IUD is right for me, or if I should use another form of birth control?
• Are there any other health conditions that prevent me from using an IUD?
• Does my age play a factor in which type and brand of IUD I get?
• Does my insurance cover an IUD?
• How often do I need to check my IUD, either by a doctor or myself?
• What happens after an IUD expires?

Resources

American Academy of Family Physicians: Birth Control Options

Centers for Disease Control and Prevention: Intrauterine Contraception

National Institutes of Health, MedlinePlus: Intrauterine Devices (IUD)