IUD

The IUD is a small, T-shaped piece of plastic. It is put into your uterus and impacts sperm so they cannot fertilize an egg. IUDs offer 3-12 years of protection from pregnancy, depending on which IUD you get. If you want to get pregnant, you can have the IUD removed.

Types of IUDs:

Hormonal. There are three hormonal IUDs available – Mirena, Skyla, and Liletta. The hormonal options are made of plastic, and release a small amount of synthetic hormones. The hormone thickens your cervical mucus to keep sperm from reaching the uterus. Depending which IUD you get, hormonal IUDs can last between 3 and 6 years and may make your period lighter.

Non-hormonal. There is only one IUD without hormones available. It is called ParaGard. It is made of plastic and a small amount of natural, safe copper. ParaGard does not affect your periods and can work for up to 12 years.

Quick facts:

  • Invisible and easy. You can choose hormonal (Mirena, Skyla, and Liletta) or non-hormonal (ParaGard).
  • Effectiveness: IUDs are one of the most effective methods.
    • Perfect use: greater than

      99%

    • Typical use: greater than

      99%

  • Side effects: with ParaGard you might have increased blood flow, cramping.
  • Effort: low. It is inserted once and lasts for years

IUD

Quick facts:

The IUD is a small, T-shaped piece of plastic. It is put into your uterus and impacts sperm so they cannot fertilize an egg. IUDs offer 3-12 years of protection from pregnancy, depending on which IUD you get. If you want to get pregnant, you can have the IUD removed.

Types of IUDs:

Hormonal. There are three hormonal IUDs available – Mirena, Skyla, and Liletta. The hormonal options are made of plastic, and release a small amount of synthetic hormones. The hormone thickens your cervical mucus to keep sperm from reaching the uterus. Depending which IUD you get, hormonal IUDs can last between 3 and 6 years and may make your period lighter.

Non-hormonal. There is only one IUD without hormones available. It is called ParaGard. It is made of plastic and a small amount of natural, safe copper. ParaGard does not affect your periods and can work for up to 12 years.

  • Invisible and easy. You can choose hormonal (Mirena, Skyla, and Liletta) or non-hormonal (ParaGard).
  • Effectiveness: IUDs are one of the most effective methods.
    • Perfect use: greater than

      99%

    • Typical use: greater than

      99%

  • Side effects: with ParaGard you might have increased blood flow, cramping.
  • Effort: low. It is inserted once and lasts for years

Get it and forget it. If you do not want to worry about remembering birth control, the IUD just may be for you. Once it is in, you can leave it in for 3 to 12 years.

Hands free. No packages or prescriptions to pick up at the pharmacy. There is nothing that could get lost or forgotten.

Total privacy. No one can tell when you have an IUD. (Some partners say they can feel the strings, but no one else will know it is there.) There is no packaging, and nothing you need to do just before you have sex.

Safe and sound. Most experts agree, if you are healthy and have a uterus, you are probably a good candidate for the IUD. That is true even if you are young, have not ever been pregnant, or have not had kids yet. It is also a great method for new moms (even if you are breastfeeding).

The pregnancy question. You should be able to get pregnant very quickly after you have the IUD removed. If you are not ready to get pregnant as soon as you have an IUD taken out, be sure to protect yourself with an alternate method.

The first step to getting an IUD is to talk with your health care provider. She or he will ask you questions and give you an exam to make sure the IUD is right for you.

You can get the IUD inserted any time of the month. Some providers like to insert it during your period, but any time is fine as long as you can be sure you are not pregnant. It may be the most comfortable to get it done during the middle of your period (that is when your cervix, the opening to your uterus – is open the most).

It is common to feel some cramps when you get an IUD inserted, but they will go away with rest or pain medication. Some women might feel dizzy, too. Once the IUD is in, you will notice a little string that hangs down into your vagina. That is there so that the IUD can be removed later. (The strings do not hang out of the vagina.)

Once it is in, you should check the ends of the strings a few times a year to make sure it is in place. This is how:

  1. Wash your hands with soap and water, then sit or squat down.
  2. Put your finger in your vagina until you touch your cervix, which will feel firm and rubbery like the tip of your nose.
  3. Feel for the strings. If you find them, congrats! Your IUD is good to go. But if you feel the hard part of the IUD against your cervix, you may need to have it adjusted or replaced by your provider.

Do not tug on the strings! If you do, the IUD could move out of place.

If you are not comfortable checking for the strings, you can let your provider do that the month after insertion, and then yearly after that.

Everyone is different. What you experience may not be the same thing as another woman.

The Positive: there are actually lots of things about birth control that are good for your body as well as your sex life.

  • Easy to use
  • Does not interrupt the heat of the moment
  • Super long-lasting protection without much effort
  • Safe for smokers and those with hypertension and diabetes
  • The ParaGard brand of IUD does not change your hormone levels
  • The hormonal IUDs may reduce cramps and make your period lighter. (Some women’s periods stop completely.)
  • You can use it while you are breastfeeding

The Negative: everyone worries about negative side effects, but for many women, they are not a problem. Most women adjust to having an IUD pretty quickly, but it could take a few months.

The most common complaints:

  • Spotting between periods (especially during the first few months after you get an IUD)
  • Increased period flow (for users of the ParaGard brand)
  • Cramps and backaches

Other issues to watch out for:

  • IUD slipping out
  • Infection
  • IUD pushing through the wall of the uterus

If you still feel uncomfortable after three months, switch methods and stay protected.

*For a very small number of women there are risks of serious side effects

We are here to help you. If it still does not feel right, we have ideas for other methods. Just remember: If you change methods, make sure you use another method while you switch.

Will my IUD hurt my partner?

  • The IUD should not hurt your partner. You may have heard that the IUD strings can bother men while having sex, but most partners cannot even feel the strings. If your partner can feel the strings, and that bothers him, your healthcare provider might be able to trim them. Plus, they usually soften over time.

Should I be worried about spotting?

  • Spotting, which can happen with a bunch of different methods, does not make you lose that much blood, even though it might seem like it.
  • Still not working? You may have more luck on a pill with a slightly higher dose of estrogen, or one that provides estrogen during a different part of your cycle.
  • Try a different method: pill

What if my periods are heavier and/or my cramps are worse?

  • You are probably using a copper IUD (ParaGard). Try it for a few months, and take ibuprofen the first few days of your period.
  • Still not working? If you like the ease of using an IUD, but find that the side effects do not get better with time or painkillers, try switching to a hormonal IUD (Mirena) or to the implant
  • Try a different method: implant; IUD

What if my partner can feel the IUD strings?

  • The strings of the IUD usually get softer over time. If they are a problem for your partner, talk to your health care provider about adjusting them or cutting them shorter.

What if I want to get pregnant?

  • If you are ready to get pregnant, ask your provider to remove your IUD. The hormones in your body should go back to normal quickly and you can start trying right away.

My IUD was expelled. What is the likelihood it will happen again?

  • IUD expulsion can occur in 2-10% of women in the first year after insertion. Expulsion can be more likely for women who:
    • Have not been pregnant
    • Are younger than 20 years
    • Have a history of very heavy or very painful periods (though these are reasons providers recommend the hormonal IUD in the first place)
    • Had the IUD put in right after giving birth or have a 2nd trimester abortion
  • A partial expulsion may mean that the IUD was not quite in the right position: it may have been too low in the uterus and just worked its way out. This could be something that happened around the time of insertion, or may be related to uterine characteristics, such as size, angle, or presence of conditions like fibroids that can cause irregular shape. For women who have an IUD expulsion, the chance of expelling a 2nd IUD may be higher – in the 20% range (up to 30% in some studies).
  • Still not working? If you like the ease of using an IUD, but are having problems with expulsion, you could try switching to the implant – a long-acting and low-maintenance option
  • Try a different method: implant

Will getting the IUD inserted hurt?

  • IUD insertion pain can vary from person to person. Unfortunately there is not a great drug to take to make insertion less painful.
  • You can try taking ibuprofen beforehand the insertion, and make sure you get the IUD inserted when your cervix is open, such as when you are on your period or ovulating. Even if there is some pain, it might be worth it for years of pregnancy-free sex.

I want to get my IUD removed. Can I remove it myself?

  • You may be able to find some stories online about people removing their own IUD. We do not recommend trying it. There is not enough research at this point to know if it is safe. If you are not happy with your IUD, going to your provider to get it removed will give you a chance to talk about other options for birth control.
  • If you are ready to get pregnant, you can talk with your provider about things you should do to prepare for a healthy pregnancy.
  • Still not working? If you are not happy with the IUD but you do not want to get pregnant, consider a different kind of IUD if you have only tried one. If you want something that lasts for a while and is easy to use, the implant might be another good option.
  • Try a different method: implant; IUD

Can I use tampons if I have an IUD?

  • You should be fine as long as you are careful not to pull on the IUD strings, which you should not need to worry about too much since the string of a tampon is outside of your vagina and the strings of your IUD should be up near your cervix. (If you find that your IUD strings are anywhere near your tampon strings, you should go see your health care provider because your IUD might be expelled.)