If you’re looking into your options for birth control, one method you may want to think about is the IUD. They’re not for everyone, but today’s IUDs are considered both effective and safe for most women. And they’re also long-lasting.
What Is an IUD?
Four types are available in the United States.
Three -- Liletta, Mirena, and Skyla -- release small amounts of the hormone progestin (levonorgestrel) into your body. It’s the same hormone used in many birth control pills. These types of IUDs tend to make your period lighter and may be a good option if you have heavy periods.
The fourth is ParaGard, also called the copper T IUD. It’s hormone-free. The copper triggers your immune system to prevent pregnancy. It can cause your periods to be heavier, especially at first. But ParaGard lasts longer than hormonal IUDs.
How effective are IUDs?
If you use an IUD correctly, your chance of getting pregnant is less than 1%.
What are the benefits of IUDs?
- They last a long time.
- They're mostly hassle-free. Once you have one inserted, you don't have to think about it, and neither does your partner.
- It’s one cost, upfront.
- They’re safe to use if you're breastfeeding.
Who can use them?
- You have an STD or had a recent pelvic infection.
- You’re pregnant.
- You have cancer of the cervix or uterus.
- You have unexplained vaginal bleeding.
In rare cases, the size or shape of your uterus may make it tough to place an IUD.
How is an IUD inserted?
The procedure is similar to getting a Pap smear. You’ll put your feet in stirrups. The doctor will put the IUD in a small tube that she’ll insert into your vagina. She’ll move the tube up through the cervix into the uterus. Then she’ll push the IUD out of the tube and pull the tube out. Strings attached to the IUD will hang 1-2 inches into the vagina.
The procedure is uncomfortable, and you may have cramps and bleeding, but they tend to go away in a few days. Some women may also feel lightheaded from the pain.
You can have most IUDs placed at any time in your cycle. But it may be more comfortable to have one inserted while you’re having your period. This is when your cervix is most open.
How soon do IUDs start working?
The non-hormonal ParaGard is effective as soon as it’s inserted.
If it’s put in during your period, hormonal IUDs start working right away. Otherwise, this type may take up to 7 days to be effective.
How long does one last?
This depends on what kind of IUD you get.
- 3 years for Liletta and Skyla
- 5 years for Mirena
- 10 years for ParaGard
Will my periods change?
With hormonal IUDs, many women have fewer cramps. For the first few months, some women have irregular spotting. Eventually, most women have light periods or no period at all. Pregnancies rarely happen with IUDs, but if not having a period will make you constantly worry that you’re pregnant, you may want to consider the copper IUD instead.
The copper ParaGard may make periods heavier and cramping worse. This may go away after a few months.
Can my partner feel it?
Your partner shouldn't be able to feel anything, but if he does, it will only be minor contact with the strings of the IUD. This shouldn't cause any discomfort. The strings soften the longer you have the IUD and can be trimmed shorter.
Are there side effects?
Rare but serious side effects from IUDs include:
Can my IUD fall out?
Your doctor will check your device during your regular office visits. Your cervix should hold the IUD in place, but in rare cases, it can fall all the way or part of the way out.
This is more likely if:
- You don't have children.
- You’re under 20 years old.
- You had the IUD put in right after having a baby or after having a second-trimester abortion.
- You have fibroids in your uterus.
- Your uterus is an unusual size or shape.
IUDs are more likely to come out during your period. You may see the device on a pad or tampon. Check periodically to make sure you can feel the strings. If they feel shorter or longer or if you can feel the IUD itself pushing against your cervix, it may have moved. If this happens, contact your doctor.
What if I want to have kids in the future?
Using an IUD shouldn’t affect your ability to have children later on. If you want to get pregnant, ask your doctor to take out your IUD. Your cycle should return to normal as soon as the IUD is removed.
How is an IUD removed?
Your doctor will take out the IUD in her office. It should only take a few minutes. You’ll put your feet in stirrups and the doctor will use forceps to slowly pull the IUD out. You may have some cramping and bleeding, but this should go away in 1-2 days.