IUD and Other Options for Emergency Contraception

Medically Reviewed by Traci C. Johnson, MD on August 24, 2022
4 min read

Emergency contraceptives are birth control you can use to prevent pregnancy after you have unprotected sex, or if your other birth control fails.

You may be familiar with the emergency contraception pill, or morning-after pill. But you can also use a copper intrauterine device (IUD) as emergency birth control. Your doctor inserts the IUD, a T-shaped device, into your uterus up to 5 days after you've had unprotected sex.

Your doctor will check your medical history first to make sure it’s safe for you to use an IUD.

An IUD is the most effective type of emergency birth control. Less than 1% of women who use an IUD as an emergency contraceptive get pregnant.

There are two types of IUDs, hormonal and copper. But only the copper IUD (Paragard) is used for emergency contraception.

The copper in the IUD causes sperm to stop moving, which keeps them from reaching your egg. The IUD may also keep your egg from implanting in your uterus.

Both of these things lower your chance of pregnancy. But if you’re already pregnant, an IUD won’t work as an emergency contraceptive.

You may leave the copper IUD in place after you use it for emergency contraception. An IUD can prevent pregnancies for up to 10 years.

While you're getting the IUD inserted, you might have nausea, dizziness, fainting, low blood pressure, or a slower heart rate. These symptoms should go away after a few minutes. Your doctor may suggest that you lie down until you feel better.

You may notice other side effects after you get an IUD, especially if you keep it in place as regular birth control. It may cause cramps and heavy bleeding during your period. Over-the-counter pain relievers can ease the pain. Your doctor might give you medication to help with heavy periods.

These side effects usually go away within a year after you start using an IUD.

IUDs are not only very effective, but safe for most women. But they do have some risks, including:

Pelvic infection. If you have a sexually transmitted disease (STD), don't use an IUD as an emergency contraceptive. In that case, the IUD may cause a pelvic infection. These infections can lead to infertility if you don’t treat them. If you don’t have an STD, you have a very small chance of pelvic infection from an IUD.

Damage to your uterus. When a doctor inserts an IUD, it can get stuck in or slightly tear your uterus. This only happens in 1 out of 1,000 women. But if your uterus is damaged, your doctor must remove the IUD as soon as possible.

Falling out. Sometimes, an IUD comes out of your uterus into your vagina. That's most likely to happen in the first few months after you get it. But it only happens to about 2% to 10% of women with IUDs. It's more common if you get an IUD right after you give birth, or if you've never been pregnant. If it happens to you, tell your doctor right away, and use another form of birth control.

If you don’t want to use an IUD to prevent pregnancy, you can take an emergency contraception pill. There are three kinds of morning-after pills. Some, but not all, need a doctor’s prescription:

  • Ulipristal (Ella). This pill delays or stops ovulation. It affects how your progesterone, a hormone that gets you ready for a possible pregnancy, works in your body. You can take this pill up to 5 days after unprotected sex. You'll need a doctor's prescription to get this type of emergency contraception.
  • Progestin-only pill. This pill, sometimes called the mini-pill, works best if you take it within 3 days of having unprotected sex. The hormone progestin stops or delays your ovulation to prevent pregnancy. It’s the same hormone in many other birth control pills and hormonal birth control methods. You can get this pill without a prescription at most pharmacies.
  • Combined pills. A strong dose of some pills that contain both estrogen and progestin can work as emergency birth control. The combination of hormones delays ovulation. You need a doctor's prescription for these pills. And you need to take them within 5 days of having unprotected sex. But they work best if you take them as soon as possible. The number of pills you should take depends on what brand you use. Your doctor can tell you what dosage you need.