For many women, an intrauterine device (IUD) is a good birth control option. It’s safe, 99% effective at preventing pregnancy, and long lasting. It works as soon as it’s put in, lasts between 3-10 years, and can be removed any time. As soon as it’s out, you can become pregnant.
But some women who choose an IUD are surprised by what it involves. Here, they share what they wish they had known before getting an IUD.
Not All IUDs Are the Same
There are two types of IUDs: hormonal IUDs (Kyleena, Liletta, Mirena, Skyla) and nonhormonal copper IUDs (Paragard). Each has pros and cons.
Hormonal IUDs release the hormone progestin. With a hormonal IUD, you may have more PMS-like symptoms, like acne, breast tenderness, headaches, moodiness, and nausea. Your periods may be lighter, shorter, and less painful.
Nonhormonal IUDs are made with copper to prevent sperm from living in your uterus. With a copper IUD, you may have heavier periods and more cramps.
“My OBGYN suggested the Mirena IUD for managing my endometriosis pain,” says Tabitha Britt, a freelance journalist from Harrison, NJ. “While it helped with my pain, the side effects just weren't worth it. It caused serious weight gain and depression. When I switched to the copper IUD, I lost weight and slowly became myself again.”
Ask your doctor which may be best for you.
Insertion Can Hurt
It’s common to feel pain or discomfort when your doctor inserts an IUD. Some women feel mild pressure. Others have more intense pain.
“I wish I’d known how much it hurts,” says Melissa James, a copy designer in Yorktown, VA. “Childbirth was less painful. I couldn’t even walk afterward.” James learned from her first experience and was better prepared for next time. Before she got a new IUD, her doctor prescribed a cervical softener and anti-anxiety medication.
But not everyone feels pain. Alissa Poland of Lexington, KY, says it was uncomfortable but not as bad as she’d heard. “The pain is really hyped up,” Poland says. “If it were a horrible procedure for every person, I’d imagine they’d have started doing it another way by now.”
You May Have Cramping, Lightheadedness, and Other Symptoms
When your doctor puts in your IUD, you may have cramping, dizziness, or fainting. Sarah Baillie of Buffalo, NY, says her friends told her to expect cramping. “But the lightheadedness caught me off guard.”
For some women, symptoms last a few hours. For others, it may be a longer. “I stayed in bed for 2 days because the cramping was so bad,” says Caitlin Jones, a personal trainer in Pittsburgh, PA.
You may have other symptoms like acne, breast tenderness, headache, and mood changes, but they’re less common.
You May Have More Bleeding
After you get an IUD, you may have irregular bleeding or spotting between periods. It can last 3-6 months. If it lasts longer, your doctor may recommend birth controls to ease pain and regulate your cycle.
Kristin Light, a marketing professional in Toronto, knew an IUD was the right choice for her but didn’t know she'd have lingering symptoms. “I wish I’d known that before the benefits kicked in I’d be facing 3-4 months of continuous bleeding,” she says.
Your Period Could Stop
For some women, there’s less bleeding -- or none at all.
“I wish I had known how many women stop getting their periods,” says Marissa Blaszko, a blogger in Hartford, CT. “My doctors warned me about a bunch of side effects, but never that I might stop bleeding. It's been great for 3 years. Had I known, I would’ve gotten one years earlier.”
It Can Slip Out of Place
Experts say it’s uncommon, but your IUD may be dislodged or expelled from your uterus. If it comes out, even partially, you can get pregnant and it has to be removed.
Rachael Weesjes, who lives in Ontario, Canada, became pregnant when her copper IUD slid out of place. “The IUD stayed for the entire pregnancy, and by the time my son was born it was lodged under my right rib,” she says.
You may not notice if your IUD is out of place. Try checking it once a month. You can feel for the strings to see if they’re protruding from your cervix.
Complications Are Possible but Rare
Complications like infection, pelvic inflammatory disease (PID), and perforation of your uterus may happen, but they’re rare.
“I had two IUDs over a 10-year period. They worked well, but the strings caused Gardnerella vaginalis, which is a bacterial infection,” says Laura Horton, founder of Hound101.com in Columbus, OH.
Talk to your doctor about the pros and cons of getting an IUD. Knowing what to expect can help you decide if it’s right for you and help you prepare better.
Sarah Walsh, an account manager in Lancaster, PA, says getting an IUD was one of the best decisions she’s made. “My husband and I have no plans to have children and my IUD has given me such peace of mind,” she says. What she discovered later was a bonus. “I no longer really get a period. It’s delightful.”