Is an IUD Right for Me?
All of us who need birth control want to find the method that is best for us. And every woman has different needs when choosing a method. Whether you're thinking about getting an IUD, you're using an IUD, you're a concerned partner, or you're just someone who's curious about it, you may have many questions.
Here are some of the most common questions we hear women ask about IUDs. We hope the answers help you decide if one is right for you.
Highlights
What Is an IUD?
The letters IUD stand for "intrauterine device." IUDs are small, "T-shaped" devices made of flexible plastic. A health care provider inserts an IUD into a woman's uterus to prevent pregnancy.
There are two brands of IUD available in the United States — ParaGard and Mirena.
 The ParaGard IUD contains copper. It is effective for 12 years.
 The Mirena IUD releases a small amount of progestin, a hormone. It is effective for five years.
How Does an IUD Work?
Both the ParaGard and the Mirena IUDs affect the way sperm move, preventing them from joining with an egg. If sperm cannot join with an egg, pregnancy cannot happen. Both types also alter the lining of the uterus. Some people say that this keeps a fertilized egg from attaching to the lining of the uterus. But there is no proof that this actually happens.
The progestin in the Mirena IUD helps prevent pregnancy. Progestin works by keeping a woman's ovaries from releasing eggs — ovulation. Pregnancy cannot happen if there is no egg to join with sperm. Progestin also prevents pregnancy by thickening a woman's cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.
How Effective Is the IUD?
Effectiveness is an important and common concern when choosing a birth control method. IUDs are one of the most effective forms of birth control available. Less than 1 out of 100 women will get pregnant each year if they use the ParaGard or the Mirena IUD.
Keep in mind that the IUD doesn't protect against sexually transmitted infections. Use a latex or female condom along with the IUD to reduce the risk of infection.
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The ParaGard IUD can be used as emergency birth control, to prevent pregnancy after unprotected intercourse. It can reduce the risk of pregnancy by 99.9 percent if inserted within 120 hours (five days) after unprotected intercourse. |
How Safe Is the IUD?
Most women can use either the ParaGard or the Mirena IUD safely. But all medications have some risks, so safety is a common concern when choosing a birth control method. Certain conditions increase the risk of side effects. Talk with your health care provider about your health and whether an IUD is likely to be safe for you. There are many other methods of birth control that may be safe for you if you cannot use an IUD.
What Are the Benefits of an IUD?
The ParaGard and the Mirena IUDs are two of the least expensive, longest lasting forms of birth control available to women today. There are many other benefits.
- IUDs may improve your sex life. There is nothing to put in place before intercourse to prevent pregnancy. Some women say that they feel free to be more spontaneous because they do not have to worry about becoming pregnant.
- The ParaGard IUD does not change a woman's hormone levels.
- The Mirena IUD may reduce period cramps and make your period lighter. On average, menstrual flow is reduced by 90 percent! For some women, periods stop altogether.
- IUDs can be used during breastfeeding.
- The ability to become pregnant returns quickly once the IUD is removed.
Some women may worry that they are pregnant if they do not have a regular period. But the IUD is very effective. If you are concerned about a possible pregnancy, you can always take a pregnancy test.
Overall, most women who get an IUD are satisfied with their choice. Ninety-nine percent of IUD users are pleased with them.
What Are the Disadvantages of an IUD?
Many of us like to weigh the benefits against the risks when making decisions about our health. It's important to think about the possible side effects of using an IUD.
The IUD can change your period:
- Spotting between periods is common.
- ParaGard may cause a 50–75 percent increase in menstrual flow. In some cases, this can lead to a low red blood cell count.
- You may experience menstrual cramps or backaches.
You'll likely adjust to your IUD very quickly. But for some women, it may take several weeks or months to adjust. Simple pain relievers can usually reduce bleeding, cramping, and other discomforts. If they are severe and do not seem to lessen, tell your health care provider.
Serious problems with the IUD are rare. There are three main things to watch out for when using an IUD:
- The IUD can sometimes slip out of the uterus. Sometimes it comes all the way out. Sometimes it only comes out a little. This is more likely to happen to women who are younger and who have never had a baby. If the IUD slips out of place, pregnancy can happen. If it comes out only part of the way, it has to be removed.
- In rare situations, a woman could develop an infection when using the IUD. This happens if bacteria get into the uterus when the IUD is inserted. Most infections develop within three weeks of having the IUD inserted. If the infection is not treated, it can affect a woman's ability to become pregnant in the future.
- In very rare situations, when the IUD is inserted, it can push through the wall of the uterus. This might sound painful, but it usually isn't. Usually, when this happens, the health care provider will notice it and it can be fixed right away. But if not, the IUD can move around and harm other parts of the body. When this happens, surgery may be needed to remove the IUD.
Most often, if complications happen, they are easy to treat with medicine or other treatments.
It's important to pay attention to any symptoms you might have after starting the IUD. Tell your health care provider immediately if you
- find the length of the string ends to be shorter or longer than they were at first, when you feel for them with your fingers
- are not able to feel the string ends when you check
- feel the hard plastic bottom of the "T" part of the IUD against the cervix, when you check
- think you might be pregnant
- have periods that are much heavier than normal or last much longer than normal
- have severe abdominal cramping, pain, or tenderness in the abdomen
- have pain or bleeding during sex
- have unexplained fever and/or chills
- have flu-like symptoms, such as muscle aches or tiredness
- have unusual vaginal discharge
- have a missed, late, or unusually light period
- have unexplained vaginal bleeding
IUDs and Pregnancy
The risk of pregnancy while using a ParaGard or Mirena IUD is very low. But if the IUD slips out of place, pregnancy can happen. If you become pregnant, have the IUD removed as soon as you find out that you are pregnant. If you are pregnant with an IUD in place, there is an increased risk of
- ectopic pregnancy
- dangerous pelvic infection
- miscarriage
- early labor and delivery
Even with the risks, some women may choose not to have the IUD removed during pregnancy. If you don't want to have the IUD removed while you are pregnant, you need to work with your health care provider through your pregnancy. |
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Ectopic pregnancies are a serious concern. They can be life-threatening. Women who use IUDs are much less likely to have an ectopic pregnancy than women who are not using birth control. But if a woman does become pregnant while using an IUD, it is more likely to be ectopic than if she was not using the IUD.
Symptoms of an ectopic pregnancy include
- irregular vaginal bleeding
- pain in the abdomen or tip of the shoulder
- sudden weakness or fainting
If you have any of these symptoms while using an IUD, get medical care right away. |
How Soon After Getting an IUD Can I Have Sex?
You can have sex as soon as you like after the IUD is inserted.
- The ParaGard IUD is effective immediately.
- The Mirena IUD is effective immediately if inserted within seven days after the start of your period. If you have Mirena inserted at any other time during your menstrual cycle, use another method of birth control like a condom, female condom, or spermicide if you have vaginal intercourse during the first week after insertion. Protection will begin after seven days.
What Should I Do After Getting an IUD?
You should have a checkup after your first period. Don't wait longer than three months after you get your IUD to make sure it is still in place. Women using an IUD should have regular checkups to make sure everything is all right. This can be done at the same time as your periodic pelvic exam. Remember when you have your IUD inserted. That way, if you see other health care providers, you can tell them when it needs to be replaced. The ParaGard IUD should be replaced after 12 years. The Mirena IUD should be replaced after five years.
How Do I Check My IUD?
If an IUD is going to slip out of place, it will most likely happen in the first few months of use. But it may occur later. The IUD is most likely to slip out of place during your period. Check your pads, tampons, or cups to see if the IUD has fallen out. If it has, you must check with your health care provider. Until then, use another form of birth control such as latex or female condoms.
Between your periods, you can check for the string ends. It is especially important to check every few days for the first few months.
To check for the string ends ...
- Wash your hands. Then either sit or squat down.
- Put your index or middle finger up into your vagina until you touch the cervix. Your cervix will feel firm and somewhat rubbery, much like the tip of your nose.
- Feel for the string ends that should be coming through. If you find them, it means that the IUD is in place and working. However, if the string ends feel longer or shorter than before, or if you feel the hard part of the IUD against your cervix, it may be that the IUD has moved and needs to be put back in place by your health care provider. You should not attempt to put the IUD back in place yourself. Be sure to use another form of birth control until it is put back in place.
- Do not pull on the string ends. Pulling might make the IUD move out of place or even come out.
How Is an IUD Removed?
Having an IUD removed or replaced is usually simple. Your health care provider will do it for you. Women should never try to remove IUDs themselves or ask nonprofessionals to do it for them. Serious damage could result.
In rare cases, IUDs cannot be easily pulled free. In these cases, the cervix may have to be dilated and a surgical tool may be used to free the IUD. In very rare cases, surgery becomes necessary.
Where Can I Get an IUD? How Much Does an IUD Cost?
You need to see a health care provider to get a ParaGard or Mirena IUD. Your health care provider can help you decide if an IUD is right for you and tell you what to expect during an IUD insertion. You can find a health care provider who can help you with getting an IUD at your local Planned Parenthood health center or at other clinics.
The IUD is the most inexpensive long-term and reversible form of birth control you can get. Unlike other forms of birth control, the IUD only costs money in the beginning. The cost for the medical exam, the ParaGard or Mirena IUD, the insertion of the IUD, and follow-up visits to your health care provider can range from $175 to $500. That cost pays for protection that can last from 5 to 12 years.
Medicaid and private health insurance may cover the cost of the ParaGard or Mirena IUD. Family planning clinics usually charge less than private health care providers.
Published: 02.10.08 | Updated: 02.10.08
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