What is an IUD?
IUD stands for “intrauterine device.” Shaped like a “T” and slightly larger than a quarter, an IUD fits inside your uterus, and is one of the safest, most effective methods for preventing pregnancy. While the IUD is a good choice for women or teens who do not want to get pregnant for at least one year, some women use IUDs for reasons other than birth control. For example, one type of IUD can be used to treat heavy, painful periods, or anemia from heavy periods. They can also be useful for emergency contraception, given that they are effective immediately after placement and do not require time for hormones to take effect.
How does an IUD work?
IUDs prevent pregnancy by preventing sperm from reaching and fertilizing eggs, although some aspects of the precise mechanism of action are unknown. IUDs are not abortifacients; in other words, they do not interrupt an implanted pregnancy. Pregnancy is prevented by a combination of the “foreign body effect” of the plastic frame and the specific action of the medication (copper or Levonorgestrel) that’s released, which impairs sperm function and implantation, and prevents fertilization.
How does IUD insertion and removal work?
An IUD can be inserted in your gynecologist’s office setting. The best time to have an IUD inserted is during your period, as this is when your cervix is most open. Overall, the entire procedure takes less than five minutes. You may experience some mild cramping from insertion, so some women often choose to take over-the-counter pain medication, such as ibuprofen or acetaminophen, before coming to the office.
Once inserted, an IUD can be removed on request, or at the time of expiration, approximately three to 10 years later. Removal takes about two to three minutes by your gynecologist in the office. You may experience some normal cramping and bleeding as a result, but this should go away quickly.
What are the different types of IUDs?
Five different IUDs are available in the United States, and they fall under one of two categories:
1. Copper-containing IUD (non- hormonal)
- There is only one copper-containing IUD. It is called Paragard and can stay in your uterus for up to 10 years to prevent pregnancy. Some women who use it notice heavier or longer periods than they had before getting the IUD, especially at first. However, Paragard lasts longer than hormonal IUDs.
2. Progestin-releasing IUDs
- There are four progestin-releasing IUDs: Mirena, Kyleena, Skyla, and Liletta.
- Mirena, Liletta, and Kyleena can stay in your uterus for up to five years to prevent pregnancy, and Skyla can stay in place for up to three years. Many women who use progestin-releasing IUDs have lighter, less painful periods than they had before getting the IUD. Some women stop getting a period completely. This is not harmful and does not need to be treated. Regular periods return when the device is taken out.
The benefits of using an IUD
There are several benefits patients experience when using an IUD. For example:
- IUDs are very effective. Fewer than 1 in 100 women who use these devices get pregnant during the first year of using them.
- They’re mostly hassle-free. You do not have to remember to do anything or take any birth control medicines on a regular basis.
- IUDs have few side effects.
- IUDs do not contain estrogen, a hormone that some women can’t take.
- If you decide you want to get pregnant, you can have the IUD taken out.
- If you use an IUD for several years, it costs less overall than many other types of birth control. That’s because there are no costs after you have it inserted.
- They’re safe to use if you’re breastfeeding.
Effectiveness & reversibility
Let’s talk more about the effectiveness of the IUD. If you use an IUD correctly, your chance of getting pregnant is less than 1%. Here is a breakdown of birth control methods and their effective rates:
- Nexplanon, IUDs, and bilateral tubal ligation have a failure rate for typical use of less than one in 100 women per year.
- Birth control pills, the patch, the Depo-Provera injection, and the ring have a failure rate for typical use of six to 12 in 100 women per year.
- Natural family planning, the pull out method, and condoms have a failure rate for typical use of 18 or more in 100 women per year.
Using an IUD should not affect your ability to have children later on. If you want to get pregnant, simply ask your doctor to remove your IUD. Your cycle should return to normal very soon after the IUD is removed, and you can then begin trying to conceive.
The disadvantages of using an IUD
While there are many benefits to using an IUD, there are still some downsides that should be considered. For example:
- You may experience changes in your bleeding patterns. With Paragard, some women have heavier or longer periods than they had before getting the IUD, especially at first. On the other hand, with the progestin releasing IUDs, you can have irregular bleeding, lighter periods, or no period at all.
- Unlike condoms, an IUD does not protect you against sexually transmitted infections. However, you and your partner can use a condom to prevent spreading infections.
- There is a small chance the IUD will come out during your period. If this happens, you will need a new IUD. If you see your IUD in your underwear, on your pad, or in the toilet, call your care provider. You will have a follow-up visit after it is placed to ensure correct placement.
- Only a doctor or nurse can insert or remove an IUD.
Who should not use an IUD?
There are some women should, for medical reasons, avoid using an IUD. Some examples are below.
- You can’t use a copper IUD if you have an allergy to copper or have Wilson’s disease, which causes your body hold too much copper.
- Women with liver disease or breast cancer should not use a hormonal IUD.
- Women who have an STD or who have had a recent pelvic infection should not use an IUD.
- Pregnant women should not use an IUD.
- Women who have cancer of the cervix or uterus should not use an IUD.
- If you have unexplained vaginal bleeding, it is best to avoid the IUD.
Don’t be afraid to speak up
As a physician myself, I can tell you firsthand that your care provider is happy to answer any questions you may have about your birth control methods or the IUD. It’s what we’re here for!
If you already have an IUD placed, you should know there are several reasons for which you may need to let your care provider know you have a problem. In particular, you should see your doctor or nurse right away if:
- You have bad pain in your lower belly
- You have a positive pregnancy test
- You cannot feel the string of the IUD or if the string seems shorter than usual
- You think your IUD might have moved or fallen out
- You had sex with someone who has or might have an STD, or you think you have an STD
Your gynecological health is important, and the IUD is just one excellent method for birth control today. Speak with your physician to determine the best course for you.
Author: Melanie Schatz, MD, a board-certified OB/GYN with Main Line OB/GYN Associates.
To schedule an appointment with Dr. Schatz, call (610) 688-3744.