An intrauterine device, more commonly known as an IUD, is a small apparatus placed inside the uterus to prevent pregnancy. Made from thin plastic and shaped like a T, these devices are coated with either copper or progestin. You must obtain a prescription in order to get an IUD and have it placed by a doctor or nurse. IUDs offer long-lasting pregnancy prevention, making them a popular choice for hassle-free, reliable birth control.
How IUDs Work
There are two types of IUDs:
- Hormonal IUDs
- Copper IUDs
Hormonal IUDs gradually secrete progestin to thicken the mucus in your cervix and stop your body from releasing an egg. The thick mucus prevents sperm from making it into the uterus. If they do somehow make it through, the lack of an egg means there is nothing for them to fertilize. A hormonal IUD prevents pregnancy for three to five years.
Copper IUDs are coated with copper instead of hormones, because copper triggers an immune response in your body which thickens the cervical mucus so sperm can’t make it into the uterus. In addition, the copper ions on the IUD are toxic to sperm, adding another layer of protection to prevent fertilization. This is an excellent option for women who are sensitive to hormonal birth control variants. Copper IUDs prevent pregnancy for up to 10 years.
Currently, there are five brands of IUDs available to women in the United States:
- Mirena: Lasts for five years and helps to lighten or eliminate periods
- Kyleena: Lasts for five years and usually lightens but does not eliminate periods
- Skyla: Lasts for three years and offers protection with the lowest level of hormones
- Liletta: Lasts for four years and has a lower cost for those without health insurance
- Paragard: Lasts for 10 years and is free of hormones.
Mirena, Kyleena, Skyla, and Liletta are hormonal IUDs, while Paragard is a copper IUD.
IUDs are very effective at preventing pregnancy. In fact, both copper and hormonal IUDs are more than 99% effective, meaning that fewer than 1 out of 100 women using an IUD will have an accidental pregnancy over the course of a year. That makes IUDs more effective than pills, patches, rings, shots, and condoms.
Copper IUDs prevent pregnancy right away. In fact, copper IUDs can even be used as emergency contraception within five days after unprotected sex. Hormonal IUDs are effective about seven days after insertion. A backup form of birth control, such as a condom, is needed if you have sex before it becomes effective.
There are a number of significant advantages of using IUDs for birth control, including:
- Long-lasting, effective pregnancy protection
- Low cost that is often covered by insurance
- No need to get a new prescription every year
- Hormonal IUDs cause women to have shorter, lighter periods or stop having periods altogether
- No missed or late doses since it works automatically every day
- Added privacy since it is undetectable by others, even sexual partners
- Can be removed at any time with a speedy return to normal fertility levels
Copper and hormonal IUDs offer one of the easiest ways to prevent pregnancy. After having it placed, it continues to work for several years without any changes to your normal routine or additional visits to the doctor. It has become an increasingly popular form of birth control. In 2002, 1.5% of women in the U.S. used IUDs. As of 2019, 7.8% of U.S. women (about 4.4 million) have IUDs.
One notable drawback to keep in mind is that IUDs do not protect against STIs. You’ll still need to use a condom to protect against infection during sex.
Side Effects of IUDs
There are a few possible side effects that may occur with IUD use, including:
- Hormonal IUDs: PMS-like symptoms (headaches, mood swings, nausea, acne, breast tenderness, etc.) and spotting for several months after insertion.
- Copper IUDs: Longer, heavier periods with stronger cramping.
Although very rare, there are also a few possible complications with IUDs:
- IUD expulsion
- Perforated uterus
- Pelvic inflammatory disease (PID)
If you have trouble dealing with the side effects of your IUD, talk to your health care provider. They can advise you about whether the side effects are likely to diminish over time or whether you should consider another IUD brand or birth control type. You should also get in touch with your doctor if you have any of the following symptoms while using an IUD for birth control:
- Unexplained fever or chills
- Severe cramping, pain, or bleeding
- Belly or pelvic pain
- Pain during sex
- Change in the length of the IUD string or trouble locating the string in the vagina
- Changes in the color or smell of vaginal discharge
- Possible pregnancy
An IUD must be placed by a health care provider. The device is carefully moved through the vagina and cervix and placed in the uterus. The IUD has strings attached that can be felt in the back of the vagina. The doctor or nurse will cut the strings to the appropriate length.
If you want to learn how to check the strings yourself so you can confirm that your IUD is still properly placed, just ask your health care provider at your appointment. You and your partner should not be able to feel the IUD during sex.
You may feel some mild discomfort during your IUD insertion. Afterward, it’s not uncommon to experience some cramping and spotting. However, the symptoms should become milder over time and go away within a few weeks or months.
A doctor or nurse needs to remove the IUD when it reaches its expiration date or you decide you no longer want it in. They will gently pull on the string for a slow and careful removal.
Once the IUD is out, your fertility will quickly return to normal. One study found that after having their IUD removed for a planned pregnancy, 94.3% of women conceived, with 55.9% conceiving within the first three months after their IUD was removed.
If you think an IUD may be right for you, talk to your health care provider. Once the IUD has been inserted, you can enjoy worry-free pregnancy protection for years.