After delivering your baby, your provider will discuss birth control with you—and the great news is that there are a number of options available for couples in all stages of family planning. Some are short term solutions, like the pill, condoms, and patches, while others are designed to be longer-acting. One of these long-acting reversible contraceptives, or LARC methods, are intrauterine devices—more commonly known as IUDs. Here’s everything you need to know about IUDs, including how they work, how they’re removed and replaced, and the side effects you may experience.
How Do IUDs Work?
An intrauterine device, or IUD, is a very small piece of T-shaped plastic inserted into the uterus in order to prevent pregnancy. There are two types of IUDs currently available in the US that work in different ways:
- Hormonal IUDs: these devices are coated with the hormone progestin, which helps prevent pregnancy in two important ways. Progestin thickens the mucus on the cervix which helps to block and trap sperm, and also stops eggs from leaving the ovaries.
- Copper IUDs: Copper IUDs contain no hormones and are coated in copper. Sperm naturally avoid copper, making it extremely hard for sperm to move past the IUD to the egg.
IUDs are over 99% effective at preventing pregnancy, and some can even be used as emergency contraception. If certain types of IUD are inserted within 5 days of having unprotected sex, they are over 99% effective at preventing a pregnancy from occurring.
How Long Do IUDs Last?
There are a range of brands in the US that are effective for different lengths of time, including:
- Skyla (Progestin): up to 3 years
- Mirena (Progestin): up to 8 years
- Liletta (Progestin): up to 8 years
- Paragard (Copper): up to 12 years
It’s important to keep track of your IUD insertion date to ensure its replacement or removal once it’s expired. The great news is that even if your IUD is well within its working timeframe, after removal you can potentially get pregnant within your next monthly cycle.
How Are IUDs Inserted?
Before inserting an IUD, your provider will perform a pelvic exam to ensure there are no concerns about your cervix or uterus. Your provider may offer you medicine which can help open your cervix and/or numb it before inserting the IUD. They will then insert a speculum into the vagina and cervix, and use a special tool to insert the IUD into your uterus. An IUD insertion is a quick process that typically takes less than five minutes, and can be inserted at any point in your monthly cycle. In some cases, an IUD can be inserted immediately following childbirth, or in the second month postpartum (typically at your 6 week follow up appointment with your provider).
After insertion, a small string will come out of your cervix to allow for removal later. You may be able to feel the string, but it’s important not to tug on it as you could move the IUD out of place. Though IUDs typically remain in place without issue, it’s important to ensure it doesn’t move or slip during your period. Always check to ensure your IUD doesn’t come out along with a tampon. It’s important to note that menstrual cups aren’t recommended for IUD users. If you do use a menstrual cup, it’s important to check it every time you remove it to ensure your IUD hasn’t come out.
How Are IUDs Removed or Replaced?
When you’re ready for your IUD to be removed or replaced, it’s important to schedule an appointment with your provider to do so. You should never attempt to remove your IUD on your own. To remove, your provider will gently pull on the string coming out of your cervix, which will fold the IUD and allow it to come out. If the IUD doesn’t come out easily, your provider may need to use special instruments to remove it.
As long as there aren’t any complications while removing your old IUD, you can have a new one inserted at the same appointment with your provider.
What Are the Side Effects of IUDs?
Many women experience mild side effects during or right after the placement of their IUD:
- Some cramping or mild pain is common, though some women don’t experience any discomfort during IUD insertion at all.
- Dizziness may occur during or after receiving an IUD, and there is a very small chance of fainting
- Cramping and spotting are normal after your appointment, however if your IUD is causing pain, discomfort or you experience any other side effects it’s important to get in touch with your provider.
Are there Risks of IUDs?
There are a few slight risks of using an IUD as birth control including:
- An infection could occur if bacteria gets into the uterus upon the insertion of your IUD. Symptoms of infection include pelvic pain, unusual discharge or bleeding, and fever.
- There is a small chance of your IUD pushing into the wall of the uterus. If this occurs, surgery may be necessary to remove the IUD.
- While the chances of getting pregnant with an IUD are very low (less than 1%), it’s important to contact your provider immediately if you suspect you are pregnant. Pregnancies occurring with an IUD in place have a higher chance of being ectopic, which are dangerous and require immediate medical attention.
We hope this helps you understand the ins and outs of IUDs as birth control. If you have any questions about whether an intrauterine device is a good option for you, it’s important to schedule some time to discuss it with your provider.