Patient education: Intrauterine devices (IUDs) (The Basics)

What is an intrauterine device? — An intrauterine device ("IUD") is a type of birth control. It is a small, T-shaped device. A doctor or nurse puts an IUD in your uterus by going through your vagina and cervix (figure 1).

IUDs are made of flexible plastic and have 2 thin plastic strings that hang out of the cervix. They are very small, a little more than 1 inch (2.5 cm) in width and length.

An IUD is one of the safest, most effective methods for preventing pregnancy. It is a good choice for people, including teens, who do not want to get pregnant for at least 1 year. An IUD can also be used to prevent pregnancy if it is put in within 5 days after you have unprotected sex. This is known as "emergency contraception."

You can also use IUDs for reasons other than birth control. For example, 1 type of IUD can be used to treat heavy, painful periods.

What are the different types of IUDs? — There are 2 categories of IUDs available in the US. One type contains copper. The other type contains a hormone called "levonorgestrel" (figure 2):

●Copper IUD – There is only 1 copper-containing IUD (brand name: Paragard). It can stay in your uterus for 10 years, or longer for some people, to prevent pregnancy. Some people who use it get heavier or longer periods than they had before getting the IUD.

●Hormonal IUDs – There are 4 hormone-containing IUDs (brand names: Mirena, Liletta, Kyleena, Skyla) (figure 2). Depending on which of these you have, it can stay in your uterus for up to 8, 5, or 3 years. Many people who use hormonal IUDs have lighter, less painful periods than they had before getting the IUD. Some people stop getting a period at all, but this is not harmful. After having the IUD removed, periods usually return to normal within a month or 2.

Other types of IUDs are also available outside of the US.

What are the benefits of using an IUD? — The benefits of using an IUD include:

●IUDs are very effective. Fewer than 1 in 100 people who use an IUD get pregnant during the first year of use.

●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 people can't or don't want to 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.

●There is evidence that using an IUD lowers your risk of getting cervical cancer.

What are the downsides of using an IUD? — The downsides of using an IUD include:

●Unlike condoms, an IUD does not protect you against infections that you can catch during sex. These are called "sexually transmitted infections" ("STIs") or "sexually transmitted diseases." But you and your partner(s) can use condoms to prevent spreading infections.

●There is a small chance that the IUD will come out during your period. If this happens, you will need to get a new IUD. If you see your IUD in your underwear, on your pad, or in the toilet, call your doctor or nurse.

●The initial cost is higher than the cost of other methods. But, there are no more costs after it is inserted.

●Only a doctor or nurse can insert or remove an IUD.

You should not get an IUD if you recently had an infection that spread to your uterus and other nearby organs. This is called a "pelvic infection." STIs such as chlamydia and gonorrhea can cause pelvic infections.

Which type of IUD is best for me? — Your nurse or doctor can talk to you about the options and help you choose the right IUD for you.

A copper IUD might be a good choice if you:

●Want or need to avoid hormones

●Want to avoid big changes in your period, such as not having any periods or bleeding or spotting between periods

●Want birth control for up to 10 years, or possibly longer

A hormonal IUD might be a good choice if you:

●Have heavy, painful periods. These IUDs can make your periods lighter and less painful.

●Have pelvic pain from a condition called "endometriosis." These IUDs might help reduce the pain.

●Want birth control for up to 8 years, depending on which device you choose

Does it hurt to have an IUD put in? — You will likely feel some discomfort and slight cramping after the nurse or doctor puts the IUD in your uterus. People who have never given birth might feel more discomfort than people who have. The cramps generally go away within a day or 2. Over-the-counter pain medicines like ibuprofen (sample brand names: Advil, Motrin) or naproxen (sample brand name: Aleve) can help cramps go away faster.

After the IUD is in place, you should not be able to feel it.

Should I see a doctor or nurse? — If you have an IUD, see your doctor or nurse right away if:

●You have bad pain in your lower belly.

●Your period is late or very different from normal.

●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 STI, or you think you have an STI.

●You have an unexplained fever.

More on this topic

Patient education: IUD insertion (The Basics)
Patient education: IUD removal (The Basics)
Patient education: Choosing birth control (The Basics)
Patient education: Emergency contraception (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Permanent birth control for women (The Basics)
Patient education: Birth control after having a baby (The Basics)
Patient education: Pelvic ultrasound (The Basics)

Patient education: Long-acting methods of birth control (Beyond the Basics)