What you need to know about intrauterine devices (IUDs)
An intrauterine device (IUD) is a long-acting reversible contraception (LARC) method. It lasts for up to 10 years, depending on the device. IUDs can be removed if you want to get pregnant or stop using them.1
Types of IUDs
The copper IUD is also a type of emergency birth control. If you need it for emergency birth control, it should be placed within 5 days after unprotected sex. You can then keep it and use it as regular birth control.1
How does an IUD work?
An IUD mainly prevents fertilization. Hormonal IUDs use progestin. This makes the mucus in your cervix thicker and the lining of your uterus thinner. These changes help stop the sperm from reaching the egg. Copper IUDs make it harder for sperm to move, so they are less likely to reach the uterus. IUDs do not protect against sexually transmitted infections (STIs).1
How effective is an IUD?
An IUD is a very effective way to prevent pregnancy. Fewer than 1 out of 100 women using an IUD will get pregnant in the first year of use. IUDs and birth control implants, another form of LARC, are 20 times more effective than birth control pills, the patch or the ring.1
How long does it take for an IUD to start working?
If you get a hormonal IUD placed more than 7 days after your period starts, use a backup form of birth control or don’t have vaginal sex for the next 7 days.1
The copper IUD works as soon as you get it. You don’t need to use another birth control method or avoid sex.1
What are the benefits of IUDs?
The benefits of having an IUD may include:1
- It can be put in at any time
- After a doctor puts it in, you don’t have to do anything else to stop pregnancy
- It works for many years
- You can still use a tampon
- You can use it while nursing
- Using an IUD doesn’t make it harder to get pregnant later
- Hormonal IUDs can help make periods less painful and lighter over time
Potential side effects of IUDs
When you use an IUD, how much you bleed during your period may change. Hormonal IUDs might cause more spotting, longer periods or more bleeding at first. Your period may eventually get lighter and shorter. Period pain often gets better, too. Sometimes, your period might stop completely with a hormonal IUD.1
If you have a copper IUD, you might have more pain and heavier periods in the first few months.1
Other side effects can include headaches, nausea, sore breasts and changes in your mood.1
Are there serious risks of using an IUD?
Serious problems from IUDs are not common. These complications typically happen during or soon after the IUD is placed. Rare risks may include:1, 2
- The IUD comes out of the uterus. This is more likely in teenagers, those with heavy periods and people who have an IUD placed immediately after childbirth. Your provider can place a new IUD if this happens.
- The IUD can puncture the uterus. This only happens about 1 in 1,000 placements. If this happens, it will need to be removed.
- Pelvic inflammatory disease (PID) is rare but may happen after the IUD is placed. People with an undiagnosed STI are more likely to develop PID.
- It is uncommon, but pregnancy can happen with an IUD. If the pregnancy progresses, the IUD should be removed.
- IUDs can make it a little more likely to have an ectopic pregnancy. This means the egg grows outside the uterus, usually in a fallopian tube. An ectopic pregnancy is very serious and needs medical care right away.
Who can use an IUD?
LARC methods are typically safe and usually work well for teens and adults of any age. They may also be a good option right after you have a baby.1
How to get an IUD inserted
First, you should talk to your obstetrician/gynecologist (OB/GYN), or another health care provider, about your health history. You may be given a pregnancy test or a test for sexually transmitted infections (STIs). Then your provider will give you a pelvic exam. After the exam, your provider will put the IUD in through the vagina and cervix, into the uterus.1
Does getting an IUD hurt?
Getting an IUD may cause some short-term discomfort.1
The IUD has thin plastic strings. Your doctor will use these strings to take out the IUD when you want to stop using it. After putting in the IUD, the doctor will cut the strings so they hang just a little past your cervix and into your vagina.1
You shouldn’t feel the strings, but sometimes your partner might notice them during sex. If this happens and it bothers you, your doctor can trim the strings shorter.1
Frequently asked questions about birth control pills
Copper IUDs don’t stop the ovaries from making an egg (ovulating) each month.3 Hormonal IUDs can prevent ovulation.4
IUDs are one of the most effective forms of reversible birth control. Less than one out of 100 people using an IUD will get pregnant in the first year of use.1
Hormonal IUDs last up to 8 years or more, while copper IUDs can stay effective for up to 10 years.2
When you want to stop using your IUD, your provider can take it out during a pelvic exam. They will find the strings and gently pull the IUD out. Taking out the IUD is usually quicker than putting it in.1
IUDs are an effective way to prevent pregnancy. They last a long time and most people can use them safely. If you are thinking about getting an IUD, talk to your doctor to see what is best for you. Learning about IUDs can help you make a smart choice for your health.