Everything You Need to Know Before Getting an IUD

The complete guide to this form of birth control

Updated 09/09/18


Looking for a new birth control and not really sure where to begin? Allow us to introduce the IUD (Intrauterine Device). The IUD is a T-shaped device made of plastic (and sometimes copper), about three inches long and very thin, with two small strings that hang from the bottom. This form of birth control is over 99 percent effective in preventing pregnancy.

With an IUD, you don’t have to worry about pregnancy for up to five years (or ten if it’s copper)! No pills. No daily reminders. No muss. No fuss.

“Studies show that the IUD has the ‘highest patient satisfaction’ amongst contraception users,” Dr. Sherry A. Ross, women’s health expert and author of She-ology tells Brides. “I would say IUDs are making a serious and purposeful comeback especially with the threat of losing birth control accessibility for women.”

We couldn’t agree more. Not to get too political here, but we do need to talk about this. With everything currently happening in the Supreme Court, it’s important to know your long-lasting birth control options should the pill, progesterone shot, or other forms of birth control become compromised.

Medical experts across the board agree that the IUD is working for women. According to a 2013 survey from Planned Parenthood, IUDs are the #1 choice of OB-GYNs for birth control.

Is the IUD the right choice for you? We have all the information you need right here.

Types of IUDs

There are two main types of IUDs. Some release hormones (progesterone/levonorgestrel) that stop an egg from releasing during ovulation, just like birth control pills. Dr. Ross tells us that unlike the pill, which release hormones into the bloodstream, an IUD hormones are localized to the uterus.

Types of progesterone IUDs include Mirena (lasts 5 years), Skyla (lasts 3 years), Kyleena (lasts 3 years), and Liletta (lasts 3 years). Mirena is slightly bigger than the other three progesterone IUDs, but has less risk of becoming dislodged. Smaller IUDs will likely be less uncomfortable to insert, depending on your body.

The other IUD is a copper IUD, Paragard. This works by thickening the uterine lining to prevent egg attachment. This option contains no hormones and is a good choice for any woman with hormone sensitivity, or those who have been through cancer.

Dr. Ross explains that all IUDs are safe to use whether or not you have been pregnant before.

How insertion works

Your OB-GYN will put your feet in the stirrups as if you’re going to get a Pap, real up close and personal.

She or he will then insert the IUD through the cervix, where is sits inside of the uterus. It can be quite painful, but the entire process, start to finish, only lasts about five minutes. The insertion itself is, like, thirty seconds.

We’re not going to lie, it is not a walk in the park. It hurts. It feels a bit like a very intense period cramp. You may benefit from taking Ibuprofen (or another painkiller) before insertion. Always speak to your doctor first.

Usually, your doctor will request you come for insertion during your period, as your cervix is slightly more dilated during this week, but you can still get an IUD whether or not you’re on your period.

It may sound scary to have something placed up through your cervix, but remember that your cervix can dilate to allow a baby to pass through it. It can handle an IUD. Wait seven days after insertion to have sex so the IUD can take effect.

The side-effects you should know about

As with all forms of birth control, there are definitely side-effects with the IUD that every woman should know about. Knowing what to expect before getting and IUD will help you in the long run.

After insertion, you may experience cramping and bleeding for up to a week. You may experience irregular spotting or bleeding for the first three to six months. “Women using the copper IUD may experience heavier, longer and more painful periods,” says Dr. Ross. With the progesterone IUD, your period may stop altogether which can be a welcomed side-effect.

For some women, they may have cramping once a month without any bleeding. Don’t be alarmed if this happens. All of this varies from person to person. It is highly unlikely that you will gain weight, have mood swings, or experience acne as you might with the birth control pill, Dr. Ross explains.

An IUD may not be ideal if you have a sensitive cervix. If you experience cervical sensitivity after sex or spotting, talk to your doctor. While in most cases you won’t be able to feel an IUD, for those with cervical sensitivity, an IUD may be uncomfortable for you.

What are the risks?

Other than side-effects, the health risks are important as well. You need to know what you’re putting in your body and what can happen, however unlikely.

“The main risks of using an IUD include heavy bleeding and cramping mainly seen with the Copper IUD (Paragard),” Dr. Ross tells us.

Other, scarier risks include: “Uterine perforation, which can be a complication associated with faulty insertion and expulsion of the IUD from the uterus during the first year.” Uterine perforation is when the IUD comes through the wall of the uterus. We know that sound terrifying, but it is extremely rare. This only happens in about 1 in every 2,000 cases.

Expulsion is when the IUD decides it isn’t happy in your uterus and pushes itself out the cervix. It doesn’t hurt, per say, but it will stop the IUD from preventing pregnancy. To make sure your lil’ IUD is in place, put one or two fingers up your vagina and feel for the IUD strings. They are akin to dental floss. This will let you know your IUD is straight chillin’ and you are covered. Doctors recommend you do this after every period or every four weeks.

Could the IUD be right for you?

Ah, now this is the question. You’ll have to make the choice that works best for you! Most insurance will cover the IUD, so be sure to ask your doctor about your options. You and your OB-GYN can make this choice together. Lay out the pros and cons.

If you’re a person who forgets to take her pill everyday and wants a form of birth control that doesn’t require a daily G-cal reminder, an IUD might be just the thing you need.

If you’re a highly anxious person who can’t stomach the idea of a device being inside their body, it might not be the best choice.

Think it through. It’s totally your game. Remember, if you get an IUD and hate it, you can always have it removed.

Gigi Engle is a certified sex coach, educator, and writer living in Chicago. Follow her on Instagram and Twitter at @GigiEngle.

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