In search of a new form of birth control, but aren't sure what's right for you? Allow us to introduce you to 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 birth control method is over 99 percent effective in preventing pregnancy.
Meet the Expert
Dr. Sheryl A. Ross is an OB-GYN, author, and health expert who has been a women's health advocate for more than 25 years. She is the author of She-ology and She-ology the She-quel. With Coast Science, Dr. Ross co-founded the women's wellness brand She-ology to treat disruptive hormonal cycles with safe supplements.
With an IUD, you don’t have to worry about pregnancy for up to five years (or 10 if it’s copper). No pills. No daily reminders. No muss—no fuss. Have we piqued your interest? Here's what to know before getting an IUD.
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. Ross tells us that unlike the pill, which releases hormones into the bloodstream, IUD hormones are localized to the uterus.
Types of progesterone IUDs include Mirena (lasts 5 years), Skyla (lasts 3 years), Kyleena (lasts 5 years), and Liletta (lasts 5 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 women with hormone sensitivity or those who have been through cancer.
Ross says that all IUDs are safe to use whether or not you have been pregnant before.
How Insertion Works
While the procedure itself is quick and swift, it's totally normal to get cold feet in the days leading up to your appointment. Usually, your doctor will request that you come for insertion during your period, as your cervix is slightly more dilated during this week, but you can still get an IUD, regardless of if you’re on your period.
Your OB-GYN will put your feet in the stirrups as if you’re going to get a Pap. She or he will then insert the IUD through the cervix, where it sits inside of the uterus. It can be quite painful, but the entire process, from start to finish, only lasts about five minutes. The insertion itself is about 30 seconds.
We’re not going to lie, it's 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, but be sure to consult your doctor first.
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—surely, 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, familiarize yourself with the side effects of getting an IUD. Knowing what to expect beforehand will be beneficial to you in the long run.
Post-insertion, you may experience cramping and bleeding for up to a week, as well as irregular spotting or bleeding during the first three to six months. “Women using the copper IUD may experience heavier, longer, and more painful periods,” Ross says. 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, Ross says.
An IUD may not be ideal if you have a sensitive cervix. Should you experience cervical sensitivity after sex or spotting, talk to your doctor.
What Are the Risks?
Besides 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 primarily seen with the copper IUD (Paragard),” Ross says.
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 sounds terrifying, but it is extremely rare. This only happens in about one of every 2,000 cases.
Expulsion is when the IUD decides it isn’t happy in your uterus and pushes itself out of the cervix. It doesn’t hurt, per se, but it will stop the IUD from preventing pregnancy. To make sure your IUD is in place, position 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 positioned correctly. Doctors recommend you do this after every period or every four weeks.
Could the IUD Be Right for You?
Ultimately, you’ll have to make the choice that works best for you. Most insurance companies will cover the IUD, so be sure to chat with your OB-GYN to weigh the pros and cons.
If you’re prone to forgetting to take the pill every day—and desire a form of birth control that doesn’t require a daily G-cal reminder—an IUD might be for you.
On the other hand, if you’re a highly anxious person who can’t stomach the idea of a device being inside your body, it might not be the best option.
Your body, your choice. Think it through. Remember, if you get an IUD and hate it, you can always have it removed.