The Intrauterine Device (IUD)

An Intrauterine Device (IUD) is a T-shaped, plastic device inserted into the uterus by a healthcare professional. There are two types of IUDs available:

1. Copper, which can remain in place for 10 to 12 years.
2. Progesterone (natural female sex hormone); two types:
   • Mirena, lasts five to seven years.
   • Other types, replace every year.

IUDs prevent pregnancy by inhibiting fertilization of the egg. Although not entirely known, it is believed that the IUDs affect the way the sperm and egg move and/or affect the lining of the uterus to prevent implantation of the egg.

IUDs are recommended for women in long-term mutually monogamous relationships, such that the risk of getting a sexually transmitted infections (STIs) is low.

How is it Used?

The IUD is inserted into the uterine cavity by a healthcare provider, usually during menstruation when it is easier to insert. The string at the end of the IUD will hang down through the cervix a short distance into the vagina and should be checked periodically (especially after menstruation).

How is it Inserted?

Answer from Barbara Boyer, DO:

The IUD is inserted during an office visit. It is placed into the uterus through the cervix. The patient is placed on the table just like she is going to have a Pap smear. A speculum is inserted, like with a Pap smear. 

The area that the brush touches when you have a pap smear is your cervix. The IUD is inserted in through the cervix up about 1 inch into your uterus. This is moderately painful, like bad cramping. 

I usually ask people to take two Tylenol or ibuprofen before they come in for the procedure. After that, the string is cut and the speculum is removed.

Does It Protect Against STIs?

No! Unfortunately, using an IUD does not protect you against any STIs.

Does It Protect Against Pregnancy?

Yes. The chances of getting pregnant while using an IUD is:

• Copper:
  • Typical use: 0.8 percent
  • Perfect use: 0.6 percent
• Progesterone:
  • Typical use: 2 percent
  • Perfect use: 1.5 percent

Advantages and Disadvantages

Advantages:

• With an IUD in place, the female does not have to think about using contraception when having sex, or every day in the case of the pill, although she should use other means to prevent against STIs. For this reason, IUDs are rarely placed in women who are at risk for STIs.
• The IUD does not change the hormone levels throughout the body as do other contraception methods such as the pill.
• The cost of the copper IUD can be low in the long run compared to birth control methods that must be purchased more frequently.
• For a progesterone IUD, period flow and cramps decrease.

Disadvantages:

• For copper IUDs:
  • Menstrual cramps may increase.
  • Bleeding may occur between periods.
  • Periods may be heavier and last longer. This may cause anemia.
  • Increases risk of serious infection – such as Pelvic Inflammatory Disease (PID) – and sterility.
  • IUD may fall out.
• Pregnancy while using the IUD, although rare, may be dangerous and lead to infections or ectopic pregnancies.

Things to Remember

IUDs do not protect against STIs. Women who do not know the sexual health status of their partners should not use this form of birth control!

Last Reviewed: October 2015