Intrauterine Devices (IUD)

An intrauterine device (IUD) is a small plastic T-shaped device used for birth control. It is inserted into the uterus where it stays to prevent pregnancy.

Alternative Names

Mirena; ParaGard

Description

An IUD is usually inserted by your health care provider during your monthly period. Either type can be inserted quickly and easily in the provider's office or clinic.

The provider slides a plastic tube containing the IUD through the vagina and into the uterus.
Using a plunger in the tube, the provider pushes the IUD into the uterus.
The provider removes the tube, leaving two small strings that dangle outside the cervix within the vagina.

The strings have two purposes:

They let the provider or woman check that the IUD stays properly in position.
They are used to pull the IUD out of the uterus when it is time to remove it. This should only be done by a health care provider.

This procedure can cause discomfort and pain, but not all women have the same side effects. During insertion, you may feel:

Little pain and some discomfort
Cramping and pain
Dizzy or light-headed

Some women have cramps and backaches for 1 to 2 days after insertion. Other may have cramps and backaches for weeks or months. Over-the-counter pain relievers can ease the discomfort.

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Why the Procedure is Performed

IUDs are an excellent choice if you want:

A long-term and effective birth control method
To avoid risks and side effects of contraceptive hormones

But you should learn more about IUDs when deciding if you want to get an IUD.

An IUD can prevent pregnancy for 3 to 10 years. Exactly how long the IUD will prevent pregnancy depends on the type of IUD you are using.

IUDs can also be used as an emergency contraception. It must be inserted within 5 days of having unprotected sex.

Risks

While uncommon, IUDs carry some risks:

There is a small chance of getting pregnant while using an IUD. If you do get pregnant, your provider can remove the IUD to lower the risk of miscarriage or other problems.
A higher risk of an ectopic pregnancy, but only if you do get pregnant while using an IUD. An ectopic pregnancy is one that occurs outside the womb. It can be serious, even life-threatening.
A rare chance the IUD may make a hole in the uterine wall when it is inserted.

Before the Procedure

Talk with your provider about whether an IUD is a good choice for you.

Also ask your provider:

What you can expect during the procedure
What your risks might be
What you should watch for after the procedure

For the most part, an IUD can be inserted at any time:

Right after giving birth
After an elective or spontaneous miscarriage

If you have an infection, you should NOT have an IUD inserted.

Your provider may advise you to take an over-the-counter painkiller before getting the IUD inserted. If you are sensitive to pain in your vagina or cervix, ask for a local anesthetic to be applied before the procedure starts.

After the Procedure

You may want to have someone drive you home after the procedure. Some women have mild cramping, low backache, and spotting for a couple of days.

If you have a progestin-releasing IUD, it takes about 7 days for it to start to work. You do not need to wait to have sex. But you should use a backup form of birth control, such as a condom, for the first week.

Your provider will want to see you 4 to 6 weeks after the procedure to be sure the IUD is still in place. Ask your provider to show you how to check that the IUD is still in place, and how often you should check it.

An IUD can slip partly or all of the way out of your uterus. If this happens, contact your health care provider right away. Do NOT try to remove an IUD that has come part of the way out or has slipped out of place.

Call your health care provider right away if you have:

Flu-like symptoms
Fever
Chills
Cramps
Pain, bleeding, or fluid leaking from your vagina

References

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 121: Long-acting reversible contraception: Implants and intrauterine devices. Obstet Gynecol. 2011 Jul;118(1):184-96. PMID: 21691183 www.ncbi.nlm.nih.gov/pubmed/21691183.

Association of Reproductive Health Professionals. Copper T IUD. Available at: www.arhp.org/MethodMatch/details.asp?productId=2. Accessed September 27, 2014.

Association of Reproductive Health Professionals. Hormonal IUD. Available at: www.arhp.org/MethodMatch/details.asp?productId=3. Accessed September 27, 2014.

Centers for Disease Control and Prevention (CDC), Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Jun 21;62(RR-05):1-60. PMID: 23784109 www.ncbi.nlm.nih.gov/pubmed/23784109.

Cleland K, Raymond E, Westley E, Trussel J. Emergency contraception review: Evidence-based recommendations for clinicians. Clin Obstet Gynecol. 2014 Sep 24. PMID: 25254919 www.ncbi.nlm.nih.gov/pubmed/25254919.

Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, et al. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012 May 24;366(21):1998-2007. PMID: 22621627 www.ncbi.nlm.nih.gov/pubmed/22621627.

Yoost J. Understanding benefits and addressing misperceptions and barriers to intrauterine device access among populations in the United States. Patient Preference and Adherence. 3 July 2014;8:947-57. PMID: 25050062 www.ncbi.nlm.nih.gov/pubmed/25050062.