Birth Control and the IUD (Intrauterine Device)

Intrauterine devices (IUDs) are small devices placed in your uterus to interrupt the process of insemination. IUDs have been on and off the market for decades. They’re very popular around the world and one of the most effective forms of birth control.

An estimated 2 to 8 in every 1,000 women (0.2 per 100 women for Mirena) who have IUDs get pregnant in a year of typical use.

There are two types of IUD: copper and hormonal. Currently, there are four brands of IUDs available in the United States. ParaGard is a copper IUD, and Mirena, Liletta, and Skyla are hormonal IUDs that use progestin.

IUDs are an excellent choice of birth control for many women. However, they’re not the best choice for women who are at a high risk for sexually transmitted infections (STIs).

How does an IUD work?

Effectiveness: over 99% effective

Availability: at some clinics

Effort: lasts from 3-6 years and requires a quick procedure to insert and remove

Sexually transmitted infections: doesn't provide protection

Hormones: contains progestin

Both the copper and hormonal types of IUDs work by making it difficult for sperm to reach your egg and requires insertion by a trained health care professional

ParaGard causes an inflammation response in the lining of your uterus. This inflammation is toxic to sperm. It also makes your uterus hostile to implantation, if fertilization occurs.

But recent studies have failed to find evidence that fertilization ever occurs. ParaGard works for up to 10 years after insertion.

There several hormone containing IUDs that contain the progesterone hormone called Levonorgestin or L-IUDs.

Skyla 12 mg 3 years

Kyleena/Liletta 19mg 5 years

Mirean 52 mg 5 years.

Mirena works to thin the lining of your uterus to prevent the transport of sperm into your fallopian tubes where fertilization must occur. The progestin it releases also thickens your cervical mucus and can prevent ovulation. Is is FDA approved to prevent pregnancy AND/OR reduce heavy menstrual cycles.

Mirena can last for up to five years after insertion.

Mirena can also decrease:

Severe menstrual pain and pain related to the abnormal growth of uterine-lining tissue outside the uterus (endometriosis)
The risk of pelvic infection
The risk of endometrial cancer

Because of these noncontraceptive benefits, Mirena is often prescribed for women with:

Heavy menstrual bleeding
Cramping or pain with periods
Endometriosis
Abnormal growth of the lining of the uterus (endometrial hyperplasia)
Abnormal growth of uterine-lining tissue into the muscular wall of the uterus (adenomyosis)
Anemia
Fibroids

Skyla and Liletta are smaller and contain a lower dose of progestin. They both thin your uterus lining, and can last up to three years. Skyla has a narrower shaft and is easier to place.

How is an IUD inserted?

An IUD is inserted by a healthcare professional. Make an appointment with your doctor to determine if the IUD is the best birth control option for you. An IUD can be inserted any time it’s certain that you’re not pregnant.

Your doctor will insert the IUD through your cervix and into your uterus. The procedure usually takes less than 15 minutes. It can be done with or without local anesthesia. You’ll probably feel some cramping or discomfort. Dr. Quezada also likes to utilize a sonogram to visibly confirm proper mid endometrial cavity placement.

There’s a very small risk of expulsion when the IUD is implanted. For the first few months, it’s important to check that it’s still in place. You should do this every month.

Benefits & side effects

Acne: unlikely to be affected

Headaches: unlikely to be affected

Weight: unlikely to be affected

Menstrual changes: may become lighter with fewer cramps, or it may stop completely

Additional info: may help reduce symptoms of PMS

After the procedure

Once a month, check to feel that your IUD strings are protruding from your cervix. Be careful not to pull on the strings.

To check your IUD:

Wash your hands with soap and water.
Put your finger into your vagina until you touch your cervix.
Feel for the string ends.

You should be able to feel the string. If the string feels shorter or longer than normal, there may be a problem. You should not feel the hard end of the IUD against your cervix.

About a month after the IUD is inserted, your health care provider may re-examine you to make sure the IUD hasn't moved and to check for signs and symptoms of infection.

While you're using IUD, contact your health care provider immediately if you:

Think you may be pregnant
Have unusually heavy, persistent vaginal bleeding
Have abdominal pain or pain during sex
Have an unexplained fever
Have unusual or foul-smelling vaginal discharge, lesions or sores
Develop very severe headaches or migraines
Have yellowing of the skin or eyes
Were exposed to an STI
Can no longer feel the IUD strings, or they suddenly seem longer

It's also important to contact your health care provider immediately if you think IUD is no longer in place. Your provider will check the location of your IUD and, if it's displaced, remove it if necessary.

Expulsion is rare. If it happens, it will probably be during your period. Expulsion is most likely to occur in the first few months after insertion. While you’re waiting for the IUD to be reinserted, use an alternative form of contraception.

Removal

Your IUD can remain in place for up to 3-10 years depending on which one you ordered and had placed. To remove your IUD, your health care provider will likely use forceps to grasp the device's strings and gently pull. The device's arms will fold upward as it's withdrawn from the uterus. It can be removed when you are done using or or removed and replaced with a new device if you want to continue using its protection.

Light bleeding and cramping is common during removal. Rarely, removal can be more complicated.

Intrauterine Device (IUD)