Intrauterine Devices

Abstract

An IUD is a small T-shaped device that is placed through your vagina and cervix into the top of your uterus (womb) by your health care provider. There are 2 kinds of IUDs, nonhormonal or hormonal:

The copper IUD (Paragard) is effective for up to 10 years. It has no hormones.

IUDs keep sperm from reaching an egg. If sperm can't get to an egg, pregnancy won't happen. The copper IUD changes the lining of the uterus and kills sperm that enter the uterus so they can't reach an egg. The hormonal IUDs prevent ovulation (release of an egg) and make the mucus in your cervix (opening of the uterus) thicker so that sperm can't reach an egg.

IUDs work very well in protecting you from getting pregnant. Fewer than 1 out of 100 of those using an IUD will get pregnant each year. This is about the same as using the birth control implant, or having a tubal ligation or vasectomy.

Your health care provider will insert the IUD. It may be inserted right after giving birth, at your postpartum visit, or another time, often during your period. Your provider will help you pick the best time. The IUD is put into your uterus through your vagina and cervix. First, your provider will put a speculum into your vagina to hold it open. Then, your provider may use an instrument to hold your cervix in place while they insert the IUD. A string attached to the IUD comes out of your uterus into the top of your vagina. It is used to pull out the IUD when you want it removed. Your provider will cut the strings on the IUD. You will be able to feel the strings with your fingers when you check for them.

Inserting an IUD usually only takes a few minutes. You may feel cramping during and after the insertion. You may take ibuprofen (Advil, Motrin) or naproxen (Aleve) an hour before your appointment to have less pain when the IUD is inserted. You can also take these medications if you have cramping right after the IUD is inserted. It helps to be well hydrated and nourished before and after the IUD insertion.

Your health care provider will let you know the date your IUD should be removed. You can decide to have your IUD removed at any time before this date if you experience undesirable side effects or decide you want to become pregnant. To remove the IUD, your provider will put a speculum into your vagina and then gently pull on the IUD strings. You may feel mild cramping as the IUD is removed.

You will be protected against pregnancy as soon as a copper IUD is in place. If a hormonal IUD is inserted during the first 7 days of your period, you will be protected against pregnancy as soon as it is in place. If a hormonal IUD is inserted more than 7 days after your period starts, you will need to use another type of birth control, such as condoms, for the first 7 days after the IUD is in place.

The most common side effect of IUDs is changes in your normal menstrual period. With the copper IUD, periods may be heavier with more cramps. With the hormonal IUDs, periods may be shorter, lighter, or may stop completely. Hormonal IUDs can also cause bleeding that is irregular and spotting between your periods. These bleeding changes usually only last for a few months. Some people using hormonal IUDs report headaches, acne, breast pain, mood changes, or depression.

You may have cramping, bleeding, or spotting after the IUD is inserted and then off and on for a few months. While uncommon, there is a small chance of getting an infection in the uterus right after the IUD is inserted. The IUD can go through the uterus when it is being placed. If this happens, you may need surgery to remove the IUD. Your chance of getting an infection or having the IUD go through your uterus is less than 1 in 1000. Sometimes the uterus will push the IUD out into the vagina. This is why it is important to check your strings each month to be sure your IUD is still in place. It is very rare to get pregnant while you have an IUD. If this happens, the IUD will be removed. IUDs do not protect against sexually transmitted infections.

Flesch-Kincaid Grade Level: 7.1

Approved February 2024. This handout replaces “Intrauterine Devices” published in Volume 63, Number 4, July/August 2018.

This handout may be reproduced for noncommercial use by health care professionals to share with clients, but modifications to the handout are not permitted. The information and recommendations in this handout are not a substitute for health care. Consult your health care provider for information specific to you and your health.