Contraception (Birth Control)
IUD (Intrauterine Device)
What is an IUD?
An IUD, or intra-uterine (in-tra-YOU-ter-in) device, helps prevent pregnancy. It is a small device that is inserted into a woman’s uterus by her doctor. There are two types. Both are plastic, T-shaped, and flexible.
- Paragard T380A® — This IUD does not contain hormones. It prevents pregnancy for up to 10 years.
- Mirena® — This IUD contains the hormone levonorgestrel (lev-oh-nor-JESS-trel). It prevents pregnancy for up to 5 years.
Talk to your doctor or nurse about which IUD is right for you.
IUDs are covered only by certain insurance plans. Call your insurance plan to check your coverage.
How effective is an IUD?
Fewer than 1 out of 100 women using an IUD become pregnant. An IUD starts working immediately after it is inserted into the uterus.
How does an IUD work?
The Paragard T380A® releases small amounts of copper. This copper is believed to reduce the sperm’s ability to swim. Mirena® stops the sperm from going up into the uterus. IUDs thicken the mucus produced by the cervix at the top of the vagina. Because the mucus is thicker, sperm cannot swim through it. They cannot get into the uterus or fallopian tube to fertilize an egg.
Some people think that an IUD may work by preventing a fertilized egg from implanting in the uterus. No studies have been able to prove this so far.
What if I want to get pregnant?
You can become pregnant right away after an IUD is removed.
Who can use an IUD?
- women who want long-term, effective birth control
- women who are at low risk for an STD (sexually transmitted disease). This means women who have only 1 sex partner, and whose partner has sexual intercourse only with them.
Who cannot use an IUD?
- women with unexplained vaginal bleeding (until the cause is found)
- women with active inflammation of the cervix (cervicitis) or active PID (pelvic inflammatory disease)
- women who have or have had cancer of the cervix or uterus
- women with an allergy to copper or who have Wilson’s disease cannot use Paragard T380A®.
- women who are currently pregnant or who may be pregnant
If any of the following apply to you, you may not be able to use an IUD:
- You have chronic pelvic pain (you shouldn’t use the Paragard T380A®).
- You have 1 sex partner who has multiple partners, or who is at high risk for STDs.
- You want to get pregnant within 1 year.
- You have severe menstrual cramping, heavy menstrual bleeding, or both (you shouldn’t use the Paragard T380A®).
- You have untreated cervical dysplasia (dis-PLAY-zha) or 2 abnormal Pap tests without a colposcopy (col-POSS-koh-pee) exam.
- Your uterus is an abnormal shape or size.
Why do some women choose to use an IUD?
- It’s a very effective birth control method.
- It gives long-term protection against pregnancy (5 to 10 years depending on type).
- It gives ongoing protection against pregnancy (no daily pills or shots to take).
- You will have less menstrual flow and cramping (with Mirena®).
- It is less expensive over the long term.
How is an IUD inserted?
Your doctor will insert the IUD in the office. Although it is a long-term birth control method, he or she can remove it at any time. Follow-up depends on the type of IUD that is inserted. You may be scheduled for a follow-up appointment anywhere from 1 to 3 months after insertion to make sure the IUD is correctly positioned.
Side effects at the time of insertion are very rare but can include:
- bleeding for 1 to 2 days after insertion (may be longer with Mirena®)
- cramping or pain in the lower belly (abdomen)
- a hole (perforation) in the uterus (very rare)
Are there side effects with an IUD?
- Side effects are possible when you have an IUD. Talk with your doctor if you have any questions about the following:
- heavy bleeding with periods and increased pain with or between periods (with Paragard T380A®)irregular bleeding and/or spotting for the first few months after insertion (more common with Mirena®)
- pelvic infections associated with STDs (the IUD does not protect against STDs)
- in the rare event of pregnancy with an IUD in place, increased risk of tubal pregnancy (pregnancy in the fallopian tube) or miscarriage
When to call your doctor
Call your doctor right away if you have any of the following:
- heavy vaginal bleeding (soaking 1 or more pads or tampons in an hour)
- severe lower belly pain
- pain during sex
- vaginal bleeding or spotting that concerns you
- any unusual vaginal discharge
- you think you may be pregnant
- your IUD falls out
Use condoms the right way
To protect against STDs (sexually transmitted diseases), use condoms the right way.
Except for not having sex (abstinence), latex condoms give the best protection from many STDs including HIV, the virus that causes AIDS. Condoms are helpful only if used the right way. Use a latex condom every time you have sex. Always put the condom on before the penis touches or enters the vagina. If you or your partner has an allergy to latex, you should use a plastic (polyurethane) condom.
Important steps for using condoms the right way:
- Check the expiration date.
- Check the condition of the package.
- Open the package carefully.
- Hold the condom by the last 1/2 inch at the tip, and squeeze out the air.
- If the penis is uncircumcised, pull back the foreskin.
- Place the condom on the tip of the penis.
- Unroll the condom to the base of the penis. Smooth out any extra air.
- If you want or need to use lubricant on the condom, only use water-based lubricants like K-Y Jelly or Surgilube. Do not use oil-based lubricants. They can weaken condoms and cause them to break. Do not use petroleum jelly, cooking or vegetable oil, mineral or baby oil, massage oil, butter, margarine, oil-based creams, or lotions.
- Immediately after ejaculation, hold the condom firmly by the rim at the base of the penis, and pull the penis and condom out of the vagina together, while the penis is still erect.
- Look carefully at the condom to see if there is a hole in it. If you are not sure, fill the condom with water to see if it leaks.
- Discard the condom. Wrap it in tissue, and throw it away. Do not flush it down the toilet.
- Never re-use a condom.