IUD (Intrauterine Device)
An Intrauterine Device (IUD) is a small, "T-shaped" device inserted into the uterus to prevent pregnancy.
As soon as the IUD is removed, it no longer protects against pregnancy.
The IUD is more effective than most other forms of birth control. However, the IUD does not protect against sexually transmitted infections (STIs).
Only 2% of women in the U.S. use an IUD as a form of birth control. Many women are afraid to use an IUD because one type caused side effects and was withdrawn from the market in 1975. Today's IUDs are safer and more effective.
Types of IUDs
There are currently two types of IUDs available in the U.S.:
- Hormonal IUD. The hormonal IUD must be replaced every 5 years.
- Copper IUD. The copper IUD can remain in the body for as long as 10 years.
Both types of IUDs are T-shaped, but they work in different ways.
The hormonal IUD releases a small amount of the hormone progestin into the uterus. This thickens the cervical mucus, which decreases the chance that the sperm will enter the cervix. It may make the sperm less active and make the sperm and the egg less likely to be able to live in the fallopian tube. It also thins the lining of the uterus. This keeps a fertilized egg from attaching and makes menstrual periods lighter.
The copper IUD releases a small amount of copper into the uterus. This can prevent the egg from being fertilized or attaching to the wall of the uterus. The copper also prevents sperm from going through the uterus and into the fallopian tubes and reduces the sperm's ability to fertilize an egg.
Inserting the IUD
A doctor must insert and remove the IUD. The IUD often is inserted during or right after your menstrual period. The doctor puts the IUD in a long, slender, plastic tube. He or she places it into the vagina and guides it through the cervix into the uterus. The IUD is then pushed out of the plastic tube into the uterus. The IUD springs open into place, and the tube is withdrawn.
Insertion of the IUD does not require anesthesia (pain relief), although you may have some discomfort. Taking over-the-counter pain relief medication before the procedure may help. Sometimes a doctor will use local anesthesia to insert the IUD.
Some women may not be able to use an IUD. The size or shape of a woman's uterus may not be compatible with the IUD. Women who have had a recent abnormal Pap test result or other conditions should not use an IUD.
You may be asked to read and sign a consent form before using an IUD. Make sure you understand everything about the IUD to be inserted. If you have questions, ask your doctor.
Once the IUD is inserted, the doctor will show you how to check that it is in place. Each IUD comes with a string or "tail" made of a thin plastic thread. After insertion, the tail is trimmed so that 1–2 inches hang out of the cervix inside your vagina. You will be able to tell the placement of the IUD by the location of this string. The string will not bother you, but your partner may feel it with his penis. This should not interfere with his sexual feeling.
It is important to check the string regularly. To do this, you must insert a finger into your vagina and feel around for the string. You can do this at any time, but doing it right after your menstrual period is easy to remember. If you do not feel the string or if you feel the IUD, call your doctor. The IUD may have slipped out of place. Use another form of birth control until your IUD is checked.
If you can feel the IUD, see your doctor. Do not try to remove it yourself.
You Should Not Use an IUD If You:
- Are pregnant
- Have or have had within the past 3 months pelvic inflammatory disease
- Have a known or suspected pelvic cancer
- Have abnormal vaginal bleeding
- Have or have had within the past 3 months certain pelvic infections
- Have a sexually transmitted disease, such as chlamydia or gonorrhea
- Have certain liver conditions (hormonal IUD only)
- Are allergic to any part of the IUD
- Have uterine fibroids or other problems that may interfere with inserting an IUD
Serious complications from use of an IUD are rare. However, some women do have problems. These problems usually happen during, or soon after, insertion:
- Expulsion: The IUD is pushed out of the uterus into the vagina. It happens within the first year of use in about 5% of users. This rate decreases with length of use. It is more likely to occur in women who have not had children. If the IUD is partly or fully expelled, it is no longer effective.
- Perforation: The IUD can perforate (or pierce) the wall of the uterus during insertion. This is very rare and occurs in only about 1 out of every 1,000 insertions.
- Infections: Infections in the uterus or fallopian tubes can occur. This may cause scarring in the reproductive organs, making it harder to become pregnant later. In women at low risk for STDs, this occurs in as few as 1 out of every 1,000 women using an IUD.
- Pregnancy: Rarely, pregnancy may occur while a woman is using an IUD. If the string is visible, the IUD should be removed by a doctor. If the IUD is removed soon after conception, the risks caused by having the IUD in place are decreased. If the IUD remains in place, there are increased risks to the mother and fetus, including increased risk of miscarriage, infection, or preterm birth. If pregnancy occurs, there is also an increased risk that it will be an ectopic pregnancy. However, pregnancy may go to term with an IUD in place. If you are using an IUD and think you may be pregnant, talk to your doctor about your options and risks.
Reference: Center of Disease Control and Prevention.