Intrauterine Device (IUD)
Serving the Greater Miami Area
The intrauterine device (IUD) is one of the most effective forms of birth control. It is a small, plastic device that is inserted and left inside the uterus to prevent pregnancy. The IUD can be used by women of all ages, including teenagers and those who have never had children.
An IUD is a small, T-shaped plastic device that is wrapped in copper or contains hormones. The IUD is inserted into your uterus by your doctor. A plastic string tied to the end of the IUD hangs down through the cervix into the vagina. You can check that the IUD is in place by feeling for this string. The string is also used by your doctor to remove the IUD.
Types of IUDs
Hormonal IUD The hormonal IUD, such as Mirena, releases levonorgestrel, which is a form of the hormone progestin. The hormonal IUD appears to be slightly more effective at preventing pregnancy than the copper IUD. The hormonal IUD is effective for at least 5 years.
This IUD prevents fertilization by damaging or killing sperm and making the mucus in the cervix thick and sticky, so sperm can’t get through to the uterus. It also keeps the lining of the uterus (endometrium) from growing very thick.1 This makes the lining a poor place for a fertilized egg to implant and grow. The hormones in this IUD also reduce menstrual bleeding and cramping.
Copper IUD The most commonly used IUD is the copper IUD (such as Paragard). Copper wire is wound around the stem of the T-shaped IUD. The copper IUD can stay in place for at least 10 years and is a highly effective form of contraception.
Copper is toxic to sperm. It makes the uterus and fallopian tubes produce fluid that kills sperm. This fluid contains white blood cells, copper ions, enzymes, and prostaglandins.
How it works
Both types of IUD prevent fertilization of the egg by damaging or killing sperm. The IUD also affects the uterine lining (where a fertilized egg would implant and grow).
You can have an IUD inserted at any time, as long as you are not pregnant. An IUD is inserted into your uterus by your doctor. The insertion procedure takes only a few minutes and can be done in a doctor’s office. Sometimes a local anesthetic is injected into the area around the cervix, but this is not always needed. IUD insertion is easiest in women who have had a vaginal childbirth in the past. Your doctor may have you feel for the IUD string right after insertion, to be sure you know what it feels like. You may be given antibiotics to prevent infection.
What To Expect After Treatment
You may want to have someone drive you home after the insertion procedure. You may experience some mild cramping and light bleeding (spotting) for 1 or 2 days.
Your doctor may want to see you 4 to 6 weeks after the IUD insertion, to make sure it is in place.
Be sure to check the string of your IUD after every period. To do this, insert a finger into your vagina and feel for the cervix, which is at the top of the vagina and feels harder than the rest of your vagina (some women say it feels like the tip of your nose). You should be able to feel the thin, plastic string coming out of the opening of your cervix. It may coil around the cervix, which can make it difficult to find. Call your doctor if you cannot feel the string or the rigid end of the IUD.
If you cannot feel the string, it doesn’t necessarily mean that the IUD has been expelled. Sometimes the string is just difficult to feel or has been pulled up into the cervical canal (which will not harm you). An exam and sometimes an ultrasound will show whether the IUD is still in place. Use another form of birth control until your doctor makes sure that the IUD is still in place.
If you have no problems, check the string after each period and return to your doctor once a year for a checkup.
You may be a good candidate for an IUD if you:
- Do not have a pelvic infection at the time of IUD insertion.
- Have only one sex partner who does not have other sex partners and who is infection-free. This means you are not at high risk for sexually transmitted infections (STIs) or pelvic inflammatory disease (PID), or you and your partner are willing to also use condoms.
- Want an effective, long-acting method of birth control that requires little effort and is easily reversible.
- Cannot or do not want to use birth control pills or other hormonal birth control methods.
- Are breast-feeding.
- The copper IUD is recommended for emergency contraception if you have had unprotected sex in the past few days and need to avoid pregnancy and you plan to continue using the IUD for birth control. As a short-term type of emergency contraception, the copper IUD is more expensive than emergency contraception with hormone pills.
Risks of using an intrauterine device (IUD) include:
- Menstrual problems. The copper IUD may increase menstrual bleeding or cramps. Women may also experience spotting between periods. The hormonal IUD may reduce menstrual cramps and bleeding.
- Perforation. In 1 out of 1,000 women, the IUD will get stuck in or puncture (perforate) the uterus. Although perforation is rare, it almost always occurs during insertion. The IUD should be removed if the uterus has been perforated.
How Well It Works
- When using the hormonal IUD, about 2 out of 1,000 women become pregnant in the first year.
- When using the copper IUD, about 6 out of 1,000 women become pregnant in the first year.
- Most pregnancies that occur with IUD use happen because the IUD is pushed out of (expelled from) the uterus unnoticed. IUDs are most likely to come out in the first few months of IUD use, after being inserted just after childbirth, or in women who have not had a baby.
- Advantages of IUDs include cost-effectiveness over time, ease of use, lower risk of ectopic pregnancy, and no interruption of foreplay or intercourse.
Other advantages of the hormonal IUD:
- Reduces heavy menstrual bleeding by an average of 90% after the first few months of use.
- Reduces menstrual bleeding and cramps and, in many women, eventually causes menstrual periods to stop altogether. In this case, not menstruating is not harmful.
- May prevent endometrial hyperplasia or endometrial cancer.
- May effectively relieve endometriosis and is less likely to cause side effects than high-dose progestin.
- Reduces the risk of ectopic pregnancy.
- Does not cause weight gain.