Intrauterine Device (IUD)

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).

Insertion

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.

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.

• 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.