What Are IUDs and Types?
What Is an IUD?
IUDs are small, T-shaped devices inserted into the uterus by a health care provider that remain in place and prevent pregnancy for years. An IUD can be replaced when the contraceptive properties expire, or when contraception is no longer desired.
What Are the Types of IUDs?
There are two main types of IUDs:
- Hormonal IUDs, which release the female hormone progestin (levonorgestrel) into the uterus, causing thickening of the cervical mucus which prevents sperm from reaching or fertilizing the egg, thinning the uterine lining, and possibly preventing the ovaries from releasing eggs
- Copper IUDs, which prevent sperm from reaching and fertilizing the egg, and can prevent an egg from attaching in the uterus
- If an egg does become fertilized, a copper IUD can prevent it from implanting into the uterine lining
What Are the Side Effects of IUDs?
IUDs are not necessarily bad for you. They just may not be the right form of birth control for all people. Side effects of IUDs include:
- Pain when the IUD is inserted, and cramping or backaches for a few days after
- Irregular periods
- Spotting between periods
- Heavier or longer periods
- More or worse cramping during your periods
- Hormonal IUDs may cause side effects similar to those caused by oral contraceptives, such as breast tenderness, mood swings, headaches, and rarely, acne
Most of these side effects will ease up or go away completely after three to six months, once the body has acclimated to the IUD.
Serious risks from IUDs are uncommon, but may include:
- Expulsion from the uterus
- This happens in about 2% of cases, usually during the first few months of use, and is more likely when an IUD is inserted right after childbirth or in a woman who has never been pregnant
- If an IUD slips out, a woman can become pregnant
- The IUD must be removed by a healthcare provider
- This is very rare — occurs in about one out of 1,000 women, in which an IUD punctures (perforates) the uterus
- When this happens, it’s almost always when the device is being inserted
- An IUD should be removed if the uterus is perforated
- If bacteria enter the uterus when the IUD is inserted, the infection can occur
- If the infection is not treated, it may be more difficult to conceive in the future
- It’s possible, though unlikely, for a woman to become pregnant even if an IUD is correctly inserted
- If pregnancy occurs, the IUD must be removed as soon as possible due to an increased risk of ectopic pregnancy and other serious health problems
- Ovarian cysts
- Hormonal IUDs may cause benign (non-cancerous) ovarian cysts, which usually go away on their own
Warning signs that may indicate a problem with an IUD include:
- You can feel the hard plastic bottom of the IUD coming out through your cervix
- Bad cramping, pain, or soreness in your lower belly or stomach
- The length of the IUD string feels shorter or longer than it was
- You think you might be pregnant
- Unexplained fever, chills, or difficulty breathing
- Pain or bleeding during sex
- Vaginal discharge is different than normal
- Vaginal bleeding that is heavier than usual
See a doctor right away if you experience any of the above signs and symptoms and have an IUD.
Disadvantages of an IUD include:
- It does not protect against sexually transmitted infections (STIs, also called sexually transmitted diseases, or STDs)
- You cannot use a menstrual cup with an IUD
- Use of a menstrual cup may cause the IUD to move out of place
- The cost of insertion can be high
- It needs to be inserted and removed by a doctor
How Is an IUD Inserted?
Prior to insertion of an IUD, a doctor will usually perform a physical examination of the vagina, cervix, and uterus.
- Prior to the procedure, patients may be given medicine to help open the cervix and anesthetic to numb the cervix
- A speculum is inserted into the vagina and a special inserter is used to place the IUD through the opening of the cervix into the uterus
- The insertion of an IUD may cause some cramping or pain during the procedure, but it only lasts a minute or two
- The procedure usually takes less than five minutes
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