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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.
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 and you don't have a pelvic infection. 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 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:
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.
The IUD is a highly effective method of birth control.1
Also, the hormonal IUD:
Risks of using an intrauterine device (IUD) include:
Disadvantages of IUDs include the high cost of insertion, no protection against STIs, and the need to be removed by a doctor.
The hormonal IUD may cause noncancerous (benign) growths called ovarian cysts, which usually go away on their own.
The hormonal IUD can cause hormonal side effects similar to those caused by oral contraceptives, such as breast tenderness, mood swings, headaches, and acne. This is rare. When side effects do happen, they usually go away after the first few months.
When using an IUD, be aware of warning signs of a more serious problem related to the IUD.
Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
The IUD is most likely to work well for women who have been pregnant before. Women who have never been pregnant are more likely to have pain and cramping after the IUD is inserted. They are also more likely to expel the IUD. But they can still use the IUD.
Pelvic inflammatory disease (PID) concerns have been linked to the IUD for years. But it is now known that the IUD itself does not cause PID. Instead, if you have a genital infection when an IUD is inserted, the infection can be carried into your uterus and fallopian tubes. If you are at risk for a sexually transmitted infection (STI), your doctor will test you and treat you if necessary, before you get an IUD.
Intrauterine devices reduce the risk of all pregnancies, including ectopic (tubal) pregnancy. But if a pregnancy does occur while an IUD is in place, it is a little more likely that the pregnancy will be ectopic. Ectopic pregnancies require medicine or surgery to remove the pregnancy. Sometimes the fallopian tube on that side must be removed as well.
An IUD can be a safe birth control choice for women who:4
- Grimes DA (2007). Intrauterine devices (IUDs). In RA Hatcher et al., eds., Contraceptive Technology, 19th ed., pp. 117–143. New York: Ardent Media.
- Trussell J (2007). Choosing a contraceptive: Efficacy, safety, and personal considerations. In RA Hatcher et al., eds., Contraceptive Technology, 19th ed., pp. 19–47. New York: Ardent Media.
- Fritz MA, Speroff L (2011). Endometriosis. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1221–1248. Philadelphia: Lippincott Williams and Wilkins.
- Speroff L, Darney PD (2011). Intrauterine contraception. In A Clinical Guide for Contraception, 5th ed., pp. 239–279. Philadelphia: Lippincott Williams and Wilkins.
Last Revised: May 7, 2013
Author: Healthwise Staff
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