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IUDs are some of the best options for birth control: long-term, highly effective, low-maintenance, easily reversible, and low likelihood of complications. IUDs don’t prevent the transmission of sexually transmitted infections (STIs, aka STDs).
An Intrauterine Device (IUD) is a small plastic or copper implant that is inserted into the uterus to prevent pregnancy by impeding fertilization. Depending on the brand, they can last anywhere from 2-10 years. Copper IUDs can be used as emergency contraception if inserted within 5 days of unprotected sex.
There are two types of IUDs available in the United States: hormonal (Skyla, Mirena, and others) and copper (ParaGard). They’re equally effective, so talk to your doctor about which one would be better for you.
Copper IUDs don’t release hormones; the copper coil that is wrapped around device creates an environment that’s toxic to sperm. They also prevent implantation of an egg that does get fertilized, which is why they’re effective as emergency contraception.
Hormonal IUDs are made of plastic, and steadily release hormones. They act to thicken cervical mucus to prevent sperm entering the uterus, and also sometimes suppress ovulation.
Getting an IUD
A doctor needs to insert the IUD for you. Like most birth control, the cost can vary a lot depending on whether you have insurance and where you go to receive treatment. If you don’t have insurance, there may be programs in your area that can help you get an IUD for low or no cost.
The procedure takes just a few minutes. Since the IUD needs to be inserted through the opening of the cervix, the process can cause a little discomfort. Occasionally, it’s severely painful, but for most people it’s not much worse than moderate menstrual cramps.
Once it’s inserted, there will be two little strings coming out of the cervix. Your doctor will trim these and tuck them out of the way behind the opening the cervix, and they’ll move and shift as your cervix normally changes in shape at different times of your menstrual cycle. You and your partners probably won’t be able to feel the IUD strings, and even if you can initially, it’s usually not a big deal—the strings soften over time. The strings are used to help remove the IUD when the time comes. You shouldn’t tug on the strings, but it’s a good idea to feel the strings with your fingers occasionally to be sure your IUD hasn’t shifted.
Removing an IUD
An IUD can be removed easily if you decide you’d like to get pregnant. You shouldn’t remove the IUD by yourself—have a doctor do that. Fertility goes back to normal very quickly.
Stuff to watch out for
Serious side effects are extremely rare, but if you’re worried, here are some complications to be aware of:
- Especially if you’ve recently had an IUD inserted, the ends of the strings can feel like they’re poking you or your partner if you’re having vaginal sex. If that happens, you can move the strings back out of the way yourself, or you can have your doctor trim them.
- The uterus can expel the IUD. Often a doctor can re-insert a new one, but of course if the IUD is dislodged, its effectiveness will decrease.
- The IUD can perforate the inside of the uterus.
- As with any contraception, there’s still a very small possibility that you could get pregnant. If you do, the pregnancy is very likely to be ectopic, which could be harmful or deadly to you and you would need to go seek medical care right away.
- The insertion process can cause infection that can lead to pelvic inflammatory disease (PID)
Again, all of the above are very rare—just pay attention to how you feel after the IUD is inserted, and ask your doctor if you notice anything abnormal.
So, should you get an IUD?
You should talk with a healthcare professional about what’s best for you, but IUDs are some of the best, longest-lasting, and most effective birth control options out there!