Should You Use the Intrauterine Device (IUD)?
Learn about the pros and cons of the two various IUD methods of birth control.
Sanaz Majd, MD
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Should You Use the Intrauterine Device (IUD)?
Birth control is often a hot topic of conversation in my clinic. There are so many options out there for women today, which is great news, but as a result it can sometimes be very challenging and difficult to make a decision.
Should You Use the Intrauterine Device (IUD)?
I find more and more women interested in longer termed birth control methods, such as the intrauterine device (IUD). These options are great for those who:
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can’t seem to remember to take a pill every day
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are in a monogamous relationship and just don’t want to think about birth control on a daily basis
What Is an IUD?
The IUD is a soft flexible “T-shaped” device that is inserted by a trained clinical provider in a five to ten minute office procedure. It is similar to a pap smear, where a speculum is inserted, however, different in that the IUD is inserted past the cervix and into the uterus. It may cause some mild to moderate pelvic cramping, similar to period cramps, and that is why many providers will advise you to take some ibuprofen one hour prior to your procedure (as long as you don’t have any contraindications to taking it).
The IUD has “strings” that dangle from the uterus into the vagina, and you may be able to feel these strings with your fingers. As long as you make sure that you don’t pull on the strings (because that is how the IUD is removed), you can self-check for the presence of the IUD once a month. If the strings are not there, use a back up method and call your doctor right away.
Does an IUD Cause Any Symptoms?
It is preferable to have the procedure done while you are on your period in order to assure that you aren’t pregnant, and you will be given a pregnancy test on the same day of the procedure just to make sure.
You may experience pelvic and abdominal cramps up to one or two weeks afterwards, for which ibuprofen is typically prescribed.
Which IUD Should You Get?
There are two types of intrauterine devices, and the pros and cons are quite different. If you are contemplating getting the IUD, make sure you have the right information about both types so that you can make an informed decision.
The Hormone-Containing IUD
This IUD contains a progesterone-only hormone called levonorgestrel that is slowly released into the uterus over a five-year time period. It is about 99% effective in preventing pregnancy in several main ways:
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the hormone thins out the lining of the uterus, making pregnancy unlikely
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it also thickens cervical mucus and prevents the sperm from traveling into the uterus and fertilizing the egg
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it may also prevent the implantation of the egg into the uterus, although not its main mechanism of prevention
This hormone-containing IUD lasts five years, and because it thins out the lining of the uterus, it may cause your periods to become very light or even non-existent. It is especially useful for those women who have very heavy periods and want to lighten them. However, if you typically get mental relief each month when you get your period, then this IUD is probably not the ideal method for you. Lastly, because there is no estrogen in this IUD, it’s a good option for women who are breastfeeding.
The Copper-Containing IUD
This IUD doesn’t contain any hormones and is instead made of copper. It’s a good option for women who don’t do well with hormonal contraceptive methods, who have a health condition in which hormonal contraceptives are not recommended, or who are breastfeeding. It is 99% effective in preventing pregnancy, by two main methods:
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it thickens the cervical mucus and prevents the sperm from traveling into the uterus and fertilizing the egg
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it may also prevent the implantation of the egg into the uterus
This copper IUD lasts up to ten years, but like both IUD types, it can be removed at any time. The copper IUD doesn’t typically change the normal female cycle, however, it may cause heavier periods in some. So if your periods are already rather heavy, it may not be the right option for you.
What Are the Risks of IUDs?
Though IUDs have many pluses, they aren’t without risks, including the following:
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Pelvic inflammatory disease: The IUD has a possibly very slight increased risk of causing an infection of the pelvis called pelvic inflammatory disease (or PID). PID is more risky in those with multiple sexual partners, and if severe enough, it can increase risk of infertility.
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Perforations: The IUD insertion procedure itself can carry a very rare risk of creating a hole, called a perforation of the uterus. When this happens, you need an emergency repair the same day.
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Danger of being expelled: Rarely the IUD may expel out of the uterus on its own. If this happens, you need to call your doctor right away and use a back up method of birth control in the meantime.
Lastly, it is important to remember that neither IUD methods protect against HIV or other sexually transmitted infections. So please use a condom each and every time.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Thanks for listening to House Call Doctor’s quick and dirty tips to understand your body. Have a great week!
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