18 Things Every Woman Should Know About Getting an IUD (2023)

18 Things Every Woman Should Know About Getting an IUD (1)

Guille Faingold/Stocksy

Intrauterine devices (IUDs) are quickly becoming the HBICs of the contraception game. If you’re thinking about getting one, here’s everything you need to know:

(Video) What you need to know about IUD

1. There's more than one kind.

All IUDs are small, T-shaped devices that a doctor inserts through the cervix into the uterus. Each has a small string that goes from the cervix into the vagina, which a physician uses to remove the device. There are a number of IUD brands, each of which delivers different effects: ParaGard is non-hormonal. The copper coils on its frame cause a harmless inflammatory response that is toxic to sperm and eggs that lasts up to 10 years, or until you have the device removed.

Hormonal IUDs, like Mirena, Liletta, Kyleena, and Sklya, release a synthetic form of progesterone called progestin. This prevents pregnancy by thickening cervical mucus to keep sperm from entering the uterus and by thinning the uterine lining to stop a fertilized egg from implanting in the uterine wall. Depending on the brand, a hormonal IUD can be effective for three to six years, or until you have it removed, according to the Mayo Clinic.

2. They are 99 percent effective in preventing pregnancy.

IUDs are the most dependable birth control you can get, short of permanent sterilization, according to the Centers for Disease Control. Unlike the pill or condoms, this set-it-and-forget-it method leaves virtually no room for user error. The copper IUD is immediately effective; hormonal IUDs begin working right away if inserted during the first week of your cycle, which begins the day you get your period. When inserted outside this timeframe, you’ll need to use backup birth control such as condoms for seven days.

3. The copper IUD can be used as emergency contraception.

If inserted within five days of unprotected sex, it stops sperm from swimming well enough to reach an egg, according to Planned Parenthood. (Because hormonal IUDs function differently, they can not be used as emergency contraceptive.)

4. They don't prevent STIs.

Non-barrier methods like the IUD, birth control pills, emergency contraception, and subdermal implants will not prevent an infection from passing from partner to partner, according to Planned Parenthood. The only way to reduce your risk during sex is to use a female or male condom. And since exposure to STIs, like chlamydia and gonorrhea, may put you at an increased risk of pelvic inflammatory disease if you have an IUD, it’s especially important that you protect yourself, says Dr. Andrea Chisholm, OB-GYN, gynecologist at Cody Regional Health in Cody, Wyoming.

5. IUDs can be expensive upfront.

An IUD, plus insertion, can cost up to $1,300 out of pocket, according to Planned Parenthood. However, the Affordable Care Act requires insurers and employers (except those who object for moral or religious reasons) to cover IUDs and other birth control options without a copay. Be forewarned, though — some insurance plans cover the device and insertion, but not the doctor's visit to have the IUD removed, according to Bedsider.org. Check with your insurance or healthcare provider to see what an IUD costs from start to finish.

(Video) Having an IUD/IUS contraception fitted

6. IUD insertion isn't pleasant.

"There is a pinch, followed by two big cramps, and then it's done. It’s very quick,” says Dr. Leah Torres, an OB-GYN and reproductive health specialist in Utah. "I would never tell someone, 'It's not bad,' or, 'It won't hurt.' "

While a prophylactic over-the-counter pain reliever can help, the amount of discomfort a patient feels during insertion depends on the provider's skill and the patient's tolerance and expectations, Dr. Torres says. You can expect some spotting for a few days after the procedure, but it shouldn’t be a period-like flow, says Dr. Yesmean Wahdan, gynecologist and associate medical director at U.S. Medical Affairs for Bayer Women’s HealthCare. If you experience heavy bleeding or cramping that lasts more than a few weeks, call your doctor to see what’s going on, she says.

7. IUDs are safe for teens.

"Given the efficacy, safety, and ease of use, LARC [long-acting reversible contraception] methods should be considered first-line contraceptive choices for adolescents," wrote The American Academy of Pediatrics in a 2014 statement. Thereafter, a Colorado program that distributed 30,000 IUDs to low-income women resulted in a 40 percent drop in the teen pregnancy rate over four years.

8. An IUD may change your vaginal discharge.

Women using copper IUDs complained more frequently about unusual or bad-smelling discharge than women using levonorgestrel-releasing IUDs, according to a 2014 study published in The European Journal of Contraception & Reproductive Health Care. That’s likely because the copper IUD causes inflammation, which is harmless but can increase secretions of white-yellow mucus from the cervix and possibly the uterus, Dr. Chisholm says. While the symptom may resolve itself as your body adjusts to the IUD, it could be your new normal. Either way: "This fluid should not smell bad. If at any time vaginal secretions have a foul odor and/or your vagina feels itchy or irritated, you should see your doctor to be sure you don't have an infection," she says.

9. Some IUD users don’t get periods.

Thanks to the synthetic progesterone in hormonal IUDs, which thins the lining of your uterus, cramping should become less intense while periods become lighter or nonexistent, according to Planned Parenthood. But the impact on your flow depends on which brand you choose, says Dr. Wahdan. "Generally, the higher the dose of hormones in the IUD, the more likely you are to experience amenorrhea, or absence of your period," Dr. Wahdan says. Clinical trials show that 20 percent of women using Mirena, 12 percent of women using Kyleena, and 6 percent of women using Skyla stop getting their periods within the first year of use, she says. Clinical trials also showed that 19 percent of women using Liletta stopped getting their period within the first year, 27 percent by the end of the second year of use, 37 percent by the end of the third year, and 41 percent by the end of the fourth.

10. An IUD can make your period worse.

"ParaGard's primary side effect is heavier period bleeding and more cramping, which commonly lasts for the first six months after insertion," says Dr. Cheryl Chastine of South Wind Women's Center in Wichita, Kansas. That’s because the copper IUD increases inflammatory factors, such as prostaglandins, which are normally produced by your uterine lining and are responsible for monthly period cramps, Dr. Chisholm says. And the more prostaglandins you have, the more cramping you might feel. That said, an NSAID like ibuprofen should help relieve them. "If you normally have very painful cramping with your period," Dr. Chisholm says, "the ParaGard IUD is probably not a good choice for you."

(Video) Is the IUD right for you? |As told by a Nurse Practitioner|BIRTH CONTROL SERIES

11. Your IUD might mess with your skin.

Hormonal contraception that contains progestin, such as hormonal IUDs, can increase circulating levels of male sex hormones known as androgens, which can overstimulate the skin’s oil glands and ultimately provoke pimples, Dr. Chisholm says. That said, research only shows an association between hormonal contraception and acne — so there’s no prove it causes breakouts or that it definitely will for you.

12. An IUD may improve your sex life.

An IUD won’t necessarily affect your desire for sex, ability to become aroused or orgasm, or the way sex feels, according to a 2012 Journal of Medicine study. However, the comfort of knowing you’re protected from pregnancy may empower you to have more spontaneous sex, as was the case for IUD users enrolled in 2014 study conducted by researchers at University of Wisconsin-Madison.

13. Your IUD string could poke your partner during sex.

In the same 2014 study, some women said their partners felt their IUD strings during intercourse, negatively impacting their time in bed. If yours complains he can feel the string, Dr. Wahdan suggests asking your doctor to trim or tuck it behind your cervix.

14. IUDs can raise your risk of yeast infections.

Several studies link IUDs with recurrent yeast infections, suggesting that the IUDs and their strings can harbor candida, a.k.a. yeast, and allow it to thrive, particularly if you’re susceptible to yeast overgrowth, Dr. Chisholm says.

15. It’s possible for an IUD to fall out — but it’s rare.

Expulsion is when the IUD passes out of the uterus through the cervix and into the vagina, but it only happens to 2 to 10 percent of all IUD users, according to the American College of Gynecologists. If your IUD has migrated out of your uterus, you’ll feel cramping, have pain during sex, and might experience an increase in discharge, Dr. Chisholm says. If you have these symptoms or think your IUD has moved, see your doctor right away, since an IUD expulsion increases your risk of pregnancy.

16. Your IUD can poke through your uterus.

In fewer than 2 in every 1,000 women who get IUDs, the device adheres to or perforates the uterus wall, which can potential injure other organs, according to a 2015 study published in the journal Contraception. Although this typically occurs when a doctor places the IUD incorrectly, which can compromise its ability to prevent pregnancy, "it’s usually not discovered until the patient comes in with pain or a pregnancy," Dr. Chisholm says. A perforation can lead to intense pain and cramping that doesn’t get better over time. If you experience these symptoms after an IUD insertion, and an NSAID pain reliever such as ibuprofen doesn’t help, head back to your doctor’s office, and use condoms until your MD confirms the device is still in place.

(Video) Brook IUD & IUS - Knowing What to Expect

17. It's OK to leave your IUD in past its prime.

Every IUD has a designated lifespan, at which point, you’ll need a doctor to remove it. "Leaving an IUD in place past the approved time shouldn’t cause an infection or damage, so it's not necessary to rush to the doctor to have it removed immediately after it expires," Dr. Chastine says. While studies suggest that both ParaGard and Mirena are effective at preventing pregnancies for at least two years beyond the FDA-approved period, it’s smart to use a back-up birth control method, Dr. Chastine says.

18. Your IUD won’t affect your long-term fertility.

There’s no difference in pregnancy rates among former IUD users and former users of other contraceptive methods, according to one study published in The European Journal of Contraception & Reproductive Health Care. It doesn’t matter how long you’ve had your IUD — once it’s out, it’s possible to get pregnant right away.

Additional reporting by Robin Marty.

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Ashley OermanLifestyle DirectorAshley Oerman is the lifestyle director at Cosmopolitan, covering fitness, health, food, cocktails, and home.

(Video) I Got Pregnant With An IUD


What I Wish I Knew Before getting an IUD? ›

Insertion Can Hurt

It's common to feel pain or discomfort when your doctor inserts an IUD. Some women feel mild pressure. Others have more intense pain. “I wish I'd known how much it hurts,” says Melissa James, a copy designer in Yorktown, VA.

What not to do when you have IUD? ›

Immediately after insertion, it is important not to insert anything into the vagina for 48 hours (i.e. no tampons, bath, swimming, hot tub, sexual intercourse). There is about 1% chance of the IUD slipping or being expelled, and the chance is highest in the first few weeks.

What to avoid before getting an IUD? ›

If you are not currently using any forms of birth control, please abstain from unprotected intercourse for at least 14 days prior to your IUD insertion appointment. Take 600mg ibuprofen (if allergy to ibuprofen or unable to take NSAIDs, take 1000mg Tylenol) 45 minutes before your appointment.

What is the most common complication of IUD? ›

Infection. One of the most serious complications that can arise because of an IUD is infection. IUD infections are generally a result of the insertion process. The risk of infection is very minimal, and if an infection occurs, it can be treated without removing the IUD.

How do I prepare my body for an IUD? ›

Eat a light meal or snack beforehand so you don't get dizzy. Also drink some water. You'll need to give a urine sample so your doctor can make sure you're not pregnant before they put the IUD in. Ask your doctor if you should take a pain reliever, like ibuprofen or acetaminophen, before your appointment.

Do IUDs make you gain weight? ›

Weight gain can happen with hormonal IUDs due to the hormone, progestin. Any IUD weight gain is likely not an increase in body fat, but instead an increase in water retention. The hormone progestin may increase water retention that causes bloating, typically adding about five pounds.

What to watch out for after getting an IUD? ›

Irregular bleeding and spotting is normal for the first few months after the IUD is placed. In some cases, women may experience irregular bleeding or spotting for up to six months after the IUD is placed. This bleeding can be annoying at first but usually will become lighter with the Mirena IUD quickly.

How long should you rest after getting an IUD? ›

After the insertion

It is usually safe to return to work or school right away. However, if a person is feeling intense pain or cramping, they may wish to rest for a day. Following insertion of an IUD, it is normal to notice some spotting. According to Planned Parenthood, spotting can last up to 3–6 months.

What are 5 Side Effects of IUDs? ›

Side effects associated with Mirena include:
  • Headache.
  • Acne.
  • Breast tenderness.
  • Irregular bleeding, which can improve after six months of use.
  • Mood changes.
  • Cramping or pelvic pain.
20 Aug 2022

How do you stay calm during an IUD? ›

Tips On How To Make IUD Insertion Less Painful
  1. Timing Is Everything. ...
  2. Find An Experienced Doctor. ...
  3. Take An Over-The-Counter Painkiller Beforehand. ...
  4. Remember To Breathe. ...
  5. Use Distractions. ...
  6. Don't Go Hungry. ...
  7. Consider A Smaller IUD. ...
  8. Have A Heating Pad Ready.
22 Nov 2021

How long does it hurt after IUD insertion? ›

For some women, cramping lasts 1-2 days after the IUD goes in. For others, it lasts a few weeks. Or it could be as long as 3-6 months before it goes away. You may also have irregular, heavy bleeding for 3 to 6 months.

How painful is an IUD insertion? ›

It's likely that you'll feel minor pain and cramping during insertion. Some experience more significant cramping and pain. This may continue for a few days afterward. Most women find the pain tolerable and feel that the peace of mind that comes with using an effective birth control outweighs any pain or side effects.

Can IUD damage your womb? ›

The major health risks associated with IUD use are perforation of the uterus, pregnancy (both intrauterine and ectopic), and pelvic inflammatory disease. Perforation of the uterus by an IUD is a serious complication and this is possible both during the insertion and later.

When is the best time to insert IUD? ›

Pregnancies occurring with IUDs in place have an increased incidence of complications, including spontaneous abortion and septic abortion. For this reason, many providers prefer to time IUD insertion within the first 5-7 days of the menstrual cycle, further assuring that the patient is not newly pregnant.

How long does it take for IUD strings to soften? ›

If it is bothersome, you have a couple of options—the strings often soften after the IUD has been in place for a few months, but if it is still an issue your provider may be able to cut the strings shorter. 12.

Can I take a shower after IUD insertion? ›

You must wait 24 hours after your IUD is put in before you can use tampons, take a bath, or have vaginal sex.

Why do you have to wait a week after IUD? ›

Abstaining from sex helps protect you from developing a serious pelvic inflammatory disease. Also, you may experience uncomfortable side effects that occur for a day or two after your IUD is inserted.

Can I drive after IUD insertion? ›

We recommend that you do not drive yourself after an IUD procedure even if you have not had an anaesthetic, as it is possible to experience a delayed reaction after the procedure. If you have had sedation, you should not drive for 24 hours post-procedure.

Can IUD cause depression? ›

All forms of hormonal contraception were associated with an increased risk of developing depression, with higher risks associated with the progesterone-only forms, including the IUD. This risk was higher in teens ages 15 to 19, and especially for non-oral forms of birth control such as the ring, patch and IUD.

Does IUD cause acne? ›

Acne is listed as a side effect of IUDs that contain progesterone, specifically the Mirena and Skyla implants. This is because this hormone is an androgen that can over-stimulate your oil glands and contribute to acne.

Does IUD cause hair loss? ›

Why Do IUDs Cause Hair Loss? Hormonal IUDs are more likely to cause hair loss than the copper IUD. Doctors and researchers believe that low estrogen levels can cause hair loss possibly due to the progestin hormone in some IUDs.

Should I take the day off after IUD? ›

After your IUD is placed

Most people can return to their work by the next day, using ibuprofen to help with any cramping. Some vaginal spotting is normal. If you have your period at the time of placement, your period may end up being lighter or heavier, shorter or longer than usual.

How do you feel day after IUD insertion? ›

It isn't uncommon to feel cramping and backaches for a few hours or even days after the procedure, so you might want to take it easy once you get home. Heating pads can help too. Some people experience spotting from the procedure after getting an IUD, but this should go away within three to six months.

What happens to your body after an IUD? ›

Some of the symptoms that people often experience after Mirena placement include: pain, bleeding, and dizziness immediately after insertion, although these symptoms should usually go away within about 30 minutes. missed or irregular periods. bleeding more or less than usual during a period in the first 3–6 months.

Can a tampon pull out an IUD? ›

Neither a tampon nor sex should pull your IUD out.

“It really requires grabbing the string with something,” Kelly-Jones said. “You have to use a special device to remove it. And it's slippery.” It's a common concern, she said, but it's very uncommon for the IUD to be unintentionally displaced.

What does Brown period blood mean with IUD? ›

Some contraception methods like IUDs or implants release the progestin hormone into your body to prevent you from getting pregnant. As your body adjusts to the new form of birth control, you might experience side effects such as irregular menstruation, spotting, breakthrough bleeding and brown discharge.

Should I use condoms with IUD? ›

One more thing: the IUD protects you from pregnancy, but it doesn't protect you from STDs. Condoms are the only form of birth control that also protects you from STDs. So even if you have an IUD, it's still a really good idea to keep using condoms.

Which IUDs cause weight gain? ›

Two brands of hormonal IUDs, Mirena and Liletta, mention weight gain as a potential side effect.

Does an IUD affect your mood? ›

Though commonly prescribed and advertised as a safe, reliable form of contraception, hormonal IUDs may have overlooked adverse drug reactions involving mood symptoms, such as depression, anxiety, and panic disorder.

Does IUD reduce pleasure? ›

In general, hormonal and copper IUDs users report that their method of birth control has no impact on or improves their sexual satisfaction (30-33). One study found that 9 out of 10 people using either type of IUD had no change in libido and 3 out of 10 reported increased sexual spontaneity (30).

What can I ask for pain for IUD? ›

Premedication with ibuprofen (600 mg) or naproxen (500 mg) 1-2 hours before is given to minimize the pain of the IUD deployment.

How do you not pass out during an IUD insertion? ›

Vasovagal reactions are common and can be scary, but they are preventable. Tensing the muscles of the arms, hands, feet, and legs can instantly stop a vasovagal reaction and prevent fainting.

How do doctors open your cervix for IUD? ›

The patient will be in stirrups, like in a regular pelvic exam, and the doctor will first measure the uterus to make sure the device will fit. Then the cervix is opened manually with a series of dilating rods. Once the cervix is open, the doctor inserts the IUD using a narrow plunger.

Why dont they give pain meds for IUD? ›

“Local anesthetic is not routinely used during IUD insertion as it doesn't necessarily help to alleviate the uterine cramping that can occur [after insertion],” Black explains, though it can help reduce pain during the procedure.

Can you be put to sleep for IUD insertion? ›

While it is common for an IUD insertion to be done without anesthesia, many girls and their families prefer to have the procedure done while under anesthesia.

Does IUD hurt more as much as first time? ›

Most experts and people who've had an IUD replacement say that it's not as painful as when you first get an IUD.

Should I take painkillers before IUD insertion? ›

About 20-30 minutes before your appointment, please take 800 mg of Ibuprofen (Advil or Motrin). This will help to ease any cramping you may have during and after the insertion.

What is the safest IUD? ›

No hormones: Copper IUDs are safe even for people who cannot use hormonal birth control. Emergency contraception: A copper IUD begins working immediately, so it can function as an emergency form of birth control.

Can an IUD tear your cervix? ›

This occurs when your IUD pokes into, or through, the wall of your cervix or uterus. Perforation is very rare. It only happens in only 1.4 per 1,000 (0.14%) hormonal IUD insertions and in 1.1 per 1,000 (0.11%) copper-IUD insertions, according to the American College of Obstetricians and Gynecologists.

Should I pee before IUD insertion? ›

Please arrive to your appointment 10 minutes before your scheduled time, and come with a full bladder. The first thing you'll do is take a urine test to confirm that you're not pregnant, so avoid urinating for an hour prior to your appointment.

Where should an IUD sit? ›

The correctly positioned IUD is located in the uterine cavity near the fundus (Fig. 2). The stem should extend toward the cervix and the two arms should be fully unfolded during insertion, reaching laterally toward the uterine cornua.

How do I check my IUD position? ›

Ultrasound is an excellent tool to confirm the location of an intrauterine device. You can perform this exam after insertion to confirm placement or during the life of the IUD. Common indications for checking placement of an IUD: Unexpected menstrual bleeding.

Why can my partner feel my IUD? ›

The IUD has strings made of thin plastic threads that hang down into the top of the vagina. The strings should not bother you or interfere with sex or daily activities. In rare cases, your partner may feel the IUD strings during sex. If this occurs and it is a concern, your ob-gyn may be able to trim the strings.

Can I check my IUD strings right away? ›

There should be just enough string hanging into your vaginal canal to feel with the tip of your fingertips. You should check for your IUD strings with a clean finger once a month. A good time to do this is the day after your period ends. If you're unable to feel the strings, try to remain calm.

What do IUD strings feel like? ›

Checking your strings is simple: Insert a finger into your vagina and feel up toward your cervix. They will usually feel like thin bits of fishing line. It helps to know what the strings feel like before you try to find them, so don't feel too shy to ask if you can touch them before your IUD is inserted.

What to expect when you first get IUD? ›

A woman may experience cramping and pinching sensations while IUD insertion is taking place. Some women may feel a bit dizzy. It may be helpful to take deep breaths. While many women may experience some discomfort, less than 5% of women will experience moderate to severe pain.

What should I ask my doctor before getting an IUD? ›

He recommends patients ask their doctors these five questions before deciding on an IUD.
  • Is a hormonal or non-hormonal IUD best for me? ...
  • Do previous or existing health conditions matter when choosing an IUD? ...
  • How will it affect my cycle? ...
  • How long will the birth control last? ...
  • What are the potential side effects of an IUD?
17 Oct 2019

What hurts when getting an IUD? ›

When you get an IUD, it's normal to feel cramping. “Your uterus is a muscle, and when you place something inside of it, the muscle responds by tightening,” says Lisa Holloway, a nurse practitioner near Washington, DC, who specializes in women's health. Your body also releases hormones that may lead to pain.

Can you feel your IUD at first? ›

When the IUD is in place, you and your partner shouldn't feel it. You may feel the strings but not the plastic part. If you have sex and your partner feels the hard, plastic part, it may have moved. You feel pain.

How long is your first period after getting an IUD? ›

Kyleena and your period

During the first 3 to 6 months, bleeding and spotting days may increase, and your period may become irregular. Some women have heavy bleeding during this time. You may also have cramping during the first few weeks. Once your body adjusts, monthly bleeding usually decreases.

Do they test you before IUD? ›

During your appointment

The first thing you'll do is take a urine test to confirm that you're not pregnant, so avoid urinating for an hour prior to your appointment. Your provider may also use sample to test for chlamydia and gonorrhea. Next, you'll receive a pelvic exam.

How far in Are IUD strings? ›

When your doctor inserted your IUD, they left one or two thin plastic strings hanging down into your vaginal canal. These strings are about 2 inches long — just long enough to be able to feel them with the tip of your finger. They feel like light fishing line. However, many women are unable to feel these strings.

Which is the most appropriate time of IUD insertion? ›

PIP: Some clinicians feel that the best time for inserting an IUD is during a woman's menstrual period. At that time the cervix is dilated, the chance of introducing an IUD into a pregnant uterus is slight, and the menstrual bleeding masks bleeding due to insertion.

How long after IUD can I take a bath? ›

You must wait 24 hours after your IUD is put in before you can use tampons, take a bath, or have vaginal sex. You may have more cramps or heavier bleeding with your periods, or spotting between your periods. This is normal.

How long did you bleed after IUD insertion? ›

Irregular bleeding and spotting is normal for the first few months after the IUD is placed. In some cases, women may experience irregular bleeding or spotting for up to six months after the IUD is placed.


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