Intrauterine devices, or IUDs, tend to get a bit of a bad reputation because of the health concerns and injuries caused by the Dalkon Shield in the ‘70s and into ‘80s. But today, new, updated versions of the IUD are the most popular contraceptive device worldwide, though use in the U.S. is still relatively low.
How do they work?
An IUD is T-shaped plastic device that is placed in the uterus through the cervix by a doctor as a form of contraception. Fewer than 1% of users become pregnant, which makes the IUD one of the more effective forms of birth control. IUDs work by either preventing the sperm and the egg from meeting, or from keeping the fertilized egg from implanting in the uterus once they do. There are two types of IUDs:
- Progestin-based IUDs (Mirena, Skyla): Hormonal IUDs use progestin, the same hormone used in the pill to prevent conception. Progestin-based IUDs can last either up to 3 or up to 5 years without needing to be changed, though they can be removed at any time. Hormonal IUDs can have hormonal side-effects, including acne, breast tenderness, and changes in menstruation that can include heavier flow and cramping during periods, or spotting between periods.
- Copper-based IUDs (ParaGard): ParaGard is the only copper-based IUD available in the U.S. It lasts up to 10 years without needing to be replaced, though it can be removed at any time. Side effects can include anemia, backaches, changes in menstruation like heavier periods and cramping, and pain during sex.
IUDs have also been associated with a slightly increased risk of complications from STIs, such as PID. This is especially true for women with more than one sexual partner. Any medical procedure also includes the possibility of infection, but these complications aren’t particularly common.
What are the benefits?
An IUD is the most low-maintenance type of contraception – once one has been placed, it is effective for years without having to do anything to maintain it. If you change your mind, though, and don’t want it to be effective for years, it can be removed at any time. And according to the APA, you can become pregnant as early as a month after it’s been removed.
With what we now know about the risks of getting pregnant within 18 months of a previous delivery, it’s so important to figure out your birth control plan before giving birth. An IUD can be placed immediately after delivery, which is an excellent (and efficient) way to protect against unintended pregnancy. If this feels like too much, many women have their IUD placed at or near their 6-week postpartum checkup.
It’s a good idea to speak with your healthcare provider about contraception even before giving birth.
- “Long-Acting Reversible Contraception (LARC): IUD and Implant.” ACOG. FAQ 184 from The American College of Obstetricians and Gynecologists, May 2016. Web.
- Sara Kennedy, MD MPH. “Paraguard vs Mirena: Which IUD is right for you?” Bedsider. The National Campaign to Prevent Teen and Unplanned Pregnancy, Jan 9 2010. Web.