An intrauterine device (IUD) is a small device that is inserted into the uterus to prevent pregnancy. An IUD may prevent pregnancy by:
- Impairing the normal function of sperm
- Making it more difficult for a fertilized egg to implant in the uterus
In the United States, there are currently two types of IUDs. This care path includes the cost for a levonorgestrel intrauterine system (LNG-IUS), also known as a Mirena.
- A Mirena is a plastic T-shaped device that releases the hormone levonorgestrel.
- Levonorgestrel causes changes to the lining of the uterus and can prevent ovulation. This provides further protection against pregnancy.
- An LNG-IUS is also effective in reducing bleeding and cramping during menstrual periods.
- This LNG-IUS can be effective for three to five years, depending on the amount of hormones in the device.
A copper IUD is a plastic T-shaped device with copper wire wrapped around the stem and arms. A copper IUD:
- Can be effective for up to ten years.
- Is appropriate for women who cannot use, or prefer not to use, hormonal methods of birth control.
- Can be used for emergency contraception if it is inserted within five days of unprotected sex.
If pregnancy prevention is desired for a number of years, an IUD may be an appropriate choice of birth control for women of any age.
- Both the levonorgestrel and the copper IUDs are more than ninety-nine percent effective in preventing pregnancy.
- It is important to remember that IUDs do not protect against any STDs. If you are not in a committed relationship with a single partner, you should practice safe sex and use a condom during any sexual contact.
An IUD may not be recommended in certain situations, such as:
- An oddly shaped uterus
- Unexplained vaginal bleeding or bleeding disorder
- Certain types of cancer (uterine, cervical, or breast)
- Liver disease
- Participation in high-risk sexual behavior
Before placing an IUD, your healthcare provider will review your medical history and do a pelvic exam. Lab work may be done to make sure you are not pregnant and do not have a sexually transmitted disease (STD).
- An IUD is inserted through the cervix (the opening of the uterus) during an office visit. You may notice some cramping when it is put into place. Tell your healthcare provider if you feel faint, dizzy or experience sharp pain.
- Your doctor may recommend pain medication if you have cramping after the procedure.
- An IUD can be inserted at any time, but some healthcare providers recommend insertion during or just after your menstrual period. If it is inserted during your period, or right after you have a baby, the risk of the IUD falling out increases slightly.
Before you leave the office, it is important you know how to feel for the strings attached to the IUD.
- When you can feel the strings, you will know the IUD is in place.
- You should check the strings at the same time each month, such as right after you have your period. When checking, do not pull on the strings.
- Over time, the strings may feel softer and may curl around the cervix. This can make them a little more difficult to locate.
- If the strings are missing, use a backup method of birth control until you are evaluated by your healthcare provider.
Make an appointment with your healthcare provider to discuss your birth control options. If you decide to have an IUD inserted, ask your healthcare provider the following questions.
- What are the benefits and risks of the two types of IUDs approved for use in the United States?
- Is one type of IUD a better option for me than the other? Why or why not?
- How does the IUD compare with other types of birth control?
- How long will the procedure take?
- What symptoms are normal after the procedure? When should I be concerned?
- How long after insertion should I see you?
- What should I do if I cannot feel the strings or they are shorter or longer than usual?
It is important to consult your doctor when you would like to have the IUD removed. Do not attempt to remove an IUD yourself.