Intrauterine Device (IUD)

What is an Intrauterine Device (IUD)?

An intrauterine device (IUD) is a small T-shaped plastic contraceptive device inserted through the opening of your cervix into your uterus by your gynecologist during an office visit.  It has a string attached at the end, which hangs into the vagina to help you check that it is in place. You should check for the string after each period and after sexual intercourse to ensure the device is still present. The IUD is a longer-lasting form of reversible contraception, and can stay in place for 3–10 years.

There are two categories of IUDs:

  • Non-hormonal–copper T IUD
    • This IUD is made with copper and plastic and contains no hormones. The copper acts as a spermicide, killing any sperm. It can prevent pregnancy as soon as it is placed by stopping sperm from reaching and fertilizing an egg. It provides protection for up to 10 years.
    • These are one of the most effective emergency contraceptive devices when used within five days of unprotected sex.
    • Users may notice that the period may become heavier, crampier, or longer with use of this IUD
  • Hormonal IUDs
    • Hormonal IUDs are effective for 3 to 5 years, depending upon the type used. They contain the hormone progestin. Progestin prevents pregnancy by thickening the cervical mucus and thinning the lining of the uterus, thus stopping the sperm from reaching and fertilizing an egg. Hormonal IUDs are not an emergency contraceptive device, as they take a week to start working.
    • Hormonal IUDs may also be used to mitigate heavy or prolonged menstrual cycles. Users may notice that their periods become lighter, erratic, or absent.

Fitting an IUD

Before inserting an IUD, your doctor will perform a pelvic examination to assess the size, shape and depth of your uterus. You may also be tested for any sexually transmitted infections. Fitting the IUD is painless and usually takes no longer than 5 minutes. Your doctor will place the IUD through the cervix, and into your uterus. Depending on the type, you may have to use an alternative birth control for about a week.

Your IUD can be removed by your doctor at any time and you can get pregnant as soon as it is removed.

Advantages of an IUD

Advantages include:

  • Low maintenance highly effective (99% effective at preventing pregnancy) reversible contraceptive
  • Doesn't interrupt sex
  • Safe to use while breastfeeding
  • Can get pregnant as soon as it is removed
  • Management of heavy periods for those using a hormonal IUD

Disadvantages of an IUD

Disadvantages include:

  • Heavier, longer or more painful periods for the first few months (nonhormonal IUD)
  • Erratically timed periods (hormonal IUD)
  • Do not provide protection against STIs/STDs

Risks and Complications of an IUD

As with any procedure, IUDs may also be associated with certain risks and complications which include bleeding, infection, puncture of the uterus, pelvic infections, rejection of the IUD by the uterus, displacement of the IUD, need for surgical removal, and higher risk for an ectopic pregnancy (pregnancy implanted in the fallopian tube or other abnormal site outside the uterus requiring surgical or medical treatment).

  • ACOG
  • AIUM
  • American Association of Gynecologic Laparoscopists
  • NYU langone Medical center
  • American Association for Accreditation of Ambulatory Surgery Facilities
  • UpToDate