What is an IUD?

An IUD is a small T-shaped device that is placed in the uterus by a healthcare provider. It sits inside the uterus, and the cervix keeps it in place. Once it is in, you cannot feel it. There are two types of IUDs: the non-hormonal–copper T IUD and the hormonal–levonorgestrel IUD.

Non-hormonal Copper T IUD

• The non-hormonal copper T IUD contains no hormones and is made with copper and plastic. The copper prevents pregnancy by acting as a spermicide (a substance that kills sperm), preventing sperm from reaching and fertilizing an egg.
• It starts preventing pregnancy as soon as it is placed. In fact, the copper T IUD is an extremely effective method of emergency contraception when it is placed within five days of unprotected intercourse.
• Once in place, it is effective for up to 10 years.

Hormonal Intrauterine Device (IUD)

• Hormonal IUDs contain the progestin levonorgestrel, which is a hormone. Hormones are chemicals that control how different parts of your body work. The progestin causes cervical mucus to thicken and the lining of the uterus to thin. This keeps the sperm from reaching and fertilizing an egg.
• It may take a week for the hormonal IUD to begin working, so ask your healthcare provider if you should wait to have sex or use a back-up birth control method (such as a condom) in the meantime.
• It is effective for 3 to 5 years, depending on the type.
• It may also be called an intrauterine system or an intrauterine contraceptive.

Your healthcare provider will place an IUD through your vagina and cervix and into your uterus. The IUD has strings that can be felt in the back of the vagina, but they do not stick out of the vagina (like a tampon string). Your healthcare provider will cut the strings to an appropriate length once the IUD is placed.

If you are interested, your healthcare provider can teach you how to check your IUD strings on your own between visits to ensure that the IUD is still in place. Very rarely, an IUD may come out of the uterus on its own. If the IUD comes out, do not try to put it back yourself. Call your healthcare provider to insert another one for you.

It is not uncommon for women to have some mild discomfort, cramping, or spotting after the IUD is first placed. In most cases, symptoms become milder or go away in a few weeks or months.

Some women have heavier periods when they use the copper T IUD—particularly in the first three months. Speak with your healthcare provider about using over-the-counter medications that might help make your period lighter.

Ask your healthcare provider about the types of symptoms you should expect. Uncommon risks are pelvic infection after placement or perforation (poking through the side) of the uterus.

Of 100 women who use an IUD each year, one or less may become pregnant. IUDs are better at preventing pregnancy than condoms, the pill, the patch, the ring, and the shot.

An IUD can only be placed by a healthcare provider. Most family planning clinics offer IUDs.

Advantages of an IUD

• IUDs are safe and effective in preventing pregnancy—even more effective than other methods of reversible birth control.
• Along with implants, IUDs are one of the most cost-effective, long-acting reversible methods of birth control.
• It works for 3 to 10 years, depending on the type.
• There is nothing you have to remember to do.
• It is private. It is your choice if your partner knows about it.
• It can be removed at any time by a healthcare provider.
• Once an IUD is removed, your ability to get pregnant will immediately go back to whatever is normal for you.
• The copper T IUD can also be used as emergency contraception to prevent pregnancy if inserted within five days after unprotected sex.

Drawbacks of an IUD

• An IUD requires a clinic visit for placement.
• It does not protect against sexually transmitted diseases (STDs), including HIV. Always use a condom to reduce the risk of STDs.
• Shortly after placement, women may experience side effects like cramping and irregular bleeding.
• Although rare, some women develop pelvic infections, most often within the first three weeks after placement.
• Although rare, IUDs may come out of the uterus.

These methods last for several years. If you want to get pregnant, you can stop using them at any time.

IUD or IUS (intrauterine device or system)

Copper IUD

What is it?

• A T-shaped device containing copper that is put into the uterus by a healthcare provider.

How does it work?

• The IUD prevents sperm from reaching the egg, from fertilizing the egg, and may prevent the egg from attaching (implanting) in the womb (uterus).
• It does not stop the ovaries from making an egg (ovulating) each month.
• The copper IUD can be used for up to 10 years.
• After the IUD is taken out, it is possible to get pregnant.

How do I get it?

• A doctor or other healthcare provider needs to put in the IUD.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

• Out of 100 women who use this method, less than 1 may get pregnant.

Some Side Effects

• Cramps
• Heavier, longer periods or spotting between periods.

Some Less Common Risks

• Pelvic inflammatory disease
• Ectopic pregnancy (a pregnancy outside of the uterus)
• Uterine perforation
• Expulsion - the IUD is no longer in the uterus and therefore there is no pregnancy protection

Does it protect me from sexually transmitted infections (STIs)? No.

IUD with progestin

What is it?

• A T-shaped device containing a progestin that is put into the uterus by a healthcare provider.

How does it work?

• It may thicken the mucus of your cervix, which makes it harder for sperm to get to the egg, and also thins the lining of your uterus.
• The IUD with progestin can be used for up to 3 to 5 years, depending on the type.
• After the IUD is taken out, it is possible to get pregnant.

How do I get it?

• A healthcare provider needs to put in the IUD.
• You may need local anesthesia.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year

• Out of 100 women who use this method, less than 1 may get pregnant.

Some Side Effects

• Irregular bleeding
• No periods (amenorrhea)
• Abdominal/pelvic pain

Some Less Common Risks

• Pelvic inflammatory disease
• Severe infection
• Ectopic Pregnancy
• Uterine perforation
• Expulsion - the IUD is no longer in the uterus and therefore there is no pregnancy protection
• Ovarian cysts

Does it protect me from sexually transmitted infections (STIs)? No.

Implantable Rod

What is it?

• A thin, matchstick-sized rod that contains a progestin hormone.
• It is put under the skin on the inside of your upper arm.

How does it work?

• It stops the ovaries from releasing eggs.
• It thickens the cervical mucus, which keeps sperm from getting to the egg.
• It can be used for up to 3 years.

How do I get it?

• After giving you local anesthesia, a healthcare provider will put it under the skin of your arm with a special needle.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

• Out of 100 women who use this method, less than 1 may get pregnant.

Some Side Effects

• Changes in menstrual bleeding patterns
• Weight gain
• Headache
• Acne

Some Less Common Risks

• Complication of insertion and removing including pain, bleeding, scarring, infection or movement of the implant to another part of the body.
• Ectopic pregnancy
• Ovarian cysts
• It is rare but some women will have blood clots, heart attacks or strokes.

Does it protect me from sexually transmitted infections (STIs)? No.

Contraceptive Injection

This method is given as a shot (injection) every 3 months. If you want to get pregnant, you can stop using this at any time.

Progestin Shot/Injection (Depo-Provera)

What is it?

• A shot of a progestin hormone, either in the muscle or under the skin.

How does it work?

• The shot stops the ovaries from releasing eggs
• It also thickens the cervical mucus, which keeps the sperm from getting to the egg.

How do I get it?

• You need one shot every 3 months from a healthcare provider.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

• Out of 100 women who use this method, including women who don’t get the shot on time, up to 6 may get pregnant.

Some Side Effects

• Loss of bone density
• Irregular bleeding or bleeding between periods
• Headaches
• Weight gain
• Nervousness
• Dizziness
• Abdominal discomfort

Some Less Common Risks

• Ectopic pregnancy
• It is rare, but some women will have blood clots.

Does it protect me from sexually transmitted infections (STIs)? No.