A Guide to IUDs

When it comes to birth control, there are more choices than ever in regard to planning when -- or if -- to start a family. Pills, vaginal rings, implants and injections are just a few of the options that are open in modern contraception. And among these choices are intrauterine devices, or IUDs. Read on to find out more about this form of birth control and whether it may be right for you.

What are IUDs and how do they work?

An IUD is a small, flexible T-shaped device made out of plastic, silicone or copper (also known as a “coil”) that’s inserted into the uterus as a form of contraception. It’s implanted into your uterus in a procedure similar to a PAP smear, which takes place in your physician’s office. Minor pain and bleeding can result from this initially, but quickly resolve.

There are two different types of IUDs available, they can be copper-based or hormonal. The way an IUD works depends on the type of IUD that is used.

  • All IUDs alter the way the sperm moves inside the uterus in order to prevent it from making contact with the egg, thus preventing conception; they also prevent fertilized eggs from implanting in the uterus.

  • Copper IUDs use the spermicidal properties of copper to provide extra protection. Copper also acts on the immune system to help prevent pregnancy as well.

  • Hormonal IUDs use a hormone similar to progesterone to prevent ovulation.

What are the pros and cons of IUDs

There are a number of advantages to IUDs that make them very attractive to women as a form of birth control:

  • They are very effective and reduce the risk of an unwanted pregnancy by 99%.

  • They are even effective as a form of emergency contraception. If an IUD is inserted within 5 days of unprotected sex, the chances of pregnancy are reduced by 99.9%.

  • They provide long-term pregnancy protection. Depending on the type of IUD you choose, you can expect it to provide anywhere from 3-6 years with hormonal IUDs to 12 years with copper IUDs.

  • They provide reversible contraception. Another great thing about IUDs is that if you change your mind about family planning and want to get pregnant sooner than planned, the IUD can be removed and you can get pregnant again right away.

  • Hormonal IUDs can make periods lighter, which makes them attractive for women who have heavy periods.

  • IUDs can be used with a menstrual cup. Read our article ‘Can you use a Menstrual Cup with an IUD?’ to find out everything you need to know.

However, every person is different, and IUDs are not right for everyone. There are some disadvantages of IUDs that women should know about before deciding to use this form of contraception. These include:

  • IUDs can be expensive to implant, costing up to $1000 up front. 

  • IUDs in general are not recommended for women with STDs or pelvic infections, are pregnant or have cervical or uterine cancer.

  • Copper IUDs are not recommended for women with copper allergies or a condition called Wilson’s disease; also, they can cause periods to become heavier, at least in the beginning.

  • Hormonal IUDs are not recommended for women with liver disease or breast cancer.

  • In around 1 out of every 1000 cases, an IUD can cause a tear in the uterus and will have to be surgically removed.

  • The individual shape or size of your uterus can make the insertion of an IUD difficult or impossible.

If after reading this, you believe that IUDs might be a good form of birth control for you, talk to your gynecologist or primary care provider to get more information about the appropriateness of this contraception. Be sure to give them your full medical (including gynecological/obstetric) history, including your current list of medications and supplements in order to make sure that IUDs are a good contraceptive choice for you and your lifestyle.