Top 5 questions about an IUD...
Updated: Jun 24, 2020
Intra-uterine devices (IUDs) have become one of the most popular forms of birth control.
Here are the most common questions I get...
1. What type of IUD is best for me?
There are 2 basic types of IUDs:
The progesterone-containing IUDs (Mirena, Kyleena, Skyla, Liletta) help to lighten periods, can help prevent uterine cancer, and there are some smaller versions that are easier to place in women that have not had children yet. These are great options for women who have heavy periods, are significantly overweight (risk of uterine cancer), or are thinking of getting pregnant in next few years.
The copper IUD (AKA Paragard) is "hormone-free" and it may actually make your periods a little heavier, but good for 10 years. Consider this one if your periods are not very heavy and you're looking for 10 years of reliable contraception.
2. Can IUDs cause pelvic infections?
IUDs have been around a long time. When they first came out in the 1950s, they were responsible for an increase in pelvic infections. This isn't the case anymore with modern IUDs, which have been re-designed.
IUDs do not cause infections by themselves, but they could possibly make an infection worse. If you already have an untreated STD (like chlamydia or gonorrhea) at the time of placement, or you get an STD soon after placement, the IUD may help it spread into your uterus and pelvis. (This is called PID, or Pelvic Inflammatory Syndrome.) We usually recommend STD screening with placement if you are at risk for STDs, since this is treatable and preventable.
It is likely an IUD actually decreases your risk of PID after a few months since it thickens cervical mucous and blocks bacteria from entering the uterus.
3. How does an IUD work?
They thicken cervical mucous which blocks sperm from entering.
They are toxic to sperm and stop them from swimming
The progesterone IUDs also thin the lining of the uterus, which helps lighten periods, but you can't count on that for birth control (many an embryo has implanted in a thin lining).
4. Is it painful to get an IUD?
No, it's really not that painful. There is a sharp cramp when it goes in, but it all fades in minutes.
Some tips to make it easier on you..
Take some ibuprofen before your visit.
Try to get it placed when you are on your period. An IUD is easier to place (and there can be less bleeding afterward) if it's placed during - or right after - your period. So if you can schedule your visit during your period, then great (but you don't have to).
If you recently had a baby, an IUD is really easy to place at your postpartum visit.
I always say.. if you go for a 5-mile jog after I place it, then yes you will have cramping, so just plan to relax afterward.
5. Will my IUD have any side effects?
It is normal to have some light irregular bleeding that can last up to 6 months after placement, but it seems it commonly lasts about 1-2 months. This bleeding is usually light.
Some women will get ovarian cysts with an IUD. These cysts are usually small and will go away on their own, but some women may notice them. Ovarian cysts can make you feel bloated, and sometimes they can produce some estrogen, which may cause some nausea or breast tenderness. (so all the symptoms of pregnancy, which is ironic) These cysts will eventually go away on their own, but they may cause some pain when they rupture. I do see women with these cysts every once in awhile, but they usually go away in a month or 2 and women don't seem to get them again.
If you choose an IUD with progesterone in it, there can be a short initial burst of progesterone in your bloodstream after placement, and you may feel that. Progesterone tends to cause some bloating. It will feel just like PMS before your period. But after a few months those hormones are not detectable in your bloodstream, which means they really can't be causing systemic issues. That hormone stays in your uterus and doesn't travel throughout your body. Of course, check with your OBGYN about your symptoms, but it is unlikely your IUD is causing mood changes, weight gain, or any big issues at all.
An IUD might not be for you if you have a heart-shaped uterus or big fibroids. Some women just have a mildly-heart-shaped uterus or small fibroids, which doesn't change the shape of the uterus and the IUD works just fine. Sometimes a fibroid can grow and change the shape of the uterus. So if your uterus is trying to push out that IUD, we might find that's the case and then an IUD isn't your best option.
The worst thing you might hear about and IUD is that it can poke into the uterine wall or go right through it. Out of the hundreds of IUD I have placed, I have only see this happen twice in 15 years. It's rare, but possible. When this happens, women tend to have a lot of bleeding and cramping, so there's usually a warning that something isn't right. I recommend an ultrasound to check on the IUD in any of my patients that are having persistent heavy bleeding and cramping.
So the bottom line is that you really shouldn't be thinking about your IUD after it's placed. If you're in pain or having persistent bleeding and cramping, then you should go see your OBGYN. When an IUD is working well, you forget you even have it.