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IUD

The IUD is a little, t-shaped piece of plastic that gets put in your uterus to mess with the way sperm can move and prevent them from fertilizing an egg. Sounds odd, but it works like a charm. IUDs offer years of protection—between three and twelve, depending on the type you get. And if you want to get pregnant, you can have them removed at any time. In the U.S. there are three types of IUDs: Mirena and ParaGard, which are already widely available, and a new IUD called Skyla. view all methods »

types of IUDs

  • MIRENA

    This plastic IUD releases a small amount of the synthetic hormone progestin to help your body keep sperm from reaching your cervix. It lasts up to 5 years and may give you lighter periods.

  • PARAGARD

    This IUD is 100% hormone-free and doesn’t alter your periods. It's made of plastic and a small amount of natural, safe copper. It can stay inside you up to 12 years.

  • SKYLA

    This plastic IUD is the smallest one available and has been FDA-approved for women who have not had a child. It releases a small amount of the synthetic hormone progestin to help keep sperm from reaching your cervix. It works for up to 3 years.

Get it and forget it

If you're a busy person who doesn't want to worry about remembering birth control, the IUD just may be for you. Once it's in, you're good to go for years.

Hands free

No packages or prescriptions to pick up at the pharmacy, so there's nothing that could get lost or forgotten.

Total privacy

No one can tell when you have an IUD. (Some partners say they can feel the string, but that can be adjusted.) There's no tell-tale packaging, and nothing you need to do just before you have sex.

Safe and sound

Most experts agree, if you’re a healthy woman, you’re probably a good candidate for the IUD. That’s true even if you’re young, haven't ever been pregnant, or haven’t had kids yet.

The pregnancy question

You should return to fertility (fancy way of saying you should go back to being able to get pregnant) very quickly after you have the IUD removed. Which is great if you want to have a baby. But if you're not ready to get pregnant as soon as you have an IUD taken out, be sure to protect yourself with an alternate method.

Don't take our word for it. Check out the videos above to hear women and men talk about their experiences with the IUD. And be sure to ask your health care provider which method is best for you.

Thanks to the Affordable Care Act, if you have health insurance, chances are good that you’ll be able to get this method with no out-of-pocket cost.

If you don’t have insurance and you’re not on Medicaid, this method can be pricey up front. Still, the IUD can stay in place for years, so it becomes downright cheap over time. The Mirena IUD can stay in your body for up to five years, costing you the equivalent of just $9 a month. The ParaGard IUD can stay in for up to 12 years—more than a decade!—costing you the equivalent of just $4 a month. (We’re still waiting for details on how much the new hormonal IUD, Skyla, will cost without insurance.) For all three IUDs, there may be an additional cost to insert and or remove them.

Prices for Mirena*

  • This method may be free or low-cost for you
  • With Medicaid: Free
  • With insurance: Free under most plans
  • Without insurance: About $550 + $64/$25 to insert/remove (Planned Parenthood); $844 (manufacturer)

    To see how this translates over a year, here’s what it would cost to pay for Mirena month-to-month at full price:

  • Cost per month over one year: $46 (Planned Parenthood); $70 (manufacturer)

  • Cost per month over five years: $9 (Planned Parenthood); $14 (manufacturer)

  • Payment assistance: If you don't have insurance, the manufacturer offers a couple different payment plans, where you can make 4 or 24 monthly payments. Contact CVS Caremark Mirena Specialty Pharmacy at 1-866-638-8312 or the manufacturer at www.mirena-us.com or 1-888-842-2937. Also, check with your local family planning clinics and find out if they offer free or low-cost IUDs (many do).


Prices for ParaGard*

  • This method may be free or low-cost for you
  • With Medicaid: Free
  • With insurance: Free under most plans
  • Without insurance: About $450 + $64/$25 to insert/remove (Planned Parenthood); $754 (manufacturer)

    To see how this translates over a year, here’s what it would cost to pay for ParaGard month-to-month at full price.

  • Cost per month over one year: $38 (Planned Parenthood); $63 (manufacturer)

  • Cost per month over five years: $8 (Planned Parenthood); $13 (manufacturer)
  • Cost per month over 10 years: $4 (Planned Parenthood); $6 (manufacturer)

  • Payment assistance: If you don't have insurance, the manufacturer offers a few different payment plans, where you can make 4, 12, or 19 monthly payments. Contact the manufacturer at www.paragard.com or 1-877-727-2427 to find out more. Also, check with your local family planning clinics to find out if they offer free or low cost IUDs (many do).


Not bad, huh?


* FYI: This info is based on recent survey of Planned Parenthood clinics and birth control manufacturers. Your cost may vary. Some clinics accept private insurance; some don’t. If you don’t have private insurance, be sure to ask your doctor or clinic about Title X, Medicaid waivers, or other programs that could reduce the cost of your birth control.

If you want to get an IUD, the first thing you'll need to do is talk with your doctor. She or he will ask you a bunch of questions about your medical history and your lifestyle, then give you an exam to make sure the IUD is right for you.

You can get the IUD inserted any time of the month. Some doctors like to insert it during your period, but any time is fine as long as you can be sure you're not pregnant. It may be the most comfortable to get it done during the middle of your period, if you can believe that. (That's when your cervix—the opening to your uterus—is open the most.)

It's pretty common to feel some cramps when you get an IUD inserted, but they'll go away with rest or pain medication. Some women might feel dizzy, too. Once the IUD is in, you'll notice a little string that hangs down into your vagina. That's there so that the IUD can be removed later. (The strings don't hang out of the vagina like a tampon, though.)

After it's in, there's really not much you have to do other than check the string ends from time to time to make sure it's in place. Here's how:

  1. Wash your hands, then sit or squat down.
  2. Put your finger in your vagina until you touch your cervix, which will feel firm and rubbery like the tip of your nose.
  3. Feel for the strings. If you find them, congrats! Your IUD is good to go. But if you feel the hard part of the IUD against your cervix, you may need to have it adjusted or replaced by your doctor.

p.s. Don't tug on the strings! If you do, the IUD could move out of place.

p.p.s. If you don't feel comfortable checking for the strings, you can let your doctor do that the month after insertion, and then yearly after that.

There are positive and negative things to say about each and every method. And everyone's different—so what you experience may not be the same as what your friend experiences.

The Positive

Positive “side effects”? You bet. There are actually lots of things about birth control that are good for your body as well as your sex life.

The Negative

Everyone worries about negative side effects, but for many women, they're not a problem. Most women adjust to having an IUD pretty quickly, but give yourself time. It could take a few months.

  • Easy to use
  • Doesn't interrupt the heat of the moment
  • Super long-lasting protection without much effort
  • Safe for smokers and those with hypertension and diabetes
  • The ParaGard brand of IUD doesn't change your hormone levels
  • The Mirena brand of IUD may reduce cramps and make your period much, much lighter. (Some women's periods stop completely.)
  • You can use it while you're breastfeeding
The most common complaints:
  • Spotting between periods (especially during the first few months after you get an IUD)
  • Increased period flow (for users of the ParaGard brand)
  • Cramps and backaches
Other stuff to watch out for:
  • IUD slipping out
  • Infection
  • IUD pushing through the wall of the uterus

If you still feel uncomfortable after three months, switch methods and stay protected. You're worth it.

*For a very small number of women there are risks of serious side effects.

We’re here to get this method working better for you. And if it still doesn’t feel right, we've got ideas for other methods. Just remember: If you change methods, make sure you’re protected while you switch.

  • ...I'm worried that my IUD will hurt my partner.

    The IUD shouldn't hurt your partner. You may have heard that the IUD strings can bother men while having sex, but most partners can't even feel the strings. If your partner can feel the strings, and that bothers him, your healthcare provider might be able to trim them. Plus, they usually soften over time.

  • ...I'm spotting a lot—should I be concerned?

    Spotting, which can happen with a bunch of different methods, doesn’t make you lose that much blood, even though it might seem like it. We have a Provider Perspective article about spotting if you want to learn more.

    Still not working?

    You may have more luck on a pill with a slightly higher dose of estrogen, or one that provides estrogen during a different part of your cycle.

    Try a different method...

  • ...My periods are heavier and/or my cramps are worse.

    If this is the case, you're probably using a copper IUD (ParaGard). Sometimes things get better if you just give it a couple months. You can also take ibuprofen the first few days of your period.

    Still not working?

    If you like the ease of using an IUD, but find that the side effects don't get better with time or painkillers, you could try switching to a hormonal IUD (Mirena) or to the implant.

    Try a different method...

  • ...My partner can feel the string.

    If your partner can feel the strings, you can have the strings cut shorter. Just ask your health care provider. Also, the strings usually get softer over time.

  • ...I want to get pregnant.

    This one is easy. If you're ready to get pregnant, just have your IUD removed. The hormones in your body should go back to normal quickly and you can start trying right away.

  • ...I heard the pill is bad for the environment.

    Any form of birth control is better than no birth control when it comes to the environment. Still some people insist on “green” contraception. We say: Any effective method of contraception is green since the impact of birth control pales in comparison to the impact of another human.

    Still others say, “green contraception” means “hormone free.” We don’t dispute that that is one way to look at the issue. And fortunately, there are many contraceptives already on the market that are hormone free: condoms (male and female), ParaGard IUD, diaphragms, cervical cap, and the sponge.

    But a lot more goes into a green stamp of approval. The ParaGard IUD is generally thought to be the “greenest” contraceptive. It’s hormone-free, long lasting (up to a decade embracing the reduce portion of the "reduce, reuse, recycle" mantra), made from small amounts of cheap, plentiful metal (copper), and 99% effective. If for whatever reason you don't feel like the IUD is right for you, choose another method. Because when it comes to having sex, the greenest thing you can do is use birth control.

    Still not working?

    There are lots of hormone-free methods to choose from: male condom, female condoms, ParaGard IUD, diaphragm, cervical cap, fertility-awareness methods, and sponge.

    Try a different method...

  • ...My IUD was expelled. What's the likelihood it'll happen again?

    IUD expulsion can occur in 5-10% of women in the first year after insertion. Expulsion can be more likely for women who:

    • Haven’t been pregnant
    • Are younger than 20 years
    • Have a history of very heavy or very painful periods (though be mindful that these are reasons doctors recommend the hormonal IUD in the first place…)
    • Had the IUD put in right after giving birth or having a 2nd trimester abortion.

    A partial expulsion may mean that the IUD was not quite in the right position: it may have been too low in the uterus and just worked its way out. This could be something that happened around the time of insertion, or may be related to uterine characteristics, such as size, angle, or presence of conditions like fibroids that can cause irregular shape. For women who have an IUD expulsion, the chance of expelling a 2nd IUD may be higher – in the 20% range (up to 30% in some studies).

    If you want a second IUD after the first one came out, consider asking your doctor about inserting the 2nd IUD while using an ultrasound machine to make sure the IUD is inserted all the way to the fundus.

    Still not working?

    If you like the ease of using an IUD, but are having problems with expulsion, you could try switching to the implant--a long-acting and low-maintenance option.

    Try a different method...

  • ...I'm afraid that getting the IUD inserted will hurt.

    IUD insertion pain can vary from person to person, but unfortunately there isn't a great drug to take to make insertion less painful.

    You can try taking ibuprofen beforehand, and make sure you get the IUD inserted when your cervix is open, such as when you're on your period or ovulating. Even if there is some pain, it might be worth it for years of worry-free boot knocking.

quick facts /

  • Effective, long-lasting, reversible, and you can choose hormonal (Mirena and Skyla) or non-hormonal (ParaGard).

  • It's one of the most effective methods.

  • With ParaGard you might have increased blood flow, cramping.

  • It's inserted once and lasts for years.

effectiveness

Perfect use
Greater than99%
Typical use
Greater than99%
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