IUD

While the Paragard and hormonal methods that don’t contain estrogen—the shot, the Mirena IUD, the implant and the mini-pill—are safe for people who are postpartum to use immediately after giving birth, combination pills, which contain estrogen, shouldn’t be used until three weeks after giving birth, since estrogen can increase a postpartum person’s risk of blood clots.

It’s true that the up-front cost of an IUD can be high depending on your insurance, but even paying full price it ends up being pretty cheap considering how long it lasts. Mirena IUD can stay in your body for up to five years, costing you the equivalent of just $9 a month if you pay full price. The Paragard IUD can stay in your body for up to 10 years, costing you the equivalent of just $4 a month if you pay full price.


If you’re on Medicaid or have private insurance, the IUD might be free for you, or at least very cheap, since Medicaid and private insurance often pay for birth control.


If those aren’t options for you, check with the family planning clinics around you and find out if they offer discounts or payment plans for IUDs.


Check out our IUD page for more information about the cost of the IUD.


The IUD is among the most effective methods out there. In fact, both types of IUD—Paragard and Mirena—are over 99% effective.

In other words:

Fewer than 1 out of 100 women will experience an accidental pregnancy during the first year of using an IUD.

The hormonal IUD (Mirena) dramatically reduces blood loss during one’s period, protecting against anemia. It can also reduce menstrual symptoms in women who have fibroids. And, if you’re a woman who can’t use estrogen, both the hormonal IUD and the copper IUD (Paragard) are good options.

In a word, no. The best way to guard against sexually transmitted infections (STIs) if you’re having sex is still the good ol’ condom. If you’re concerned about both pregnancy and STIs, doubling up with the IUD and condoms is a great option.

IUD expulsion, where your IUD comes part of the way or all the way out of your uterus, happens in 2 to 10% of people with an IUD (that’s 2 to 10 out of every 100 people using an IUD) in the first year after insertion. If your IUD has come out of your uterus completely or partially (is sticking out of your cervix), it is no longer going to be effective as birth control, so if you don’t want to get pregnant, make sure you’re using a backup method of birth control, like condoms, if this happens.

Expulsion is more likely if you: 



1. Haven’t been pregnant
2. Are younger than 20 years old

3. Have very heavy or very painful periods (though these are reasons to use a hormonal IUD in the first place)

4. Had your IUD put in right after giving birth or right after having a 2nd trimester abortion.

5. Have a uterus that is an irregular shape (which can be something you’re born with or something caused by fibroids).

It could also happen if the IUD was placed too low in the uterus and just worked its way out. For people who have an IUD expulsion, the chance of expelling another IUD may be higher—around 20% (and up to 30% in some studies), meaning that 20 to 30 out of every 100 people who’ve expelled an IUD in the past will expel another IUD.
If you want to try an IUD again, consider asking your health care provider about inserting the IUD while using an ultrasound machine to make sure it’s inserted in the correct place.

It depends on your situation. Unless you’re in a totally exclusive relationship and you and your partner have both been tested recently for every single STI, using condoms with whatever other birth control method you choose is a good idea. Basically, if there’s any chance you or your partner could have an STI, the only way to decrease the risk of transmitting it is by using condoms, internal condoms, dental dams, and/or PrEP, (a medication which decreases the risk of getting HIV.) Other forms of birth control don’t protect against STIs.

Using a condom with another form of birth control is called dual protection. It means you’re being super-safe and protecting yourself against both pregnancy and STIs.

The pill is the most popular in the United States, but that doesn’t mean it’s a bargain in the long run. For women who know that they don’t want to have a baby for at least a few years—you’re in school, starting a career, or are just not ready—an IUD, the shot, or the implant can save you a bundle of money.

No, most forms of birth control are not effective immediately, so you want to check with you doctor before having unprotected sex. Until then, use a condom for added protection.

Using a method of birth control with estrogen, like the pill, patch, or ring, increases the risk of forming a blood clot, but the risk is so low that if you don’t have any factors that increase your chances of having a blood clot, you can safely use all types of birth control. If you do have an increased risk of blood clots because you’ve had one before you’ve had a stroke or heart attack, or you have a medical condition that increases your risk of a blood clot, like high blood pressure, then adding birth control with estrogen to the mix increases your risk too much and it’s not recommended that you use birth control with estrogen in it. But that doesn’t mean there isn’t a birth control method for you! 


If you can’t take estrogen, you have quite a few options available to you. First you have the non-hormonal methods, like the copper IUD. You can also use any of the hormonal methods that only contain progestin, not estrogen, like the implant, mini-pill, shot, and hormonal IUDs, like Mirena, Skyla, Liletta, and Kyleena. These don’t increase your risk of blood clots and are all really good at preventing pregnancy.

If you’re worried about blood clots or don’t know if you have risk factors, talk to a health care provider about which birth control methods are options for you.

Some methods are much easier to hide than others. The shot and the implant are invisible, so nobody will know you’re using birth control. The IUD is also very discrete, so that’s another possibility, though some guys may be able to feel the strings during sex. And if you are looking for a permanent solution, sterilization surgery is also undetectable, but there may be age restrictions and waiting periods for this procedure.

Yes. The American Congress of Obstetricians and Gynecologists—an association whose members make up 90% of doctors specializing in women’s health in the U.S.—has declared IUDs safe for women of all ages. They also noted that the IUD and the implant, another long-acting method, are more effective than any other form of reversible birth control.