IUD

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.

There are two kinds of IUDs available in the U.S.—with hormones and without. Mirena, LILETTA, and Skyla IUDs release a small amount of the synthetic hormone progestin to help your body keep sperm from reaching your cervix. Both Mirena and LILETTA last up to 8 years; Skyla is slightly smaller than Mirena and lasts up to 3 years.

The Paragard IUD is hormone-free and doesn’t alter your periods. It’s made of plastic and a small amount of natural, safe copper and can work for up to 12 years.

It depends which kind you get. Skyla is approved for up to 3 years and Kyleena is approved for up to 5 years. Mirena and LILETTA are both approved for up to 8 years. The non-hormonal Paragard IUD is approved for up to 10 years but lasts for 12 to 20 years.

For about 1 in 2,000 women, the IUD can get stuck in or puncture the uterus—also known as perforation. Perforation only happens when the IUD is being put in. Highly skilled providers who have inserted many IUDs are less likely to have perforations. Women who are breastfeeding or have given birth within the last month are more likely to experience perforations because the muscle of the uterus is softer at those times.

What does it mean if there is a perforation? If it’s recognized immediately, the health care provider will stop the insertion. It takes about a week for the uterus to heal, and then a woman can have another IUD inserted if she wants. More than half of perforations may go unrecognized at the time of insertion. That may mean that a woman thought she had great birth control when she may not have. If undiagnosed for months, a perforation can make removing the IUD difficult, and can sometimes require surgery. Even in the worst-case scenario of an undiagnosed perforation that requires surgery, it shouldn’t have an impact on the woman’s future fertility.

You may be able to find some stories online about people removing their own IUD, but we wouldn’t recommend trying it. There just isn’t enough research at this point to know if it’s safe.

Plus, if you’re not happy with your IUD, going to your health care provider to get it removed will give you a chance to ask about other options for birth control. Or if you’re ready to get pregnant, you can talk with your provider about things you should do to prepare for a healthy pregnancy.

Levonorgestrel is one of the longest-studied types of progestin, and all the scientific evidence to date shows it is super safe. It’s used in hormonal IUDs, some emergency contraception pills, and certain birth control pills.

Skyla and Mirena are pretty similar, but Skyla lasts for up to 3 years while Mirena lasts for up to 8 years. Also, Skyla is slightly smaller than Mirena and was FDA-approved for women who’ve never had a child, though both IUDs are totally safe for most women to use, regardless of their parental status.

As far as tampons and IUDs go, Planned Parenthood puts it like this: “Tampons and IUDs are kind of like next-door neighbors. They’re close but they live in different parts of the reproductive system. An IUD and a tampon are separated by the cervix, and don’t interfere with each other’s business.”

You should be fine as long as you are careful not to pull on the IUD strings, which you shouldn’t need to worry about too much since the string of a tampon is outside of your vagina and the strings of your IUD should be up near your cervix. (If you find that your IUD strings are anywhere near your tampon strings, you should go see your health care provider because your IUD might be expelled.)

As long as you’re careful to avoid suction or pulling your IUD strings when you remove your menstrual cup, it’s fine to use a cup and an IUD together. A recent study found that the “use of tampons or menstrual cups does not increase the risk of early expulsion of an IUD.” The packaging information for IUDs can be inconsistent, but women “can use whatever their usual menstrual product is and not increase their risk of expelling the IUD.”

Menstrual cup brands are in agreement about this. DivaCup, MoonCup/Keeper, MeLuna, Lunette, and SoftCup say that because of the physical placement of your cup, you should be fine combining one with an IUD. If you can, try to double check with your health care provider first to be on the extra-safe side.

Getting an IUD removed may be a bit uncomfortable, but generally the procedure is easier, quicker, and less painful than getting the IUD inserted.

If you have dysmenorrhea (the medical term for extremely painful periods), hormonal birth control can make a big difference. Options like the combination pill or a hormonal IUD can reduce the level of pain and heaviness of your bleeding, basically making it easier for you to live your life when you have your period. There are a bunch of hormonal methods that can help regulate your periods, decrease bleeding, or even make your period go away completely.