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Intra Uterine Device (IUD)

IUD stands for Intra Uterine Device, which is a small "T shaped" device that is inserted through the vagina and cervix into the uterus. This form of birth control prevents pregnancy but does NOT protect against sexually transmitted infections.

These Types of IUDs Currently Used in the US. 

  • Kyleena – Releases small amount of progestin (hormone); works for up to five years.
  • Liletta- Releases small amounts of progestin (hormone); works up to 3 years
  • Mirena – Releases small amount of progestin (hormone); works for up to five years.
  • Paragard – Contains copper; works for up to 10 years
  • Skyla – Releases small amounts of progestin (hormone); works for up to 3 years

These IUDs work by preventing sperm from joining with an egg. Additionally, the progestin in the Mirena helps thin the lining of the uterus and reduces the frequency of ovulation. When inserted there are small strings that hang into the vagina. A woman can touch the strings with a finger to know her IUD is in place. The IUD is removed in a physician’s office by using the strings. The IUD is 99% effective at preventing pregnancy.

The Mirena IUD tends to cause lighter menstrual bleeding.  Initially irregular or heavy bleeding may occur for up to 3 months. Eventually, many women stop having menstrual cycles all together. The Paragard IUD may cause slightly heavier or stronger menstrual bleeding and cramping but works for twice as long and does not have any potential hormonal side effects.

Possible Complications

  • Expulsion: infrequently the IUD can partially or totally slip out of the uterus.  It is more likely in younger women.  If partially expelled it will need to be removed.  Another form of birth control will need to be used immediately until the IUD can be replaced.
  • Uterine Perforation: rarely the IUD can go through the wall of the uterus.  The IUD will need to be removed right away. Surgery may be needed to remove the IUD.
  • Uterus Infection: increased chance within first twenty days after insertion.  After the first twenty days, the risk of having an infection is the same as everyone else
  • Painful Intercourse: this is rare and often improves with adjustment of the string length or change in sexual positioning.

Warning Signs

It is important to call your doctor immediately if you:

  • Find the string length has become shorter or longer
  • Cannot find the string
  • Feel the hard plastic bottom of the IUD
  • Worry that you may be pregnant
  • Periods are much heavier or longer
  • Have abdominal pain
  • Have pain or bleeding after sex
  • Have unexplained fever / chills
  • Have flu-like symptoms
  • Have unusual vaginal discharge
  • Are late for your period
  • Have abnormal vaginal bleeding

You Should Not use an IUD If you:

  • Have had a pelvic or uterine infection in the past three months
  • Have or may have a sexually transmitted infection
  • May be pregnant
  • Have cervical cancer that is not treated
  • Have uterine cancer
  • May be allergic to copper (ParaGuard has copper)
  • May have liver disease (Mirena only)
  • May have or have had breast cancer (Mirena only)

IUD Maintenance

It is important to check for your string between yours periods. To do this, wash your hands, then put your index or middle finger into your vagina until you feel the cervix (it feels like the tip of your nose). Feel for the string ends coming through.  If you find the strings then the IUD is in place and working. If the strings are longer or shorter than before call the doctor and use another form of birth control.

IUD Removal

Having an IUD removed is easy and should be done in the office. A new IUD can be replaced right after removal of the old one. Fertility usually returns quickly after removal.

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