University Health Service

Intrauterine Device

How to Prepare for Your IUD or Implant Insertion

What is an IUD?

An IUD is a small, T-shaped device that is made from a flexible plastic and is used to prevent pregnancy. There are four kinds of IUDs. The ParaGard IUD contains copper and the Mirena, Liletta and Skyla IUDs contains the hormone progestin. The ParaGard IUD can be used as an emergency birth control if it is inserted within the first 5 days after unprotected sex.
 

Brand and Duration of Protection
Hormones 
Efficacy
Menstrual Effects
Mirena - 5 years Releases progestin 99.9% Lighter periods, periods may be irregular or stop altogether, decreased cramping
Paragard - 10 years No hormones, contains copper 99.4% Heavier periods, increased cramping
Liletta - 3 years - NOT OFFERED at UHS Releases progestin 99.9% Lighter periods, periods may be irregular or stop altogether, decreased cramping
Skyla - lasts 3 years - NOT OFFERED at UHS Releases progestin 99.9% Lighter periods, periods may be irregular

How does it work?

IUDs are inserted in the uterus by a health care provider to prevent pregnancy. All IUDs affect the way sperm move to prevent the sperm from fertilizing an egg. IUDs also change the lining of the uterus, which is thought to prevent a fertilized egg from attaching to the wall of the uterus.

The progestin hormone in the Mirena and Skyla IUD prevents pregnancy by keeping ovaries from releasing eggs (ovulation). If there are no eggs for the sperm to fertilize, then pregnancy cannot happen. Progestin also thickens cervical mucus to help block sperm from entering the uterus and joining an egg.

How effective is it?

IUDs are one of the most effective methods of birth control. Less than 1 out of 100 women using IUDs will get pregnant each year.

What are the benefits?

  • While the initial cost may seem expensive, over time IUDs are the least expensive and longest lasting method of birth control.
  • You do not have to remember to take it every day/week/month or every time you have sex.
  • An IUD is a good option for users who cannot use estrogen or who are breastfeeding.
  • The ParaGard IUD (copper) does not affect your hormone levels.
  • Hormonal IUDs may reduce cramps and make your period lighter. Periods may stop altogether, which some users consider a benefit.
  • Your ability to become pregnant quickly returns after the IUD is removed.

What are the downsides?

  • Spotting between periods for the first 3-6 months.
  • Cramps and backache for the first month after the IUD is inserted. With time, these decrease in intensity and frequency.
  • IUDs do not protect against sexually transmitted infections (STI). 
  • The IUD may slip out of the uterus, either partially or completely; this is called expulsion. If it comes out even a little bit, it must be removed. If the IUD slips out, pregnancy can happen.
  • Perforation: When an IUD is inserted, it may push through the wall of the uterus, but this is uncommon (less than 1% of users).
  • Risk of infection that decreases after the first 20 days after IUD insertion.

How do I check my IUD?

You should check your IUD every month to make sure it has not slipped out. An IUD is most likely to slip out of place during your period. IUDs have strings attached to them. Between periods you can check for the strings by following these steps:

  • Wash your hands.
  • Sit or squat down.
  • Put your index or middle finger up into your vagina until you touch the cervix.
  • Feel for the string ends that should be coming through. If you find them, then the IUD is in place and working.
  • If the strings feel longer or shorter than before, or you feel the hard, plastic part of the IUD against your cervix, the IUD may have moved.
  • If the IUD has slipped out or moved, do not try to put it back in place on your own. Be sure to use a back-up method of birth control until you see your health care provider.

Where can I get it and what are costs?

IUDs (ParaGard and Mirena) are available at UHS. See Schedule an Appointment, and Cost, Insurance and Payment.

How to Prepare for Your IUD or Implant Insertion

Important tips:

During insertion, your clinician will:

  • Put a speculum into your vagina
  • Cleanse the area with antibacterial solution to minimize the chance of infection
  • Put an instrument on your cervix to stabilize it; this will cause cramping
  • Put an instrument into your uterus to measure its depth
  • Insert the IUD

You should not use an IUD if you:

  • Have or may have a current STI or other pelvic infection
  • Think you might be pregnant
  • Have cervical or uterine cancer
  • Have unexplained vaginal bleeding
  • Are or may be allergic to copper (ParaGard IUD only)

Personal experiences

I got the Mirena IUD inserted almost 4 years ago. Other than the initial cramping at insertion, I have had a great experience with it. I did have some initial spotting my first month but it's been smooth sailing since. I remember reading that some people gained weight; this never happened to me. I love this IUD and highly recommend it to anyone! (I have also tried Depo-Provera and birth control pills, neither of which were as stress-free as Mirena.)

I've had my Paragard IUD in for about 8 months now and I'm extremely satisfied with it. I experienced minor side effects of cramps and increased blood flow the first couple of months but after that everything went back to normal.  I would highly suggest it for others who need a long term birth control with minimal side effects and no hormones but at the same time would like to get pregnant in the future. It is so convenient not having to worry about birth control before every time I want to have sex.

Where can I get more information?

Talk to your health care provider. You can also get reliable information from the following websites: