Intrauterine Device (IUD)

I am thinking about an IUD for contraception.
What can you tell me about it?

IUDs currently on the market in the United States:

  • Copper IUD (Paragard)
    • Lasts 10 years
    • How it works: IUD releases a small amount of copper into the uterus; this acts as spermicide to prevent pregnancy. NON-HORMONAL.
    • Product website: Paragard
  • Progestin IUD (Mirena)
    • Lasts 5 years
    • How it works: IUD releases small amount of a hormone (progestin); this thickens cervical mucus and prevents sperm from entering cervix.
    • Product website: Mirena

Things to consider when deciding if an IUD is the right choice for you:

  • IUDs are extremely reliable methods of contraception, 99+% effective, which is roughly equal to sterilization.
  • IUDs are very cost effective, long-term contraceptives.
  • PARAGARD users sometimes have heavier, crampier periods.
  • MIRENA users almost always have irregular or semi-regular but light bleeding. Many Mirena users go on to have no period at all.
  • An ideal IUD candidate is in a mutually monogamous relationship. While an IUD does not cause sexually transmitted diseases, any IUD user who is exposed to an STD (like chlamydia) is at increased risk of developing a serious pelvic infection.

Potential risks are rare but possible include:

  • Expulsion - IUD is pushed out into the vagina; can happen at any time. (will happen to fewer than 5 in 100 women)
  • Perforation - IUD pierces the uterine wall; can only happen at the time of insertion. (will happen to about 1 in 1,000 women)
  • Infection - Primarily is a risk for women who are exposed to STDs like chlamydia. (in a properly screened group of women, will happen to about 1 in 1,000 women)
  • Pregnancy - Very rare. (fewer than 1 in 100 women will get pregnant with an IUD)

Insertion of the IUD:

  • Insertion is done in the office and usually takes only a few minutes. It’s best to schedule insertion for during or right after your period. Most women report mild to moderate discomfort and are able to resume their normal daily activities that day.

If you are interested in pursuing an IUD further please speak with the receptionist about current costs, ordering procedures, and appointment availability.

I have decided to get an IUD.
What are the next steps?

Pre-procedure:

  • Be sure to investigate insurance coverage or payment plans through the manufacturing company for the device and have your IUD ordered and sent to the midwives office for insertion.
  • Abstain from sex or use very reliable contraception for 14 days prior to insertion appointment
  • Take 600 mg ibuprofen with food prior to your appointment time to minimize cramping.
  • Arrive 10 minutes prior to appointment time to give a urine sample for a pregnancy test and complete paperwork and consent form.
  • While we usually welcome your little ones at your appointments, this visit does involve a sterile procedure and you may be more at ease if there is a caregiver for your child either at your home or in the waiting room.

Procedure:

The IUD is inserted using a speculum and sterile technique. The midwife will describe the details of the insertion throughout the procedure. Most women experience a mild to moderate level of discomfort during the insertion. You should be able to resume normal daily activities after the IUD placement.

Post-procedure:

You should not have severe abdominal pain, bleeding heavier than a period, or a fever. Cramping, spotting, and/or vaginal discharge may be present for the first weeks after insertion; they are common and usually disappear by 2 months. Do not use tampons or have intercourse for 24 hours after insertion.

The Mirena IUD is effective immediately if inserted within five days of the start of your period. If you have Mirena inserted at any other time during your cycle use another method of birth control for 7 days after insertion. The Paragard IUD is effective immediately after insertion.

Call the midwife if you have (at any time after IUD insertion):

  • Severe abdominal pain
  • Pain during intercourse
  • Pregnancy symptoms
  • A missed period (Paragard users should not miss periods but Mirena users often have irregular or missed periods)
  • Unusual vaginal discharge
  • A sharp sensation in your vagina/if you can feel the IUD itself