An intrauterine device (IUD) is a piece of T-shaped plastic (or copper) that’s placed inside the uterus to prevent pregnancy. It lasts several years and is 99 percent effective in pregnancy prevention when used properly.
Most IUDs (except Paragard) use a hormone similar to naturally-occurring progesterone to prevent pregnancy. All five IUDs can start working immediately once they’re placed, and fertility usually returns right after removal.
It’s important to do your research on the different types of IUDs and talk with your doctor about choosing the right IUD for you. You’ll need to consider cost, side effects, and whether you want to use hormones.
Here, we’ll talk about the cost of IUDs, the types available, and the considerations to make when choosing one.
In most cases, the Affordable Care Act allows you to get birth control at no cost to you, including IUDs.
Depending on where you go, you may need to pay the additional cost for insertion and removal by a healthcare professional.
What if you don’t have insurance?
If you don’t have insurance, you can find a hospital or clinic that uses the 340B Drug Pricing Program. You can also check out a Planned Parenthood center to see if you can get an IUD for cheaper.
Getting an IUD out of pocket can cost anywhere from $500 to $1,300.
In order to get an IUD, you need to go to a healthcare professional for insertion. A doctor, nurse practitioner, or other qualified professional can put an IUD in.
This appointment can be done in a primary care office, OB-GYN office, or community clinic, such as Planned Parenthood. The medical professional will place the IUD into your vagina, through your cervix, and into your uterus. The process takes about 15 minutes.
There are currently five IUDs that are FDA-approved for use in the United States.
Mirena
Mirena is the most popular IUD in the United States. It’s FDA-approved to treat those with heavy periods.
- Hormones: levonorgestrel 20 μg/day
- How long it lasts: 5 years
- Average cost: $999 out of pocket
- Failure rate: 0.2 percent
- Long-term effects: lighter periods, irregular cycles, and potential to stop periods after a year
- Side effects: 3–6 months of spotting or irregular periods
- Who it’s best for: people with heavy periods
Skyla
Skyla is smaller than others on the market, but it’s just as effective.
- Hormones: levonorgestrel 14 μg/day
- How long it lasts: 3 years
- Average cost: $982 out of pocket
- Failure rate: 0.2 percent
- Long-term effects: lighter periods, irregular cycles, and potential to stop periods after a year
- Side effects: 3–6 months of spotting or irregular periods
- Who it’s best for: those looking for lower hormone options, or a smaller IUD
Liletta
Liletta was FDA-approved in 2015 and is a great option for those who are uninsured or underinsured.
- Hormones: levonorgestrel 18.6 μg/day
- How long it lasts: up to 6 years
- Average cost: up to $934 out of pocket (Patient savings program available)
- Failure rate: 0.2 percent
- Long-term effects: lighter periods, irregular cycles, and potential to stop periods after a year
- Side effects: 3–6 months of spotting or irregular periods
- Who it’s best for: those without insurance or those looking for a cheaper IUD option
Kyleena
Kyleena uses a low level of hormones and can last for 5 years. A co-pay savings program is available if you have high out-of-pocket costs with insurance.
- Hormones: levonorgestrel 17.5 μg/day
- How long it lasts: 5 years
- Average cost: $999 out of pocket
- Failure rate: 0.2 percent
- Long-term effects: lighter periods, irregular cycles, and potential to stop periods after a year
- Side effects: 3–6 months of spotting or irregular periods. Oarian cysts can occur, but usually go away on their own.
- Who it’s best for: those who want a longer-lasting and smaller IUD
Paragard
Paragard is the only IUD without hormones. It uses copper to prevent unwanted pregnancy, and has been FDA-approved for 30 years. It works by preventing sperm from reaching the egg. However, it won’t prevent you from having a natural menstrual cycle.
- Hormones: none
- How long it lasts: 10 years
- Average cost: $1,043 out of pocket
- Failure rate: 0.8 percent
- Long-term effects: periods may return to normal after 6 months or could remain heavy and irregular
- Side effects: longer, heavier, and more frequent periods
- Who it’s best for: those who can’t or don’t want to take hormones
Most insurances will cover the cost of an IUD.
However, if you need to pay out-of-pocket, there are several options that may be available. Certain IUD manufacturers work with specialty pharmacy partners to make the cost less. There may also be copay or pricing programs available.
You may also qualify for Medicaid or another state program that can help you with the cost of an IUD.
Some insurance plans don’t cover all brands of IUDs. If that’s the case, talk with your insurance company to find out which ones they cover.
How quickly does an IUD work to prevent pregnancy?
Depending on the type of IUD, you might need to use a backup form of birth control after it’s in place.
Mirena, Liletta, and Paragard start working immediately to prevent pregnancy.
Skyla and Kyleena work right away, but they need to be placed within 7 days of your last period. If they’re placed outside this window of time, you’ll need to use another form of birth control for the first 7 days after insertion.
Is it painful to get an IUD placed?
You might have some cramping and pain with placement that should go away with time — it’s unique to every person. You can take a pain reliever, such as ibuprofen or acetaminophen, beforehand to help minimize cramping.
Some people experience dizziness or feel faint after the IUD is inserted. If you can, bring someone with you to drive you home. You may want to take it easy for the rest of the day.
What are the disadvantages of getting an IUD?
You need to make sure you’re checking monthly that your IUD is still in place. There’s a chance it could slip out, and if so, you could get pregnant.
IUDs don’t prevent sexually transmitted infections (STIs). So, if you’re at higher risk for an STI, you may want to consider another form of birth control or an additional barrier method.
Your periods may be irregular for the first 6 months after placement, but this usually goes away. The Paragard IUD might make your periods heavier and menstrual cramps worse.
When considering an IUD to prevent pregnancy, it’s important to talk with your doctor. They can answer your questions, help you weigh the risks and benefits, and help you decide which one is right for you.
Risa Kerslake is a registered nurse, freelance writer, and mom of two from the Midwest. She specializes in topics related to women’s health, mental health, oncology, postpartum, and fertility content. She enjoys collecting coffee mugs, crocheting, and attempting to write her memoir. Read more about her work at herwebsite.