An intrauterine device (IUD) is a long-term method of birth control. It’s a small T-shaped device that’s inserted into your uterus. IUDs are made of plastic or copper. Some also contain hormones.
Hormonal IUDs are effective for three to 5 five years. Copper IUDs are effective for 10 years or more. There are other benefits to using an IUD, such as convenience. Once it’s in, there’s nothing else you have to do or remember. The initial expense may be high, but there’s no ongoing cost.
When you no longer want it, your doctor can easily remove it. Fertility should return within a few weeks, if not sooner.
A doctor or other healthcare professional must place the IUD in your uterus. This can be done in a doctor’s office or clinic on an outpatient basis.
Before it’s inserted, the IUD is flat. It also has strings hanging from the end. The following steps occur during an IUD insertion:
- After performing a pelvic exam, your doctor will apply antiseptic in your vagina. Using a special applicator, they’ll insert the IUD through the cervix.
- Once the IUD reaches the top of the uterus, your doctor will expand it into a T shape. At that time, you may feel some cramping.
- Your doctor will cut the strings to the right length. The strings will hang down through your cervix and into your vagina.
Once it’s in place, you won’t feel the IUD. The procedure takes only a few minutes. You may have some spotting and minor discomfort for a few weeks after insertion. Your doctor will let you know how and when to check your IUD between visits.
The IUD works by thickening cervical mucus to make it harder for sperm to get through. It also affects the lining of the uterus. This change in the lining makes it harder for a fertilized egg to implant. Some brands of IUD contain hormones to help prevent ovulation.
Cost of an IUD
The symptoms of an infection may include:
- lower abdominal pain
- vaginal discharge, possibly with a foul odor
- pain when urinating
- painful intercourse
- a fever
- irregular menstruation
See your doctor right away if you’re experiencing any of these symptoms.
IUDs don’t directly cause infections. If you have an existing infection, inserting the IUD may spread it. Two common sexually transmitted diseases (STDs) are chlamydia and gonorrhea. That’s why some doctors may want to test for STDs before inserting an IUD.
According to the Office on Women's Health, you’re at slightly higher risk of pelvic inflammatory disease (PID) for a few weeks after your IUD is inserted. PID is an infection of your reproductive organs.
The vagina normally contains some bacteria. If bacteria are pushed up into the reproductive organs during IUD insertion, it may result in PID.
The IUD seems a bit mysterious. One reason some women are wary has to do with the Dalkon Shield IUD. This IUD was first marketed in the United States in the 1970s. Women using them experienced a high rate of pelvic infections and perforations. Deaths were reported and more than 200,000 lawsuits were filed. The Dalkon Shield was eventually pulled from the market.
Today’s IUDs are considered much safer. Side effects may include spotting between periods or mild cramping in the first few months.
It doesn’t happen often, but your IUD can slip out of place, especially if you’ve never had a baby. If that happens, you’re more likely to get pregnant. In very rare instances, the IUD can perforate the uterus. An IUD that’s out of place requires immediate medical attention.
An IUD isn’t a good choice for everyone. You may not be able to use one if you:
- have abnormalities of the uterus
- recently had pelvic inflammatory disease
- had or are at high risk of STDs
- need treatment for cervical, endometrial, or ovarian cancer
You may not be able to use certain IUDs if you’re allergic to copper. If this is the case, you can still use Mirena or Skyla. You also may not be able to use certain IUDs if you have liver disease, but you can still use ParaGard if this is the case.
Your doctor will be able to tell you about the different types of IUDs and whether or not an IUD is a good choice for you.
The first step in diagnosis will likely be a physical exam. Your doctor may also want to perform blood and urine tests. If necessary, an ultrasound or other imaging tests may be required.
Untreated PID can permanently damage your organs. Pelvic infection can lead to infertility or chronic pain.
The sooner you start treatment, the better. That usually involves taking antibiotics. Other treatments will depend on what type of infection you have.
You don’t necessarily need to have your IUD removed. That said, this may be advisable if the infection doesn’t show signs of improvement within a few days.
Studies show that treatment outcomes for women who keep the IUD versus women who have it removed are about the same, according to the Centers for Disease Control and Prevention (CDC). Those studies involved only IUDs that don’t contain hormones.
Follow your doctor’s recommendations and continue with your follow-up care.
IUDs raise the risk of infection for only a few weeks. On the other hand, they don’t offer any protection against infection, sexually transmitted or otherwise. One way to lower your risk of STDs is to use a condom.
You can also prevent infection by not douching. Your vagina has naturally occurring bacteria. Douching increases the risk of spreading bacteria up into your reproductive organs.
See your doctor right away if you have signs of infection. Early treatment can prevent it from spreading.