An intrauterine device (IUD) is inserted into the uterus to prevent pregnancy. It can be hormonal and nonhormonal. There are also different manufacturers of IUDs. The side effects can depend on these factors.
Getting a T-shaped stick inserted into your uterus may sound like no-go territory, but more people are interested in this birth control method. Appointments related to IUDs have seen a
“Young women are pulled in so many directions, and worrying about birth control shouldn’t be one of them,” says Elise M., a 24-year-old who’s had her copper IUD for 3 years.
And she’s right: Getting accurate and helpful information shouldn’t be so hard. We need to set straight the myths about infections, pain, and inconvenience.
So we asked other folks* who can say, “been there, done that (and will do it again!)” about their experiences. Plus, we’ll tell you how to handle the side effects most people don’t talk about. Here’s what you need to know to navigate your IUD experience.
*Some names have been changed at the request of interviewees.
An IUD is a small, T-shaped piece of plastic that’s placed inside the uterus to prevent pregnancy. IUDs provide long lasting, reliable protection against pregnancy, and they’re reversible.
There are two types of IUDs: hormonal and nonhormonal.
Both types work differently, but they have the same outcome: to make it difficult for sperm to reach and fertilize an egg.
Hormonal IUDs
Hormonal IUDs contain progestin, which is similar to progesterone, a naturally occurring hormone in the body. Each brand — Mirena, Skyla, Liletta, and Kyleena — contains a different amount of the hormone, which affects how long the IUD will last.
The hormone works to prevent pregnancy in a few ways:
- It thickens cervical mucus to prevent sperm from entering the uterus.
- Thickened cervical mucus inhibits sperm movement, making it harder for sperm to reach and fertilize an egg.
- It thins the uterine lining, so an egg is less likely to attach (implant) to the uterus.
Nonhormonal IUD
Paragard is the only nonhormonal IUD. It’s wrapped in a copper coil, which allows copper ions to release into the uterus and create an environment that’s inhospitable to sperm.
Not only is sperm repelled by copper, but the ions change the lining of the uterus and the makeup of the cervical mucus to further block sperm from reaching the egg.
Side effects during and immediately following insertion are often the same, regardless of the type of IUD. This can include:
- pain
- cramping
- bleeding or spotting
- dizziness
To learn more about the insertion process, check out our comprehensive guide.
In the weeks, months, and years after insertion, all hormonal IUDs have similar side effects. This can include:
- changes in menstrual bleeding
- missed menstrual periods
- cysts on the ovary
Changes in menstrual bleeding are also common in the weeks, months, and years after the nonhormonal IUD Paragard is inserted.
In rare cases, both hormonal and nonhormonal IUDs carry a risk of:
- Infection. This can result from bacteria entering the cervix or uterus. It’s most common in the first few days after insertion.
- Embedment. This happens when the IUD attaches to the wall of the uterus. It’s most common when the IUD is inserted while you’re breastfeeding or chestfeeding, or if you recently gave birth.
- Perforation. This refers to the IUD going through the wall of the uterus. It’s most common when the IUD is inserted while you’re breastfeeding or chestfeeding, or if you recently gave birth.
- Migration. This happens when the IUD moves into a different position inside the uterus. It’s most common in the first 3 months.
- Expulsion. This refers to the IUD moving out of the uterus. It’s most common in the first 3 months.
Kyleena side effects
According to the manufacturer, about 12 out of 100 people using Kyleena stop menstruating 1 year after insertion.
About 22 out of 100 users develop a cyst on the ovary. These cysts often disappear on their own in 2 to 3 months. In some cases, cysts can cause pain and may require surgery.
Kyleena users may also experience:
- bleeding and spotting between periods, especially in the first 3 to 6 months after insertion
- heavier bleeding in the days and weeks after insertion, gradually becoming lighter than usual over time
- otherwise irregular menstrual bleeding
- inflammation or infection of the outer part of the vagina (vulvovaginitis)
- abdominal or pelvic pain
- sore or painful breasts
- headache or migraine
- acne or oily skin
The manufacturer also notes that other side effects are possible. Consult a healthcare professional to learn more.
Mirena side effects
According to the manufacturer, about 2 out of 10 people using Mirena stop menstruating 1 year after insertion.
Some users develop a cyst on the ovary. These cysts often disappear on their own in 2 to 3 months. In some cases, cysts can cause pain and may require surgery.
Mirena users may also experience:
- inflammation or infection of the outer part of the vagina
- abdominal or pelvic pain
- headache or migraine
- changes in vaginal discharge
The manufacturer also notes that other side effects are possible. Consult a healthcare professional to learn more.
Liletta side effects
According to the manufacturer, some users may develop a cyst on the ovary. These cysts often disappear on their own in 2 to 3 months. In some cases, cysts can cause pain and may require surgery.
Liletta users may also experience:
- bleeding and spotting between periods, especially in the first 3 to 6 months after insertion
- periods that shorten, lighten, or stop completely
- otherwise irregular menstrual bleeding
- inflammation or infection of the outer part of the vagina
- abdominal or pelvic pain
- sore or painful breasts
- nausea or vomiting
- acne
The manufacturer also notes that other side effects are possible. Consult a healthcare professional to learn more.
Skyla side effects
According to the manufacturer, about 1 out of 16 people using Skyla stop menstruating 1 year after insertion.
About 14 out of 100 users develop a cyst on the ovary. These cysts often disappear on their own in 2 to 3 months. In some cases, cysts can cause pain and may require surgery.
Skyla users may also experience:
- bleeding and spotting between periods, especially in the first 3 to 6 months after insertion
- heavier bleeding in the days and weeks after insertion, gradually becoming lighter than usual over time
- otherwise irregular menstrual bleeding
- inflammation or infection of the outer part of the vagina
- abdominal or pelvic pain
- headache or migraine
- acne
The manufacturer also notes that other side effects are possible. Consult a healthcare professional to learn more.
Paragard side effects
The most common side effect of the copper IUD is heavier periods — especially in the first 3 to 6 months after insertion.
Other side effects may include:
- heavier or longer periods
- spotting between periods
- anemia, which occurs when the number of healthy red blood cells in your body is too low
- increased or worsened cramping
- pain during penetrative sex
- backache
- vaginal irritation
- changes in vaginal discharge
The manufacturer also notes that other side effects are possible. Consult a healthcare professional to learn more.
If you only remember one thing you’ve read here, make it this: The IUD insertion process feels different for everyone.
Healthcare professionals often describe it as a quick pinching sensation. While many people find the process to be more uncomfortable than unbearable, others experience a severe reaction.
“The second my IUD was inserted, I experienced a pretty intense cramp that made me break into a full-body sweat,” says 25-year-old Anne S.
Others report experiencing:
- moderate to severe abdominal pain
- moderate to severe abdominal pressure
- nausea or vomiting
- lightheadedness or dizziness
- fainting
These side effects usually subside within a few hours or by the next day.
How it feels for you may depend on:
- your individual pain tolerance
- the length of your cervical canal
- whether you’ve previously given birth vaginally
Before your appointment
If you’re concerned about pain or feeling anxious, talk with your clinician. They usually recommend taking 800 milligrams of ibuprofen (Advil) about an hour before the procedure, but they may be able to prescribe something stronger.
This can include:
- pain relievers
- an anti-anxiety medication
- a medication to soften your cervix
Local anesthetic or nitrous oxide (aka laughing gas) can also be used during the procedure to take the edge off.
Arm yourself with ibuprofen, a heating pad, and juice day-of. For extra comfort, bring a small bag of essentials, and wear your comfiest outfit — sweats and all — for the ride home.
Bring these:
- a grab-and-go heating pad
- a panty liner or sanitary napkin
- an over-the-counter pain reliever, like acetaminophen (Tylenol) or naproxen (Aleve)
- a bottle of water or juice to fight off any nausea or dizziness
During your appointment
Many people find it helpful to have their clinician walk them through what they’re doing.
Depending on your needs, this could mean questioning the process prior to the actual procedure or asking the clinician to verbalize what’s happening each step of the way.
If you’re into meditation — or willing to give it a try — this is the perfect time to put it into practice.
Some folks find that counting down from 100 or even counting sheep can be a helpful distraction from what your clinician is doing. Others rely on guided meditation apps to help redirect their focus.
Other techniques include:
- using headphones to listen to your favorite music or podcast
- watching TikToks on your phone
- sending your friend a voice message about how your day is going and what you’re doing the rest of the week
After your appointment
Many people experience some sort of bleeding after insertion.
“[The insertion] caused me to start what would have been my period for the month,” says Anne S. “I spotted very, very lightly for 3 or 4 days after.”
Your clinician should give you a few pads after the appointment, but if you can, stock up your cabinet with unscented liners just in case.
On average, it can take anywhere from 6 to 8 months before your body fully adjusts to the IUD. Whether this means no bleeding, constant leakage, or something in between comes down to the type of IUD you have and your own body’s reaction to the device.
Hormonal IUDs tend to cause a lighter period or no period over time. Copper IUDs tend to cause a period that’s longer, heavier, or both.
Unsure what to use? Check out our roundups of the best period underwear, menstrual cups, tampons, and more.
Also worth noting: Hormonal IUDs tend to reduce cramping, and copper IUDs increase cramping, but as with all period-related things, cramping can be pretty individual.
So if you haven’t already, consider investing in a quality heating pad. Drinking rose hip tea may also help keep any cramping at bay, so consider grabbing a box at the grocery store.
Many people who get IUDs don’t experience any serious side effects or complications. Side effects are often manageable and will lessen in time.
However, you know your body best. If something feels off or you’re experiencing unusual pain or discomfort, consult a healthcare professional as soon as possible.
You should also consult a clinician if you experience one or more of the following:
- You think you might be pregnant.
- You think you may have been exposed to a sexually transmitted infection (STI).
- You can no longer feel the IUD string.
- The IUD string feels shorter or longer than before.
- The IUD string feels like sharp, pointy, or crooked.
- You’re experiencing severe abdominal pain or cramping.
- Penetration of any kind is uncomfortable or painful.
- Bleeding happens during or after penetrative sexual activity.
- You have a change of appearance, amount, or smell of vaginal discharge.
- You develop a fever or chills.
- You have difficulty breathing.
Is it OK if you can’t feel your IUD strings?
Believe it or not, this is actually super common! An absence of strings doesn’t necessarily mean your IUD has made its great escape inside your uterus. Sometimes, the strings soften and coil behind the cervix (which, for the record, can feel like the tip of your nose).
If you can’t feel them yourself, consider asking a partner to check. They may have the advantage of not needing to contort their arm between your legs. It’s all about the angles!
Cervix length is also a factor, but you need to ask your clinician about that. During your appointment, they’ll be able to explain why you can’t feel your strings if your IUD appears to be in place.
Is it common to feel the IUD strings during sex?
Complaints about a poking string during sex may be a sign that your IUD isn’t positioned correctly or that the IUD strings are too long.
Feeling the strings during sex may also mean that the strings just haven’t softened yet, which is typical in the first few months. Over time, your partner(s) might not be able to feel the strings at all.
If it keeps happening, consult a healthcare professional. They can take a look and advise on any next steps.
What happens to your period after getting an IUD?
If your period is much lighter, things may be a little dry down there. Skip the pads or tampons as a preventive measure. Pads can cause chaffing, and without lubrication, even the smallest tampon can feel like sandpaper.
With a light flow, you may also be tempted to leave a tampon in for longer, which puts you at risk of infection.
If menstrual irregularity is your new norm, don’t ignore feelings of fatigue or dizziness, especially if they prevent you from doing your usual daily activities. In these cases, you should consult a clinician ASAP.
If you plan to use a menstrual cup, talk with a clinician about correct use. In some cases, the suction when removing the cup can inadvertently increase the risk of pulling the IUD out of place.
Is it common to break out after getting an IUD?
Unlike with the pill, hormonal and copper IUDs haven’t been
For many, temporary breakouts are a small price to pay for long-term contraception. Plus, if it just isn’t working out, you can break up with your IUD at any time.
In the meantime, step up your skin care routine. Consider talking with an aesthetician or dermatologist, or venture into the land beyond soap to try out serums, toners, and masks. These tips can help you get started.
Can an IUD protect against STIs?
An IUD may lower your risk of pregnancy, but the risk of STIs remains the same.
This means it’s never been more important to talk with your partner(s) about your current STI status and their status, and continue to get tested regularly.
What are the risks of using an IUD?
Although IUDs are safer than ever before, it’s still too soon to tell if some listed long-term risks are truly likely.
For example, the package inserts for Mirena, Liletta, Skyla, and Kyleena all advise against use if you’ve ever had breast cancer. But there hasn’t been any conclusive evidence about an increased risk of cancer.
Some
Other risks are established, but still quite rare. These include pelvic inflammatory disease and perforation.
If you’re concerned about your potential risk, talk with a clinician. Be prepared to discuss your genetic or family medical history. This can help inform the decision you and your clinician make about birth control.
Is it really possible for an IUD to fall out?
It’s extremely rare for an IUD to completely fall out of your body. If the IUD moves, it typically becomes lodged in the lower cervix, causing a distinctive pain that can’t be ignored.
Although expulsion often occurs within the first 3 to 6 months of insertion, it can happen at any time — especially if the IUD was inserted after giving birth or if you’re currently nursing.
“With my first IUD, my period went away after six months. However, [during] the last couple months I started getting my period [again] and cramped a lot,” Trina R. says. “Then the IUD fell out.”
That’s why checking for your strings and recognizing your body patterns is important. If you can’t feel your strings, but your clinician says everything seems healthy, start using a journal or download a period tracker app to help monitor changes in flow, mood, or pain.
For most people, the IUD has more pros than cons — like not having to think about birth control for at least 3 years, depending on the type you get.
Recent
“It was free, I don’t have to go to the pharmacy once a month, and I never have to think about birth control,” says Nicole S., 25. “It’s life changing.”
Tess Catlett isn’t the only Healthline.com editor to get an IUD, but they’re the only one willing to talk about it on the internet. If you have questions that Google can’t answer, give her a shout on Twitter.