Now that we’re more than 2 years into the coronavirus disease 19 (COVID-19) pandemic, you might be curious how the pandemic has impacted intrauterine device (IUD) use over time.
Read on to learn how the COVID-19 pandemic can and can’t impact IUD effectiveness, appointments, removal, and more.
If you use an IUD as your primary or only form of birth control, you can breathe easy knowing that neither a COVID-19 diagnosis nor vaccine will impact the effectiveness of your IUD.
No matter your vaccine or COVID-19 status, IUDs are more than 99% effective.
To be clear: The effectiveness of your IUD doesn’t change even if your menstrual cycle changes following a bout with COVID-19 or receiving a COVID-19 vaccination.
“Many patients who received the vaccine report irregularities in their menstrual cycle following the vaccine,” says Daniel Gomez, OB-GYN at Hospital Corporation of America (HCA) Florida Northwest Hospital in Coral Springs, Florida. “But it has not been shown to decrease the effectiveness of a patient’s contraceptive method.”
IUDs are effective for 3 to 10 years, depending on the type. Typically, nonhormonal, copper IUDs are effective for up to 10 years, while hormonal options are effective for 3 to 7 years.
“The efficacy of the IUD will decline after the expiration date,” says Felice Gersh, MD, author of “PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms.”
“It doesn’t go to 0% effectiveness after that expiration date, but it’s certainly less effective,” explains Gersh.
There are a few other things that can impact the effectiveness of an IUD, including:
- improper placement in the uterus
- certain antianxiety and antidepressant medications
- having uterine fibroids
But again, developing COVID-19 or getting any of the COVID-19 vaccinations can’t make the IUD less effective.
“Some patients experienced difficulty getting office appointments at the onset of the pandemic in 2020,” says Gomez. That’s because many offices reduced their operating hours as a precautionary measure.
But as the pandemic has developed, most of those delays have disappeared, he says.
Most OB-GYN clinics, Planned Parenthood locations, and women’s healthcare centers, for example, have returned to their usual hours. That means inserting and removing an IUD isn’t any more complicated now than it was prepandemic.
If you already have a primary care professional or OB-GYN, call their office to set up an appointment or look up their website to see if you can schedule an appointment online.
If you don’t already have a clinician on tap, check out the American College of Obstetricians and Gynecologists search tool, which allows you to find OB-GYNs in your area.
You can also find the Planned Parenthood closest to you and set up an appointment. Or call your nearest Planned Parenthood and ask if they can refer you to a clinician in your area.
How do you insert or remove an IUD exactly?
You need a healthcare professional to insert or remove an IUD. When booking an appointment, ask for exactly what you need.
If you want to get an IUD inserted, you’ll ask for an insertion appointment. If you want to get an IUD removed, you’ll ask for removal. If you need to get an expiring IUD taken out and a replacement put in, say that!
If this is your first appointment with a new clinician or you haven’t seen one in a while concerning IUDs, they may require a general checkup appointment first and perform the IUD insertion, removal, or both at your next visit. This may also be the case if you have insurance that requires prior authorization for an IUD.
At your appointment, a doctor or other healthcare professional will insert a metal tool called a speculum into your vagina to make your cervix (which is located at the back of the vaginal canal) more accessible.
Then, they’ll either insert an applicator tube (to insert an IUD) or a special grasping tool (to remove an IUD). Both procedures are usually quick, often taking less than a few minutes each.
You can lower your risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can develop into COVID-19, at a clinician’s office the same way you’d
That means:
- getting vaccinated (and boosted!)
- wearing a mask
- increasing space between you and other people when possible
- avoiding contact with people who have or have been around someone who has developed COVID-19
- washing your hands before, during, and after your appointment
To be very clear: The fact that you’ll be naked from the waist down DOESN’T increase your chances of contracting the virus.
To understand why that is, you need to understand how SARS-CoV-2 spreads.
COVID-19 is a respiratory virus. A person who has contracted SARS-CoV-2 exhales little “infected” particles (that are usually not discernible to the human eye) through their mouth and nose.
If these droplets are inhaled by someone who doesn’t have SARS-CoV-2 or otherwise land on their nose, mouth, or eyes, the virus can be transmitted.
An infected particle landing on your vulva or in your vagina won’t transmit the virus.
Maybe you’re immunocompromised. Maybe the person who usually drives you to your healthcare appointments is. Or maybe stepping foot into a clinic isn’t a risk you’re currently comfortable taking.
Good news: There are plenty of other birth control options!
“The first thing you should try to figure out is if you’re OK with a hormonal birth control option,” says Gersh.
If you’d prefer a nonhormonal option, look into the following methods:
“You can buy internal and external condoms online or at your local drugstore,” says Gersh. You can get contraceptive sponges and spermicide at most drugstores too.
Diaphragms and cervical caps, however, require a prescription and an in-person doctor’s appointment because they’re prescribed based on the size of your cervix.
If you’re OK with hormonal birth control options, telehealth may be a good option for you.
“Telehealth providers can usually prescribe any hormonal birth control option that doesn’t need to be inserted,” says Gersh. Meaning you can’t get an IUD or implant via telehealth.
But you can usually be prescribed the pill, patch, or vaginal ring.
The best online birth control platforms include:
The copper IUD is sometimes used as a form of emergency contraception.
When inserted within 5 days of penis-in-vagina sex without a condom or other birth control, the copper IUD can help protect against pregnancy, explains Gomez.
If you can’t get an appointment for insertion or don’t want to go into a clinic, “you can use the morning-after pill to prevent pregnancy,” says Gomez. “It can be obtained at the pharmacy without a prescription.”
Just keep in mind: Emergency contraceptive pills have a weight limit. Plan B, for example, is less effective for those with a higher weight.
The copper IUD is the only form of emergency contraception that’s equally effective regardless of your weight.
Depending on your individual situation, you may decide that potential SARS-CoV-2 exposure during an in-clinic appointment outweighs the risk of potential pregnancy.
Does developing COVID-19 make your IUD less effective?
Nope! “Having COVID cannot impact the effectiveness of your IUD,” says Gersh.
Can the COVID-19 vaccine affect your IUD?
Nope! “The COVID-19 vaccine isn’t going to affect the effectiveness of your IUD,” says Gersh.
Has the COVID-19 pandemic affected IUD appointments?
During the pandemic’s peak, fewer IUD appointments were available than usual, as centers limited their hours to protect their workers. But most have returned to their regular schedule and capacity.
Actually, given the convergence of COVID-19 and the fight for reproductive rights, there’s actually a reason to believe that there’s been an uptick in IUD appointments.
Indeed, some doctors are reporting an increased demand for long lasting birth control following the Roe vs. Wade reversal.
What if you can’t get your IUD removed at the recommended time?
Try not to worry too much.
“The IUD doesn’t go from being 99.9% effective one day to 0% effective the next,” says Gersh.
But after the expiration date, the efficacy does start to be impacted.
“If you can’t get an IUD removal appointment, it’s wise to start using an additional form of birth control like the internal or external condom if you don’t want to become pregnant,” she says.
Getting pregnant while you have an IUD inserted can result in an ectopic pregnancy, which can be life threatening, says Gersh.
Can you remove your IUD at home?
“You shouldn’t try to remove your IUD at home,” says Gersh, emphasizing that IUD removal should be performed by a trained professional.
“Trying to remove the IUD at home could result in infection,” adds Gomez. “And if you can’t fully remove the IUD, there are additional risks.”
Remember: There’s no harm in waiting until you can see a healthcare professional for removal. Just be sure to use a secondary form of birth control, such as condoms or other barrier methods, in the meantime.
If you do decide to remove your IUD at home anyway, read this guide to at-home IUD removal first.
Neither developing COVID-19 nor getting the COVID-19 vaccine can impact the effectiveness of your IUD.
Actually, a long lasting birth control option, such as an IUD, that requires minimal clinic, doctor, or pharmacy visits may be ideal for people worried about both unwanted pregnancy and SARS-CoV-2 exposure.
But if the insertion process is too high risk for your individual circumstances, you may be able to get a different birth control method via telehealth.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.