What Is It?
The intrauterine device (IUD) is a piece of plastic, about the size
of a quarter, that is placed inside the uterus to prevent pregnancy.
There are two types of available IUDs. One is T-shaped and covered
with copper wire. The other kind is a plastic coil that is coated
and releases the hormone progesterone.
Does It Work?
The copper-coated IUD primarily prevents pregnancy by not allowing
the sperm to fertilize the egg. When an IUD is coated with progesterone,
the hormone works to prevent ovulation (the release of an egg during
the monthly cycle) and thicken the cervical mucus, which prevents
sperm from entering the uterus.
How Well Does It Work?
Over the course of 1 year, fewer than 1 out of 100 typical couples
using an IUD will have an accidental pregnancy. In fact, studies
indicate that the IUD is one of the most effective and safe methods
of birth control. Although the IUD is an effective method of birth
control, it can come out of place and should be checked to be sure
it is in place.
In general, how well each type of birth control method works depends
on a lot of things. These include whether a person has any health
conditions or is taking any medications or herbal supplements that
might interfere with its use. The IUD allows some flexibility for
girls who cannot use a hormonal method of birth control (such as
the pill, ring, or patch) because the copper IUD is available. The
IUD also provides a long-lasting form of birth control.
Protection Against STDs
The IUD does not protect against sexually transmitted diseases (STDs).
For those having sex, condoms must always be used along with the
IUD to protect against STDs. One of the concerns with the IUD is
that girls who have multiple partners and do not use condoms can
be at greater risk for STDs, and there's the possibility that these
diseases could develop into a pelvic infection. This is true, though,
for all methods of birth control.
Abstinence (the decision to not have sex) is the only method that
always prevents pregnancy and sexually transmitted diseases (STDs).
Possible Side Effects
The most common side effects of the IUD include:
- heavier periods with more cramps with the copper IUD
- irregular or loss of periods with use of the hormonal IUD
- expulsion, or loss of the IUD. For some IUD users - particularly
teens - the IUD can fall out or become displaced and not work
- perforation of the uterus. There is a very minimal risk of the
device perforating the wall during the insertion of the device.
In the past, one type of IUD increased a woman's risk of pelvic
inflammatory disease (an infection in the upper part of a woman's
reproductive system). That early type of IUD has been taken off
the market and testing of the current IUDs indicate that the risk
of infection is very small. The other concern that used to exist
with IUDs was the possibility of ectopic pregnancies, which is when
a fertilized egg implants somewhere other than in the uterus. This
is no longer a concern. In fact scientists have found that an IUD
decreases the chances of having an ectopic pregnancy, so women who
use the IUD have less risk of having an ectopic pregnancy.
Who Uses It?
The IUD is not recommended for teens and women who have not had
a baby. Up to 10 out of 100 IUDs will come out in the first year
after they are put in. This is more common in women who haven't
had a baby, which includes many teen girls. When an IUD comes out,
a girl may not even know it, leaving her unprotected. Also, teens
who have multiple partners and who do not use condoms are at risk
for getting STDs. For that reason, most doctors won't insert an
IUD in a teen because if she gets an STD that leads to a pelvic
infection she may never be able to have a baby.
How Do You Get It?
An IUD must be inserted into the uterus by a doctor. It is often
easiest to insert during a girl's period. Copper IUDs need to be
replaced by a doctor about every 10 years. IUDs with hormones must
be replaced more frequently - up to every 5 years.
How Much Does It Cost?
An IUD costs about $250 plus the cost of having a doctor insert
and remove it. Many health insurance plans cover these costs, and
family planning clinics (such as Planned Parenthood) charge much