In the days after the 2024 U.S. presidential election, appointments for intrauterine devices, or IUDs, skyrocketed. Planned Parenthood reported that between November 5 and November 6, IUD appointments increased by 760 percent, with many patients citing concerns that the incoming administration could roll back reproductive health care access.
IUDs are a safe, effective, and convenient form of contraception and provide long-lasting pregnancy prevention. Read on to learn how IUDs prevent pregnancy, what to expect when you get one, and more.
What are IUDs, and how do they work?
An IUD is a tiny, T-shaped device that is inserted into the uterus to prevent pregnancy. There are two types of IUDs: hormonal and copper.
Hormonal IUDs—sold under the brand names Mirena, Kyleena, Liletta, and Skyla—release the hormone progestin to prevent pregnancy. They become effective at preventing pregnancy within seven days of insertion and are effective for three to eight years depending on the brand.
In addition to preventing pregnancy, hormonal IUDs may also reduce menstrual cramps, make periods lighter, or make periods stop entirely. This is why some people use them to manage conditions like endometriosis and polycystic ovary syndrome (PCOS).
Copper IUDs—sold under the brand name Paragard—prevent pregnancy by releasing copper molecules into the uterus and creating an environment that is toxic to sperm. They start preventing pregnancy immediately after insertion and are effective for up to 10 years.
IUDs may also be a more convenient way to prevent pregnancy than other birth control options.
IUDs “are easier to use when compared to needing to remember to take a pill every day, change a patch weekly, replace a ring monthly, or obtain an injection every three months,” says Dr. Melissa A. Simon, professor of obstetrics and gynecology at Northwestern’s Feinberg School of Medicine.
How effective are IUDs at preventing pregnancy?
Both hormonal and copper IUDs are more than 99 percent effective at preventing pregnancy. However, since no form of birth control is 100 percent effective, IUDs work best when used in combination with safer sex barriers like condoms, which also protect against sexually transmitted infections (STIs).
Who can get an IUD?
IUDs are safe for most people who can become pregnant. However, you may not be able to get one if you have certain STIs or a pelvic infection, have untreated cervical or uterine cancer, or think you might be pregnant.
Hormonal IUDs are not recommended if you have had breast cancer or any health conditions that increase your risk of blood clots. Additionally, you should not get a copper IUD if you have a copper allergy, Wilson disease (a rare condition where the body stores too much copper), or a bleeding disorder.
If you are unable to get an IUD, there are other birth control options that may be right for you.
Do IUDs have side effects?
Both hormonal and copper IUDs can cause some side effects that typically go away over time.
Both hormonal and copper IUDs may cause spotting between periods or irregular periods. Copper IUDs may also cause heavy periods and menstrual cramps.
How much does an IUD cost, and where can I get one?
IUDs may be free or partially covered by most health insurance plans. However, getting an IUD can cost up to $1,800, depending on your insurance coverage, the type of IUD you choose, and the number of medical exams and follow-up appointments you need.
Still, IUDs can be less expensive than other birth control methods in the long run since they offer long-lasting protection.
You can get an IUD at your gynecologist’s office or at a family planning clinic like Planned Parenthood.
What should patients expect during IUD insertion or removal?
When you get an IUD, a health care provider will insert the device through your cervix, the narrow opening that connects the vagina to the uterus. The procedure typically lasts under five minutes.
“There can be a range of feelings during an IUD insertion,” Simon says. “Some people don’t feel much at all—much like a Pap test. Some people experience cramps similar to those during their [period]. Some people experience more intense cramps, or a pinching sensation. One may also feel a little lightheaded or nauseous.”
Most patients report moderate to severe pain and cramping during insertion, so it’s important to discuss ways to manage pain with your health care provider in advance. Options include:
- Over-the-counter pain medications like Advil or Motrin. These medications are called oral non-steroidal anti-inflammatory drugs (NSAIDS) and can prevent cramping.
- Acetaminophen (Tylenol) for patients who are allergic to NSAIDS.
- Topical lidocaine, which partially numbs the cervix.
- Lidocaine injection, which partially numbs the cervix and prevents cramping throughout the procedure.
- Sedation.
You may also experience cramping and pain after the procedure.
“I tell [patients] that it is uncomfortable, and it can be intensely crampy right as it is inserted,” said Dr. Tessa Madden, a Yale Medicine obstetrician-gynecologist and family planning specialist, in a Yale Medicine article. “Some people might even have cramping after they leave the office, but the vast majority of patients do fine.”
Once your IUD is inserted, you will have a one- to two-inch-long string exiting your cervix. When it’s time to remove your IUD, a health care provider will pull on the string to slide the IUD out of your uterus. This may cause some pain, and you may experience brief cramping afterward.
Removing an IUD at home is not recommended, as rare complications can occur that may require medical intervention.
Can an IUD move or fall out?
Rarely, an IUD can slip out of place or fall out. If you have an IUD and experience any of the following events, see a health care provider who can remove and replace your IUD:
- You experience abnormal pelvic pain or bleeding.
- You cannot feel your IUD’s string in your vagina.
- Your IUD’s string feels longer or shorter than usual.
- You can feel the copper or plastic part of your IUD.
- Your IUD has fallen out.
It’s also recommended that you avoid using a menstrual cup when you have an IUD, as this can increase the risk that your IUD will move.
If you think your IUD has moved, there’s a chance that it is not preventing pregnancy. Use condoms until a health care provider confirms that your IUD is correctly placed.
How can IUDs be used as emergency contraception?
A Paragard, Mirena, or Liletta IUD can be used as emergency contraception when inserted within five days after unprotected sex. This is an ideal option if you weigh 195 pounds or more, as emergency contraception pills like Plan B may not be effective for you.
For more information, talk to your health care provider.