IUD FAQ

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The IUD or intrauterine device is a form of birth control that is available to woman of any reproductive age seeking reversible, forgettable, long-term, safe, and effective contraception. It is a small, soft, T-shaped device with a nylon string attached. A healthcare provider slides it into your uterus (womb). There are two types of IUD: copper and hormonal (Levonorgestrel, a synthetic progesterone) which work in different ways to prevent pregnancy.

An IUD helps to prevent the egg and sperm from meeting by slowing down the sperm's ability to swim and meet the egg cell. An IUD may also stop a fertilized egg from growing inside the uterus. The progesterone IUDs make the cervical mucus really thick so that sperm and germs cannot penetrate into the uterus. 

With the hormone IUDs your periods should be lighter or even go away completely. With the copper ones you should have regular periods, so the only way to know if it is in there is to check for your strings regularly. If you or your partner cannot feel them, please come back and see us. We sometimes have to do an ultrasound or X-ray to find it in the womb if the strings have pulled up into your cervix.  

• Please speak to your inserting doctor about your fears about the discomfort of insertion, we have a few options to make it more comfortable:
• 1. Tylenol  1000 mg  60 minutes before,
• 2. Ibuprofen 400 - 600 mg 60 minutes before. 
• 3. You could even take both Tyl and Ibuprofen together like after a surgery.
• 4. We can do an endocervical block with Lidocaine similar to the dentist freezing the area before the insertion, It makes the procedure slightly longer, but a lot of women find it much better, especially if we have to remove and insert, or find missing strings. 
• 5. Some women may need stronger meds, but please ask about it in your consult so we can make it as comfortable as possible. 

No; the plastic, copper or IUD strings should not be felt or seen outside of the vagina. Some women can feel their strings when they look for them to make sure they haven’t fallen out accidentally, but if you cannot feel them, don't worry about it; if we’ve checked it at your 4-6 week visit and it is still inside, then you don't have to worry. 

Checking is best done after each period, especially if you use tampons or a diva cup. Feel with fingers around your cervix- there should be something with a different texture there. Your partner should not be feeling any sharp parts. 

IMPORTANT FACTS TO KNOW:

• Yearly string checks with your healthcare provider are advisable to ensure that the IUD is still in the correct position. 
• When the recommended time for the IUD has expired, you should have it replaced or removed.
• When the IUD perforates the uterus and migrates into the abdominal cavity, it has to be surgically removed. If this occurs, there is a risk for potential damage to the bowel, bladder, blood vessels, and nerves.
• The risk of becoming pregnant is very low (less than 1%) however if you are to become pregnant  you are at risk for an ectopic pregnancy and you should immediately present to your health care provider for evaluation. 

• An IUD provides long-term contraceptive protection for three to ten years which makes it the cheapest form of birth control available. 

• Convenience: you do not have to remember to take pills or apply patches or rings regularly. As long as it is in position in the uterus, it works!

• Safe for breastfeeding.

• When you are ready to become pregnant, your healthcare provider can easily remove the IUD by pulling on the strings with no long-term effects on your fertility or future pregnancies.

• Because the IUD cannot be seen or felt, it’s private and it’s your choice to share information about the IUD if you choose.

• You are protected from pregnancy as soon as the IUD has been inserted- if you inserted it during your period. You are able to go swimming, wear tampons or have intercourse 24 hours after the insertion.

• No estrogen in any of them. This reduces the risk of having blood clots in your blood vessels and lungs almost completely. 

• The Mirena makes about 60% of women's periods go away completely and reduces the flow and cramps in most women. It is an excellent treatment for endometrial polyps or iron deficiency anemia due to heavy blood flow. With the Kyleena, 40% of women experience no bleeding.

• The Mirena prevents your inner lining of your uterus from becoming thickened. It is good for protecting people with too much estrogen in their systems like those with polycystic ovaries (PCOS), obesity, or those on hormone replacement therapy from endometrial thickening, polyps and uterine cancers.

• Does not cause hormone related facial pigmentation like cloasma or melasma.

· Very reliable birth control for women who are not allowed to get pregnant due to medical reasons like being on Accutane treatment for acne.

• It doesn't protect against sexually transmitted diseases. 
• Copper IUDs may cause irregular bleeding or heavier, longer, and more painful periods. Usually this improves within a few months after insertion. If it persists or continues between periods, please see your healthcare provider. 
• There is a slightly increased risk of infection within the first month of insertion. Please let the inserting office know if you have any signs of infection including fevers, offensive discharge or increased pelvic pain. Because of design flaws in IUDs produced in the 1970s, there was significant concern about pelvic inflammatory disease. This is no longer an issue and LARC's have a very low rate of infection. 
• Insertion can be uncomfortable: For some it is an easy insertion, for others it may be painful. Your healthcare provider can provide options to help decrease pain. 
• It does not treat acne, prevent PMS or reduce painful ovarian cysts or ovulation pains. If you have trouble with these things, then the oral pill, ring, or patch, would be a better option for you. 
• Rarely (in less than 1% of people) the IUD can perforate your uterus wall or attach itself to your uterine wall and will have to be removed by a gynecologist as a minor surgical procedure. 
• Rarely (less than 1%) of times it can fall out. This happens more often if we insert it too soon after having a baby (we usually wait 3 months after giving birth or having a C-section). Some women may experience spotting for 3 to 6 months after insertion and this may be daily, and there may be some cramping for the first few weeks that may not go away.
• The strings may migrate up into the cervical canal which means that when it comes time for the IUD to be removed, surgery may be required.