If you’re always forgetting to take your birth control pill, a more long-term pregnancy prevention method may suit you better. One long-acting reversible birth control that is growing in popularity is the IUD.
The IUD, which stands for intrauterine device, is a tiny, T-shaped device that sits in the uterus to prevent pregnancy, according to oby-gyn and maternal fetal medicine specialist Kecia Gaither, MD. Unlike birth control pills, which you need to take once a day, the IUD is a “get it and forget it” method. Once it’s in, it’s effective for several years; in some cases, even more than a decade.
Here’s what else you should know about the IUD.
IUDs are more than 99 percent effective at preventing pregnancy. However, IUDs do not prevent the spread of sexually transmitted diseases. (Only condoms can do this.)
There are two types of IUDs: hormonal and nonhormonal. The hormonal IUD contain progestin. This thickens cervical mucus, which keeps sperm out of the uterus, and thins the lining of the uterus, which prevents fertilized eggs from attaching to the uterus. It’s good for three to six years.
Because the IUD is placed directly in the uterus, it needs only a small dose of progestin. If you experienced side effects (like mood swings or the dreaded drop in sex drive) from the hormones in the Pill, you may not necessarily have the same effect from a hormonal IUD.
The nonhormonal IUD, sometimes called the copper IUD, adds no estrogen or progestin to the body, which appeals to many women. The small amount of copper in this IUD creates a toxic environment for sperm so they can’t swim to an egg (but it’s totally safe for you and your uterus). A nonhormonal IUD lasts up to 12 glorious years (but you’ll want to read #4 before you make your choice).
IUDs do not affect fertility. Ready to start trying for a baby? The IUD is a reversible form of birth control, meaning you will be fertile again as soon as a doctor removes the IUD, which you can elect to do at any time.
IUDs can affect your period—for better or for worse. Hormonal IUDs tend to reduce cramping, lessen PMS symptoms, and lighten or even end a period. Some women even use the hormonal IUD specifically to treat painful cramps. On the other hand, the copper IUD sometimes makes periods heavier and cramping more intense. However, women who currently have light periods and cramps may not find this to be an issue, and these side effects often even out after about a year.
Insertion of the IUD can be painful, but it varies from person to person. Some women even experience nothing more than a little pressure or discomfort. (Here’s what to expect at an IUD insertion.)
You can still use tampons with an IUD. The IUD sits in the uterus, and tampons go in the vagina, so the two can happily coexist. Menstrual cups are a bit more of an issue due to the suction effect, which could theoretically dislodge the IUD, but this is still unlikely. A 2012 study in Contraception followed 930 women with IUDs and found that neither tampons nor menstrual cups increased the rates of early IUD expulsion compared to women who used pads during their period.
Serious IUD complications are rare. But it is important to be aware of potential risks. IUDs can slip out of your uterus, leaving you susceptible to an accidental pregnancy. There’s also a (very rare) possibility of the IUD perforating the wall of the uterus. The IUD may also increase your risk of pelvic inflammatory disease, but primarily only in those whose risk is already higher.