Intrauterine Device (IUD)

An IUD is one of the most effective methods for birth control. It is convenient and more than 99% effective in preventing pregnancy. The IUD is generally covered by insurance due to the Affordable Care Act.

There are three types of IUDs: Mirena, Skyla, and PARAGARD. All of these IUDs are inserted (and removed) by your healthcare provider. The following information will help you decide which IUD is best for you.

Mirena

  • Progestin (levonorgestrel) contraceptive
    • low dose of progestin is delivered into your uterus
    • the hormone is local and not systemically absorbed
  • Thickens cervical mucus to prevent sperm from entering the uterus
  • Inhibits sperm from fertilizing an egg
  • Estrogen-free
  • Lasts 5 years
  • Menstrual cycles may be lighter
  • Thins the uterine lining and FDA approved to treat heavy menstrual cycles

Skyla

  • Progestin (levonorgestrel) contraceptive
    • low dose of progestin is delivered into your uterus
    • the hormone is local and not systemically absorbed
  • Thickens cervical mucus to prevent sperm from entering uterus
  • Estrogen-free
  • Similar to Mirena, but lasts 3 years instead of 5 years
  • Menstrual cycles may be lighter, but not FDA approved to treat heavy cycles

PARAGARD

  • Copper contraceptive – the copper coil creates an environment in which sperm cannot survive
  • Lasts 10 years
  • You could have heavier periods or spotting between periods – especially if you were using another method of birth control such as an oral pill or Nuvaring

Frequently Asked Questions

Question: I am nervous about having the IUD placed. What should I expect?

Answer: First, a speculum is inserted  into the vagina (just like a Pap smear). Next, an instrument is inserted into the cervix to measure the length inside your uterus and then the IUD is ready for insertion. The IUD is contained in a long, thin sterile tube and the tube is inserted into the uterus. As the sterile tube is retracted, the IUD becomes a T-shaped device inside the uterus (kind of like a little anchor). Finally, the strings of the IUD will protrude from the cervical opening and they will be trimmed.

During the insertion it is common to feel light headed. Don’t hold your breath – taking slow deep breaths should help you from feeling dizzy or nauseous. If your experience mild cramping you can take ibuprofen (Advil) 800mg every 4-6 hours as needed. You should be able to resume normal activities.

Question: Do I have to wait a month before the IUD is effective?

Answer: No. Both IUDs are 99% effective against pregnancy immediately after insertion.

Question: I have heavy menstrual cycles and I am considering Mirena. What should I expect?

Answer: Research has demonstrated that 1 out of 5 women do not have a menstrual cycle after 1 year. For some women this may be concerning, but your cycle will return after it has been removed by your healthcare provider.

Question: I have a Mirena IUD. Can I have it removed after two years if I want to get pregnant?

Answer: Yes. Mirena is effective for 5 years, but you can have it removed sooner if needed. The same applies to PARAGARD.

Question: I had an IUD placed last month and I am still spotting. Should I be concerned?

Answer: No. It is not uncommon to have spotting for 2-3 months.