My daughter, Penelope was an absolute blessing from the moment we found out that we were pregnant. I had never been pregnant before; I didn't know if I could even get pregnant, but I thankfully got pregnant fairly easily. Nine months later, Penelope was here, and we became parents of a newborn. It was great, but challenging. I totally became wrapped up in being a new mom and taking care of my new daughter and didn't really take a lot of time to think about myself or my body. When it came time for me to go back to my OBGYN for my six-week post baby checkup, I was totally taken off guard when my OBGYN asked me if I had thought about pregnancy prevention after baby. I had not, but after discussing it with my OBGYN and asking lots of questions, I decided to go with the IUD (intrauterine device).
Lots of women have questions like I did about IUDs, so I recently had a conversation with OBGYN Hannah Galey, MD, The Christ Hospital Physicians - Obstetrics & Gynecology, for answers about all things IUD.
Why choose an IUD over other forms a birth control?
Dr. Galey: The ability to prevent pregnancy is very high. The chance of pregnancy with normal use is one in 400. In comparison, oral contraceptive pills have about an 8 in 100 chance of pregnancy with normal use. The IUD also has other benefits outside of birth control, including decreased pain with periods and a high rate of not having a period at all (amenorrhea).
What is the difference between a copper IUD and ones like the Mirena?
Dr. Galey: The copper and progestin IUDs (like the Mirena) work in similar ways, by making the cervix impassible for sperm. One of the biggest differences is that the copper IUD lasts for 10 years, while the longest lasting progestin IUD lasts for six years (Liletta). Two other progestin IUDs (Kyleena and Mirena) both last for five years. The fourth progestin IUD is called the Skyla, and lasts for three years.
What makes someone a candidate for one type of IUD vs. another?
Dr. Galey: An IUD is safe for most patients. Exceptions to this (for any type of IUD) include abnormal shape of the uterus, active pelvic inflammatory disease, unexplained vaginal bleeding. For the progestin IUD, it cannot be used in patients with breast cancer, cirrhosis, or some patients with blood clotting disorders. The decision between a copper IUD versus a progestin IUD is a personal choice based upon other effects of an IUD, as well as length of time the IUD can be used.
Are there risks/side effects with one IUD vs. another?
Dr. Galey: The risks/side effects of any IUD after placement include cramping, bleeding between your periods, infection in the uterus, a uterine perforation (a hole in the wall of the uterus), unintended pregnancy, and expulsion or rejection of the IUD. In addition, the side effects of the copper IUD include a slight increase in bleeding each month. Additional side effects of a progestin IUD include having no period.
Is it painful to have an IUD placed?
Dr. Galey: IUD placement only takes a few minutes, but causes cramping when placed, especially if you have never had a baby before. We recommend taking Ibuprofen prior to IUD insertion to help with this pain.
Is it painful to have an IUD removed and replaced?
Dr. Galey: IUD removal is not painful. IUD replacement will be similar to the previous IUD placement.
Does this take place in the office or do I need any type of anesthesia?
Dr. Galey: IUD insertion takes place in the office and there is no anesthesia required.
Can I keep an IUD longer than five years and are there signs I should be looking for that it's time to be removed?
Dr. Galey: If you have the copper IUD, then you can keep your IUD in for 10 years! For the progestin IUD, if you had a Liletta placed, these have now been approved for six years. If you have a different progestin IUD including Kyleena and Mirena you should have these removed at five years and replaced. Signs that your IUD is decreasing in effectiveness include return of your period, increased bleeding with your period, or increased cramping with your period.
If a women has an IUD and decides she wants to become pregnant, how long will she have to wait from the time she has it removed until she can get pregnant?
Dr. Galey: There is no wait time needed to attempt pregnancy after an IUD removal.
Beyond birth control, can an IUD help with heavy bleeding/other period-related issues? What about an ablation? And can an ablation be used as a form of birth control?
Dr. Galey: Yes, progestin IUDs work very well to improve heavy bleeding and painful periods. The progestin IUDs can even lead to no bleeding at all.
An ablation is burning the lining of the uterus that has a high rate of ceasing periods (90 percent at one year). An ablation cannot be used as a form of birth control.
Can an IUD be felt during sex?
Dr. Galey: No the IUD cannot be felt during sex. The strings that protrude through the cervix can rarely be felt by a partner and can be trimmed shorter if needed.
Is there anyone who shouldn't get an IUD?
Dr. Galey: Those with an abnormal shape of the uterus, active pelvic inflammatory disease, or unexplained vaginal bleeding should not get any type of IUD. Those with breast cancer, cirrhosis, or some blood clotting disorders should not get a progestin IUD.
I'm two years in on my IUD and love it. Learning the facts about your body are really important when it comes to contraception and what might work for you. If you have any other questions about the IUD, make an appointment with a women's health expert from The Christ Hospital Health Network! Or click to learn more about or schedule an appointment with Dr. Galey.