• By Micah Dorfner

Contraception FAQs: Intrauterine Device

February 19, 2016

a young man and woman, couple sitting on boat dock kissing with sunset in background
Emily Linklater, D.O.
, Mayo Clinic Health System obstetrician and gynecologist, answers frequently asked questions about intrauterine devices.

What is an IUD?

IUD stands for intrauterine device.  It’s a small device that’s inserted into the uterus by your health care provider for contraception. Many times IUDs are classified as long-acting reversible contraception (LARC).

Who is a candidate for an IUD?

Almost all women are candidates for an IUD, with a few exceptions. It’s a common myth that women who haven’t been pregnant and who are adolescents aren’t candidates. Pregnancy, age and prior vaginal delivery are not required to insert an IUD. An IUD is an excellent option for women who desire a reversible form of birth control, but don’t desire pregnancy at this time. IUDs are 99 percent protective against pregnancy and don’t require daily compliance.

How are IUDs inserted and removed?

After discussing the option with your provider, an IUD can be inserted in the office setting. You may experience some mild cramping from insertion. Overall, the entire procedure takes less than five minutes. Some women choose to take over-the-counter pain medication, such as ibuprofen or acetaminophen before coming to the office. Once inserted, an IUD can be removed on request or at the time of expiration, approximately three-to-10 years later. Removal takes about two-to-three minutes.

What are additional uses for IUDs?

IUDs are used mainly for contraception. However, they can also be useful for emergency contraception, heavy bleeding, anemia, painful periods and occasionally endometriosis.

How do IUDs work?

Currently available IUDs work by preventing sperm from fertilizing ova, although some aspects of the precise mechanism of action are unknown. IUDs are not abortifacients; they don’t interrupt an implanted pregnancy. Pregnancy is prevented by a combination of the ‘foreign body effect’ of the plastic frame and the specific action of the medication (copper or Levonorgestrel) that’s released, which impairs sperm function and implantation, and prevents fertilization.

How effective in preventing pregnancy is the IUD?

It’s a very effective method. Here’s a breakdown of birth control methods and their effective rates:

  • Nexplanon, IUDs and bilateral tubal ligation have a failure rate for typical use of less than one in 100 women per year.
  • Birth control pills, the patch, the Depo-Provera injection and the ring have a failure rate for typical use of six-to-12 in 100 women per year.
  • Natural family planning, the pull out method and condoms have a failure rate for typical use of 18 or more in 100 women per year.

What types of IUDs are available?

  • Paragard (Cooper IUD), effective for 10 years, no hormones are released
  • Mirena IUD, effective for five years, releases approximately 20 mcg of progestin per day
  • Skyla IUD, effective for three years, releases approximately 14 mcg of progestin per day
  • Liletta IUD, effective for three years, releases approximately 19 mcg of progestin per day, available as a generic, usually lower cost for those without health insurance coverage

What are the next steps?

For more information, along with more detailed risks and benefits of IUDs, meet with your health care provider.  He or she will review your medical and gynecological history to ensure you’re a candidate for an IUD.

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