IUD (Intrauterine Device)

IUD (Intrauterine Device)

Two IUDs next to each other

The IUD is a small, t-shaped piece of plastic that gets put into the uterus to disrupt the way sperm moves and prevent them from fertilizing an egg. IUDs offer between three and 12 years of protection depending on the type and can be removed at any time, for any reason. In the US, there are five IUDs: Mirena, Paragard, Skyla, Liletta, and Kyleena.

Types of IUDs

An image of an IUD
Hormonal

There are four hormonal IUDs available in the US—Mirena, Skyla, Liletta, and Kyleena. All are made of plastic and release a small amount of the synthetic hormone progestin, which thickens the cervical mucus to keep sperm from reaching the uterus. Depending on the brand, hormonal IUDs can last between three and seven years and may make periods lighter.

A picture of a Paragard IUD
Non-hormonal

There's only one IUD without hormones available in the US. It's called Paragard and is made of plastic and a small amount of natural, safe copper. Paragard doesn't affect periods and can work for up to 12 years.

    Details

    Get it and forget it

    For those who don't want to worry about remembering birth control, the IUD just may be the right option. Once it's in, it's effective for anywhere from three to 12 years.

    Hands free

    No packages or prescriptions to pick up at the pharmacy, so there's nothing that could get lost or forgotten.

    Total privacy

    No one can tell when who has an IUD (though some partners say they can feel the strings). There's no tell-tale packaging, and nothing that needs to happen before sex to stay protected. 

    Safe and sound

    Most experts agree, anyone who is healthy and has a uterus, is likely a strong candidate for the IUD. That’s true even for those who are young, haven't ever been pregnant, or haven’t had kids yet. It’s also a great method for new moms (even if they're breastfeeding).

    The pregnancy question

    A person's return to fertility should occur very quickly after IUD removal, which is great for those looking to conceive. But for those who aren't ready or interested in getting pregnant, an alternative method will be required as soon as an IUD is taken out.

    Thanks to the Affordable Care Act, for those with health insurance, chances are good that IUDs are available without out-of-pocket costs. Explore all insurance options at HealthCare.gov or at a state-based marketplace. For those without insurance or Medicaid, this method can be expensive up front. Still, the IUD can stay in place for years, so it may make the most sense in the long run. 

    Prices for Mirena*

    • This method may be free or low-cost.
    • With Medicaid: free.
    • With insurance: free under most plans.
    • Without insurance: depending on a person's income, they may be able to go to a low-cost clinic to get Mirena at reduced cost. Bayer, the company that makes the Mirena IUD, works with health care providers to supply a certain number of free IUDs to people who qualify, and a health care provider can help people to apply.

    The full price of Mirena can range from $500 - $927. To see how this translates over a year, here’s what it would cost to pay for Mirena month-to-month at full price.

    • Cost per month over one year: $41 - $77.
    • Cost per month over five years: $8 - $16.

    Prices for Paragard*

    The full price of Paragard can range from $500 - $932. To see how this translates over a year, here’s what it would cost to pay for Paragard month-to-month at full price.

    • Cost per month over one year: $41 - $77.
    • Cost per month over five years: $8 - $15.
    • Cost per month over 10 years: $4 - $7.

    • Payment assistance: for those without insurance, the manufacturer offers payment plans with four or 12 monthly payments. Contact the manufacturer at Paragard.com or 1-877-727-2427 to find out more. Also, check with a local family planning clinic to find out if they offer free or low-cost IUDs (many do).

    Prices for Skyla*

    The full price of Skyla can range from $650 - $780. To see how this translates over a year, here’s what it would cost to pay for Skyla month-to-month at full price.

    • Cost per month over one year: $54 - $65.
    • Cost per month over three years: $18 - $21.

    Prices for Liletta*

    The full price of Liletta can range from $50-$750. There is also an out-of-pocket maximum of $75 with certain insurance plans. To see how this translates over a year, here’s what it would cost to pay for Liletta month-to-month at full price.

    • Cost per month over one year: $4 - $50.
    • Cost per month over three years: $1 - $17.

    *Note: Without insurance there may be an additional cost for health care providers to insert or remove an IUD. The average cost for these visits is around $150 to $250, depending on the service. For those with insurance, insertion should always be covered, but removal might not always be covered.

    To get an IUD, the first thing a person will need to do is talk with a health care provider who will ask a series of questions about medical history and lifestyle. It will also be necessary to have an exam.

    An IUD may be inserted any time of the month. Some providers prefer to insert it during their patient's period, but any time is fine as long as a person is not pregnant. 

    It's common to feel some cramps when an IUD is inserted, but they disappear with rest or pain medication. Some people might also feel dizzy. Once the IUD is inserted, a little string will hang down into (but not out of) the vagina, so that the IUD can be removed later.

    After insertion, IUDs require little to no maintenance, with the exception of checking to ensure the string ends from time to time to make sure it's in place. Here's how:

    1. Wash your hands, then sit or squat down.
    2. Put your finger in your vagina until you touch your cervix, which will feel firm and rubbery like the tip of your nose.
    3. Feel for the strings. If you find them, your IUD is good to go. But if you feel the hard part of the IUD against your cervix, you may need to have it adjusted or replaced by your provider. Do not tug on the strings however, as this could shift the IUD out of place. 

    For those who don't feel comfortable checking for the strings, a provider can do this the month after insertion, and then yearly after that.

    Every method has its own positives and negatives, and because everyone's birth control is different what one person experiences may not be the same as another's experiences.

    The Positive

    • Easy to use.
    • Doesn't interrupt the heat of the moment.
    • Long-lasting protection without much effort.
    • Safe for smokers and those with hypertension and diabetes.
    • The Paragard brand of IUD doesn't change a person's hormone levels.
    • The progestin IUDs may reduce cramps and make periods lighter. Some people's periods stop completely.
    • It can be used while breastfeeding. 

    The Negative

    Everyone worries about negative side effects, but for many people, they're not a problem. Most folks adjust to having an IUD pretty quickly, but it could take a few months. For a very small number of people there are risks of serious side effects, however, so it's best to discuss those with a provider.

    The most common complaints:
    • Spotting between periods (especially during the first few months after IUD insertion).
    • Increased period flow (for users of the Paragard brand).
    • Cramps and backaches.
    Other stuff to watch out for:
    • IUD slipping out.
    • Infection.
    • IUD pushing through the wall of the uterus.

    If after three months, an IUD still feels uncomfortable, it's important to go to a provider and discuss switching methods. 

    Do you have questions about IUD (Intrauterine Device)? Visit Bedsider.org for answers to many of the most popular questions about this method of birth control.