IUD (Intrauterine Device)

IUD (Intrauterine Device)

Two IUDs next to each other

The intrauterine device (IUD) is a small, T-shaped piece of plastic that you can have a health care provider put inside your uterus. The IUD makes it harder for sperm to move efficiently, preventing it from fertilizing an egg. In the U.S., there are five brands of IUDs available: Kyleena, LILETTA, Mirena, Paragard, and Skyla.

IUDs can offer years of protection from pregnancy. How long they last depends on the type you get. Some last for up to three years and others last for up to 12 years. If you want to get pregnant or simply want to switch to a different method of birth control at any time, you can have the IUD removed. And if you have plans to get pregnant in the future, don’t worry—having an IUD now doesn’t affect your fertility in the future.

While the IUD is safe and super effective at preventing pregnancy, it doesn’t offer protection against sexually transmitted infections (STIs). For STI protection, you can use condoms, internal condoms, dental dams, gloves, and/or PrEP (pre-exposure prophylaxis, which lowers the risk of getting HIV from sex).

Three types of IUDs (LILETTA, Mirena, and Paragard) can also be used as emergency contraception if you get them within five days of having unprotected sex. These three types of IUDs are the most effective methods of emergency contraception, preventing pregnancy in over 99% of cases.

Types of IUDs

Hormonal IUD

The hormonal IUD is a small, T-shaped piece of plastic that a health care provider can insert into your uterus to prevent pregnancy. There are four hormonal IUDs available in the U.S.—Kyleena, LILETTA, Mirena, and Skyla. All four hormonal IUDs are more than 99% effective at preventing pregnancy. All four release a small amount of progestin, which is the synthetic version of progesterone, a hormone made by the body. Progestin prevents pregnancy mainly by thickening cervical mucus to keep sperm from reaching the uterus. Hormonal IUDs can last between three and eight years, depending on which one you get. They may cause some changes to your periods, usually making them lighter, shorter or irregular, or stopping them altogether.

Two of the hormonal IUDs, Mirena and LILETTA, can also be used as emergency contraception. The risk of pregnancy decreases by over 99% when a health care provider inserts one of these IUDs up to five days after unprotected sex.

None of the types of IUDs protect against STIs.

Non-hormonal/copper IUD (Paragard)

The non-hormonal IUD, known by the brand name Paragard in the United States, is a small, T-shaped piece of plastic wrapped in copper wire. The non-hormonal IUD works by interfering with the way sperm moves and reducing its ability to fertilize eggs, and possibly also by preventing the implantation of fertilized eggs in the uterus.

Paragard lasts up to 12 years, which is longer than any other IUD and is one of the longest-lasting of any of the birth control methods. It’s also one of the most effective methods of preventing pregnancy. It’s over 99% effective at preventing pregnancy. However, copper IUDs don’t protect against STIs—no IUDs do.

The non-hormonal IUD is also one of the most effective forms of emergency contraception, along with Mirena and LILETTA, which are IUDs that contain hormones. The non-hormonal IUD can be inserted up to five days after unprotected sex to reduce the risk of pregnancy by over 99%.

Details
The intrauterine device (IUD) is a small, T-shaped piece of plastic that you can have a health care provider put inside your uterus. The IUD makes it harder for sperm to move efficiently, preventing it from fertilizing an egg. In the U.S., there are five brands of IUDs available: Kyleena, LILETTA, Mirena, Paragard, and Skyla. IUDs can offer years of protection from pregnancy. How long they last depends on the type you get. Some last for up to three years and others last for up to 12 years. If you want to get pregnant or simply want to switch to a different method of birth control at any time, you can have the IUD removed. And if you have plans to get pregnant in the future, don’t worry—having an IUD now doesn’t affect your fertility in the future. While the IUD is safe and super effective at preventing pregnancy, it doesn’t offer protection against sexually transmitted infections (STIs). For STI protection, you can use [condoms](/birth-control/condom), [internal condoms](/birth-control/internal_condom), dental dams, gloves, and/or PrEP (pre-exposure prophylaxis, which lowers the risk of getting HIV from sex). Three types of IUDs (LILETTA, Mirena, and Paragard) can also be used as [emergency contraception](/birth-control/emergency_contraception) if you get them within five days of having unprotected sex. These three types of IUDs are the most effective methods of emergency contraception, preventing pregnancy in over 99% of cases.
Thanks to the Affordable Care Act, if you have health insurance, [chances are good that you’ll be able to get this method with no out-of-pocket cost](http://bedsider.org/features/257). If you don't have insurance or Medicaid, this method can be pricey up front. Still, the IUD can stay in place for years, so it becomes downright cheap over time. #### Prices for Mirena or Kyleena* * **This method may be [free or low-cost for you](/free_birth_control)** * **With Medicaid:** Free * **With insurance:** [Free under most plans](/features/257) * **Without insurance:** Depending on your income, you may be able to go to [a low-cost clinic](/free_birth_control) to get Mirena or Kyleena at reduced cost. Bayer, the company that makes the Mirena and Kyleena IUDs, works with health care providers to supply a certain number of free IUDs to women who qualify. If you [qualify](https://www.patientassistance.bayer.us/en/), ask your health care provider to help you apply. The full price of Mirena and Kyleena can range from $500 - $858. To see how this translates over a year, here’s what it would cost to pay for one of these IUDs month-to-month at full price. * **Cost per month over one year:** $41 - $72 * **Cost per month over five years:** $8 - $14 #### Prices for Paragard* * **This method may be [free or low-cost for you](http://bedsider.org/free_birth_control)** * **With Medicaid:** Free * **With insurance:** [Free under most plans](http://bedsider.org/features/257) * **Without insurance:** Depending on your income, you may be able to go to [a low-cost clinic](/free_birth_control) to get Paragard at reduced cost. The full price of Paragard can range from $500 - $739. 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 - $62 * **Cost per month over five years:** $8 - $12 * **Cost per month over 10 years:** $4 - $6 * **Payment assistance:** If you don't have insurance, the manufacturer offers payment plans where you can make 4 or 12 monthly payments. Contact the manufacturer at Paragard.com or 1-877-727-2427 to find out more. Also, check with your [local family planning clinics](/where_to_get_it) to find out if they offer free or low-cost IUDs (many do). #### Prices for Skyla* * **This method may be [free or low-cost for you](/free_birth_control)** * **With Medicaid:** Free * **With insurance:** [Free under most plans](/features/257) * **Without insurance:** Depending on your income, you may be able to go to [a low-cost clinic](http://bedsider.org/free_birth_control) to get it at reduced cost. Bayer, the company that makes the Skyla IUD, also has [a program to offer a certain number of free IUDs](http://www.prnewswire.com/news-releases/bayer-healthcare-expands-patien…) to people who can't afford one otherwise. (Note that you have to work with a health care provider to apply to the program.) The full price of Skyla can range from $650 - $714. 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 - $60 * __Cost per month over three years__: $18 - $20 #### Prices for LILETTA* * **This method may be [free or low-cost for you](http://bedsider.org/free_birth_control)** * **With Medicaid:** Free * **With insurance:** [Free under most plans](/features/257). If your plan has a high copay, you may qualify for [copay assistance](https://www.lilettaaccessconnect.com/Resources/PDF/LILETTA%20Patient%20…) that reduces the cost of the device to $75. * **Without insurance:** Depending on your income, you may be able to go to [a low-cost clinic](http://bedsider.org/free_birth_control) to get it at reduced cost or even for free. The full price of LILETTA can range from $50-$684. There is also an [out-of-pocket maximum of $75](https://www.lilettaaccessconnect.com/Resources/PDF/LILETTA%20Patient%20…) 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 - $57 * __Cost per month over three years:__ $1 - $19 _*Note: Without insurance there may be an additional cost for your health care provider 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._

If you want to get an IUD, the first thing you'll need to do is talk with your health care provider. They will ask you a bunch of questions about your medical history and your lifestyle, then give you an exam to make sure the IUD is right for you.

You can get the IUD inserted any time of the month. Some providers like to insert it during your period, but any time is fine as long as you can be sure you're not pregnant. It may be the most comfortable to get it done during the middle of your period, if you can believe that. (That's when your cervix—the opening to your uterus—is open the most.) It's pretty common to feel some cramps when you get an IUD inserted, but they'll go away with rest or pain medication. Some people might feel dizzy, too. Once the IUD is in, you'll notice a little string that hangs down into your vagina. That's there so that the IUD can be removed later. (The strings don't hang out of the vagina like a tampon, though.) After it's in, there's really not much you have to do other than check 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, congrats! 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.

p.s. Don't tug on the strings! If you do, the IUD could move out of place.

p.p.s. If you don't feel comfortable checking for the strings, you can let your provider do that the month after insertion, and then yearly after that.

There are positive and negative things to say about each and every method. And everyone's different—so what you experience may not be the same as what your friend experiences.

The Positive

Positive “side effects”? You bet. There are actually lots of things about birth control that are good for your body as well as your sex life.* Easy to use * Doesn't interrupt the heat of the moment * Super long-lasting protection without much effort * Safe for smokers and those with hypertension and diabetes * The Paragard brand of IUD doesn't change your hormone levels * The progestin IUDs may reduce cramps and make your period lighter. (Some people's periods stop completely.) * You can use it while you're breastfeeding

The Negative

Everyone worries about negative side effects, but for many people, they're not a problem. Most people adjust to having an IUD pretty quickly, but give yourself time. It could take a few months.#####The most common complaints: * Spotting between periods (especially during the first few months after you get an IUD) * 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 you still feel uncomfortable after three months, switch methods and stay protected. You're worth it. *For a very small number of people there are risks of serious side effects.
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.