Real Sex Ed

Ask Elizabeth

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This article discusses a mature topic. Our 17-year-old and younger readers are encouraged to read this with an adult.

HBO’s new series Girls has me thinking about when I was 24 years old, not long out of college, and consumed with periodic bouts of my own “vagina panic”. When I ask myself what I know now, and didn’t know then (but wish I did), one of the first things that comes to mind is…the IUD.

This might come as a surprise because the IUD (which stands for Intrauterine Device) is what we sexual health professionals refer to as “old-school contraceptive technology.” But, like that great pair of vintage bell bottoms you have stashed in the closet, this 1970s favorite is worth revisiting. For women in their late-teens and early-twenties, IUDs can be a great birth control option because they effectively prevent pregnancy for five to twelve years!

There are two kinds of IUD on the market–Paragard and Mirena. Both are small, plastic, T-shaped devices that are inserted by a health care professional through the cervix and into the uterus. The Paragard is hormone-free, with a small copper wrapping that interacts with the body’s chemistry to interfere with the movement of sperm. The Mirena releases a continuous, low dose of hormones to prevent ovulation (when an egg is released from the ovary). Both devices also alter the lining of the uterus; which can create an inhospitable environment for fertilized eggs.

In this edition of “Ask Elizabeth,” I’m going to answer some of the questions I’ve received about IUDs. Do you have a question that you’d like to see answered in this column? Send them to me at AskElizabeth@pp-la.org.

Can I get an IUD? I’ve heard it’s just for women who’ve already had kids.

In the past, IUDs were only recommended for women who’d already experienced childbirth—but that all changed in 2005 when the Food and Drug Administration (also known as the FDA) approved IUDs for all women. IUDs today are extremely safe and reliable (with only a 1% failure rate). However, IUDs do carry a limited amount of risk for any woman. In rare cases, the IUD can puncture the uterus during insertion. There are also rare cases where the IUD is expelled (pushed out) from the uterus. This seems to be slightly more common in a) women who have their IUDs inserted shortly after childbirth and b) women who’ve never given birth before. It’s always important to talk to a health care professional about any concerns or questions you have.

If I get an IUD, will my boyfriend feel it when we have sex?

The majority of the IUD is in the uterus, which means that it shouldn’t be felt during vaginal sex. There are two small strings that are attached to the end of the IUD that are meant to hang outside of the cervix in the vaginal canal. The purpose of these strings is to verify that the IUD is positioned correctly. However, they shouldn’t interfere with vaginal sex, and your partner shouldn’t be able to feel them.

What are the most common side effects of the IUD?

The potential side effects are different for the two IUDs. With the Paragard (the copper T), the most common side effects reported are heavier periods and worse menstrual cramps. The side effects for the Mirena are similar to other hormonal methods, and these can include spotting between periods, lighter and shorter periods, and less cramping. With the Mirena, some women stop getting their periods all together, which might freak someone out if they’re not expecting it!

How do I know if the IUD is the right birth control method for me?

If you’re looking for a method, that is safe, effective, and doesn’t require remembering to do something every day, then the IUD might be for you. But not all birth control methods are right for all people—for help deciding, visit My Method or call the Planned Parenthood health center nearest you at 1-800-230-PLAN.