Everything You Need to Know About IUDs According to OB-GYNs
So long, birth control pills.
When most people think of birth control, pills and condoms are usually the first two things that pop into their minds. And while those two forms of contraceptives are incredibly popular, over the past couple of decades, IUDs—aka intrauterine devices—have become increasingly sought after. From their convenient implementation to their high efficacy, IUDs have a lot to offer—but are they the right fit for you? Keep reading to learn everything there is to know about these birth control devices.
What is an IUD?
An IUD is a tiny, T-shaped device that is inserted into the uterus to serve as a form of contraception. According to Dr. Monica Grover, a double-board-certified gynecologist at VSPOT Sexual Health Spa in Manhattan, IUDs are a form of Long-Acting Reversible Contraceptive (LARC). "This means that it doesn't require short-term dosing of a daily or monthly regimen, and can stay placed within the uterus for years at a time and be removed upon the desired conception," she explains.
How is an IUD inserted?
Unlike other forms of contraceptives, IUDs require a physician's assistance to be put in place. "IUDs are inserted vaginally into the uterus through the cervical opening," explains Dr. Zaher Merhi, an OB-GYN and the founder of Rejuvenating Fertility Center in Manhattan. "Insertion of the IUD requires training and is preferably performed by a physician under ultrasound guidance. It does not require sedation or general anesthesia." Due to the insertion, Dr. Merhi says that patients may experience minimal cramping during the process.
What does an IUD feel like?
As mentioned above, inserted IUDs can start off with minimal cramping. Dr. Grover likens the sensation to that of period cramps, so nothing too intense. "This will subside and then there may be some cramping on a monthly basis as well as spottiness for the first six months to a year," she adds, noting that these symptoms are temporary and the body will adjust to the IUD.
Once the adjustment period is up, Dr. Merhi says that patients shouldn't feel anything on a regular basis. That said, she mentions that minor pelvic heaviness—due to an object being perpetually inserted into the cervix—can occur. Additionally, she says that mild discomfort during sex can occur, though that's rare, not the norm.
There are a few key benefits of using IUDs. First and foremost, Dr. Grover says that they're one of the most minimalist methods from a hormone absorption perspective (and there are even hormone-free IUDs altogether (i.e.: the copper IUD)). As a result, they're the least likely to alter your mood and emotions. Additionally, they're not one of the most convenient forms of birth control, given they don't require putting on a condom (and trusting that it won't break) or taking a pill at the same time each day. They're also one of the most effective, given user error (i.e.: forgetting to take a pill or putting on a condom improperly) is much less likely to occur. And, IUDs are the longest-lasting form of birth control, offering between three to 10 years of contraceptive protection.
IUDs can lessen menstrual flow and pain.
Another benefit of IUDs is that there are types designed beyond pure contraceptive purposes. "Those containing progesterone [like Skyla, Liletta, and Mirena] have the added benefits of reducing menstrual flow, decreasing pain during periods, shrinking the size of large fibroids, and improving endometriosis symptoms (a pathology frequently found in women and leading to painful menses)," Dr. Merhi shares.
IUDs do not prevent against STIs.
Another thing to mention is that, like many forms of birth control, IUDs don't prevent against STIs.
IUDs do have some side effects and risks.
While copper IUDs offer a hormone-free option, they come with the potential for heavier flow during your period. That said, for some IUD users, Dr. Merhi says that the device can completely nix periods during wear.
Lastly, albeit very rare, uterine perforation and/or expulsion can occur with IUDs. "These side effects were much [more] common with older and poorly designed IUDs; however, these are very rare occurrences with the T-Shaped IUDs, which is now the design of all IUDs," Dr. Grover admits.
IUDs are covered by health insurance.
If you have health insurance, IUDs can cost as little as $0. If you don't, however, they can cost as much as $1,300, according to Planned Parenthood.
IUDs prevent pregnancy more effectively than pills and condoms.
As mentioned above, IUDs are the most effective form of birth control (outside of abstinence, that is) on the market. "IUDs provide the highest efficacy among all oral and injectable contraception methods, including birth control pills and condoms," Dr. Merhi says. "For example, the copper IUD is 98% effective as a contraceptive and Progestin IUD is 99%, whereas birth control pills are 95% at best and condoms are 85 to 90% efficacy only."
How to determine if an IUD is right for you:
Since IUDs don't prevent STIs, Dr. Grover says that someone who is in a monogamous relationship might be considered the best candidate just because they may not be having sex with other individuals. Dr. Merhi adds that anyone looking for long-term contraception, as well as women with other gynecological problems such as heavy menstrual flow or painful menses, can benefit greatly from its implementation as well. "Women who do not like to swallow pills or forget to take pills on time are also good candidates for IUD," she adds.
Those who aren't considered ideal candidates are those who are pregnant or experiencing ongoing unexplained vaginal bleeding. Dr. Grover says that in both scenarios, those pre-existing conditions must be addressed and dealt with before an IUD is a good choice.