An intrauterine device (IUD) is a form of birth control. It prevents pregnancy either by damaging or killing a man’s sperm or blocking it from entering a woman’s uterus. An IUD is a small, T-shaped device with a string attached to the end. The purpose of the string is to help you or your doctor make sure that the IUD is still in place. It also is how a doctor removes the device.

There are 2 types of IUDs available in the United States: hormonal and non-hormonal. ParaGard is the non-hormonal option. It has copper rings, or coils, that alter the chemicals in your uterine fluid to kill sperm. You should not use ParaGard if you are allergic to copper. Hormonal options include Mirena, Kyleena, Liletta, and Skyla. These release progestin hormones to thicken your cervical mucus and stop ovulation.

Path to improved health

Your primary care or women’s doctor can insert an IUD. They can insert ParaGard at any time during your menstrual cycle. Hormonal IUDs should be inserted in the first 7 days of your cycle. The procedure is quick and done in the doctor’s office. The doctor puts a small plastic tube with the IUD into your vagina. You may have pain or cramping during this process. Discomfort can last several hours or days. Most doctors suggest that you have someone else drive you home from the appointment.

IUDs start working immediately. You can have sex, exercise, and use tampons. An IUD is effective for 3 to 12 years, depending on the type. Your doctor can remove it at any time.

Call your doctor right away if you have the following symptoms or problems. They will check your IUD and may remove or replace it.

• You can’t find the string
• You can feel the IUD
• Your IUD comes loose or falls out
• You have a fever or chills
• You have abnormal blood, fluid, or odor coming from your vagina

Things to consider

You should not use an IUD if you have abnormal vaginal bleeding. Cancer of the cervix or uterus or the AIDS infection prevent IUD use as well. You shouldn’t use an IUD if you are pregnant or want to become pregnant. You can, however, get an IUD immediately after giving birth. The best time for the doctor to insert it is after delivery of the baby and placenta.

IUDs do not protect you from sexually transmitted diseases or infections (STDs or STIs). To reduce your risk of getting an STD, use a condom when you have sex. IUDs can affect your menstrual cycle. At first, you may have pain, cramping, or spotting (light bleeding) between periods. This can last for 3 to 6 months. Hormonal IUDs can cause your periods to be irregular. They may also cause you to miss periods. Copper IUDs can cause worse cramps and bleeding during your period.

The benefits of IUDs include:

• Pregnancy prevention success rate of 99% when used properly
• Use of 3 to 12 years, depending on the type
• Can be removed by your doctor at any time
• Convenience
• Safe for women who just gave birth and/or are breastfeeding
• Cannot be felt during sex
• Low risk of side effects

Risks are uncommon, but include:

• Injury to the uterus when the IUD is being inserted
• Increased risk of pelvic inflammatory disease if you have an STD
• Chance of getting pregnant, in which case your doctor should remove the IUD (If you become pregnant, the risk of miscarriage and health problems for you and the baby increase.)
• Chance of an ectopic pregnancy (This occurs when an egg fertilizes outside of your uterus. It is rare but can be harmful for a woman.)

Questions to ask your doctor

• How do I know which IUD is right for me, or if I should use another form of birth control?
• Are there any other health conditions that prevent me from using an IUD?
• Does my age play a factor in which type and brand of IUD I get?
• Does my insurance cover an IUD?
• How often do I need to check my IUD, either by a doctor or myself?
• What happens after an IUD expires?

Resources

American Academy of Family Physicians: Birth Control Options

Centers for Disease Control and Prevention: Intrauterine Contraception

National Institutes of Health, MedlinePlus: Intrauterine Devices (IUD)

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Emergency contraception is a form of birth control. It can help prevent pregnancy if used within 5 days of having unprotected sex. If you are pregnant, emergency contraception pills will not stop or harm your pregnancy.

Emergency contraception is used in certain situations, including:

• You had unprotected sex.
• You had unprotected sex and forgot to take your birth control pills.
• Your partner’s condom broke or slipped off during sex.
• Your diaphragm or sponge came out of place during sex.
• You were raped.

There are 2 types of emergency contraception available. One option is medicine, which is often known as “the morning-after pill.” In the United States, pills that contain levonorgestrel (Plan B One-Step®) do not require a prescription from your doctor. You can purchase them over the counter at a pharmacy. Pills that contain ulipristal acetate (ella®) do require a prescription.

The second option is to use an intrauterine device (IUD) that contains copper (ParaGard). You must go to a doctor to have an IUD inserted.

Emergency contraceptive pills can be very effective if they are used in time. The pills are most effective when taken within 24 hours of having sex. They are still effective when taken up to five days after having sex. Ulipristal acetate pills reduce your risk of pregnancy more than levonorgestrel pills. The pills cannot prevent pregnancy if you have unprotected sex after taking them.

ParaGard, an IUD, is a small, T-shaped device that is placed inside your uterus. Unlike pills, IUDs don’t stop your ovaries from releasing an egg. They can prevent an egg from being fertilized or implanted. An IUD is very effective for emergency contraception. It can reduce your risk of pregnancy by more than 99%. This is true if your doctor inserts it within 5 days of sex. This IUD can be left in your body for up to 10 years to prevent pregnancy. Some women use IUDs as their regular form of birth control. Common side effects of a ParaGard IUD are heavier, longer periods and spotting or cramping between periods. Symptoms usually improve in the first 3 to 6 months.

Places to get emergency contraception include:

• Your primary care doctor’s office.
• College/university and women’s health centers.
• Public health departments.
• Hospital emergency departments.
• Planned Parenthood centers.

Path to improved health

Emergency contraception can prevent pregnancy by:

• Stopping ovulation (the release of an egg from your ovaries).
• Stopping sperm from fertilizing an egg.
• Stopping a fertilized egg from implantation (attaching itself to the wall of your uterus).

Emergency contraception cannot prevent or end pregnancy if a fertilized egg already is implanted. Because of this, emergency contraception is not a means of abortion.

Most medicine brands require a single dose of 1 pill. Some brands have 2 doses (1 pill followed by a second pill 12 hours later). Sometimes, you can take both pills together. Follow the instructions for each specific brand. The U.S. Food and Drug Administration (FDA) says that some brands of regular birth control pills can be used in increased doses for emergency contraception. However, this method is less effective. It can cause more side effects. Talk to your doctor to see if your birth control pills are safe for emergency use.

Some women feel nauseous after they take emergency contraceptive pills. This feeling should go away in about 2 days. Your doctor can give you medicine to reduce nausea. Other possible side effects include:

• headache
• cramping
• tender breasts

Things to consider

Keep in mind, emergency contraception does not protect against sexually transmitted diseases (STDs). You should not use any emergency contraception if you know you are pregnant or are trying to get pregnant.

Women who are breastfeeding should not use pills that contain ulipristal acetate. Pills also are less effective for women who are overweight or obese. Instead, these women should use the ParaGard IUD. Do not get an IUD if you:

• Have abnormal bleeding.
• Have cancer of the cervix or uterus.
• Have the AIDS infection.
• Are allergic to copper.

Emergency contraceptive pills can affect your menstrual cycle. Talk to your doctor if you do not get your period within 1 month after taking them. Your doctor also can tell you when to start taking your regular form of birth control again. It will vary if you use a hormonal form, such as pills, shots, the patch, or a vaginal ring. If you use a barrier method, such as a diaphragm or condoms, you can start using it right away. If you do not use birth control, talk to your doctor about which method will work best for you.

Questions to ask your doctor

• Which type of emergency contraceptive pills should I use?
• What happens if I take extra regular birth control pills in an emergency?
• How soon after unprotected sex should I take a pregnancy test?
• Will emergency contraception cause an abortion?
• Can I use emergency contraception even if I can’t normally tolerate birth control pills?

Resources

National Institutes of Health, MedlinePlus: Emergency contraception

U.S. Department of Health and Human Services, Office on Women’s Health: Emergency Contraception

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