What is an IUD?

The letters "IUD" stand for "intrauterine device." The IUD is a safe and highly effective form of long-acting reversible contraception (LARC). IUDs are small, "T-shaped" contraceptive devices made of flexible plastic. IUDs are inserted into the uterus by a medical provider with special training.

There are currently 5 types of IUDs available on the United States; ParaGard, Mirena, Kyleena, Liletta, and Skyla. The Paragard is a nonhormonal IUD and a plastic T wrapped with copper wire which can be left in place for up to 12 years. The Mirena, Kyleena, Liletta, and Skyla IUDs use the hormone progestin to prevent pregnancy. Progestin is very similar to the hormone progesterone that bodies make naturally. Mirena and Liletta IUDs work for up to 7 years. The Kyleena IUD works for up to 5 years and the Skyla works for up to 3 years.

The IUD is the reversible contraceptive method used by more people across the globe than any other method. 

How does it work to prevent pregnancy?

It isn't precisely known how IUDs prevent pregnancy but the general assumption is that they prevent the sperm from fertilizing ova (eggs). The IUD is a foreign body which creates an environment not hospitable to sperm. The Paragard releases copper ions which impair sperm function. The hormonal IUDs release progestin which causes thickening of cervical mucus which blocks movement of the sperm, thins the lining of the uterus, and ovulation may be suppressed due to the systemic effect of the hormone.

How effective is the IUD in preventing pregnancy and STIs?

The IUD is one of the most effective methods of contraception available. Less than 1 in 100 people will get pregnant each year using the IUD. However, IUDs do not offer any protection against sexually transmitted infections (STIs). 

What are the benefits of using an IUD?

  • IUDs have a good safety record.

  • IUDs offer an alternative to birth control pills for those who can't use a method containing estrogen.

  • IUDs are cost effective over time.

  • Convenient and private.

  • Long term protection which can be revered easily and quickly.

  • Decreased bleeding and cramps are often experienced with hormonal IUDs.

  • An IUD can be put in place immediately after a pregnancy has ended (whether by termination, miscarriage or delivery).

  • The Paragard IUD can be placed in the first 5 days after unprotected intercourse as a highly effective form of emergency contraception.

  • Decreased risk of endometrial cancer.

  • Decreased risk of ectopic (tubal) pregnancy. 

What are the disadvantages of using an IUD?

  • The procedure for insertion can be uncomfortable, with cramping and pain immediately following insertion.

  • Increased menstrual cramps and bleeding for some users with the Paragard.

  • Irregular bleeding with the hormonal methods, particularly in the first few months after insertion. Some people will stop having periods with these IUDs, which is safe but which may or may not be desirable for some people. 

  • Very small risk of perforation of the uterus.

  • There is a 2-10% risk of explusion of the IUD in the first year. This risk is increased in those who haven't had children, who are under age 20, who are immediately post-partum, or who have severe cramps or heavy bleeding. There is a 30% risk of expulsion if someone has had a previous IUD expulsion.

  • Small risk of infection.

  • Some people using the hormonal IUDs will experience progestin side effects. Most of these side effects are local rather than systemic and are reduced over time, but some users experience breast change, moodiness and acne.

  • Paragard has no hormonal benefits or disadvantages. Some people who have had decreased cramps, bleeding or acne on oral contraceptives may find that these symptoms worsen if they switch to the Paragard. 

Who should not use an IUD?

The choice to use an IUD is one you will make after a discussion with your provider. The following are some conditions which may be contraindications to the insertion of an IUD:

  • Current pregnancy

  • Active pelvic infection

  • Allergy to copper or Wilson's disease (Paragard)

  • Allergy to levonorgesterel (Mirena or Skyla)

  • Unexplained vaginal bleeding

  • Anemia due to heavy periods (Paragard) 

Past concerns about IUDs

There are some lingering misconceptions about this form of birth control. One is that IUDs are dangerous, causing infection and infertility. A type of IUD called the Dalkon Shield was removed from the market in the 1980s. It caused serious infections due to a design flaw. Reviews of the medical literature point to a very low risk of infection or infertility among current IUD users. Another misconception is that the IUD is only for those who have given birth. We now know that the IUD can be inserted and used safely by people of all ages and by those who have not given birth. 

How do I know which IUD is right for me?

When choosing which IUD is right for you, it usually comes down to what you want your period to look like, whether you want a hormonal or non-hormonal option, and for how long you want the device.

The Paragard, which contains copper and is non-hormonal, is good for 12 years. Many people report longer and heavier periods with the Paragard. This can also mean that your period may get more crampy with the Paragard. 

On the other hand, the Liletta and Mirena (both hormonal) are good for 7 years and most people report having light or no period after 6 months. The Skyla (effective for 3 years) and Kyleena (effective for 5 years) are smaller devices that contain fewer hormones, hence why their lifespan is shorter than the Liletta and Mirena. Many people report getting a short, light regular period with Skyla and Kyleena after 6 months. 

It is important to note that with any birth control change, it takes about 3-6 months for your body to adjust, meaning that side effects, such as irregular bleeding and cramping, are more common in that timeframe. The process of insertion is the same for all IUDs and may trigger/delay your period and cause some cramping for a few days post-procedure. This is all normal. Over-the-counter painkillers, such as ibuprofen or Tylenol, as well as a heating or ice pack can help with the cramping.

Where can I go to get an IUD and how much does it cost?

Depending on your insurance plan, Health Services may be able to offer you an IUD on site and without cost, or can refer you to an outside provider if that will allow you to get the method without cost or for lower cost. Brown students can make an appointment by calling 401.863-3953. Without insurance, an IUD would cost between $900-$1200.The IUD is covered by most insurance companies. You can call your health insurance company to find out what your out of pocket cost would be, if any. 

Related Links

For more information about IUDs you can visit:

Planned Parenthood

  • 401.863-2794
    Health Promotion
  • 401.863-3953
    Health Services
  • 401.863-6000
    Sexual Assault Response Line
  • 401.863-4111
  • 401.863-3476
    Counseling & Psychological Services
  • 401.863-4111