“The copper IUD (brand name Paragard) is FDA-approved for up to 12 years. Hormonal IUDs are effective between three and seven years depending on the brand,” explains Elissa Nagy, D.O., an OB/GYN at Perinatal Associates for GBMC Health Partners.
IUDs work by stopping sperm from entering the uterus to avoid fertilization. Both types of IUDs are incredibly successful at preventing pregnancy, with an efficiency rate of 99%. But even though IUDs are effective and easy to use, there are still many misconceptions about them.
Misconception 1: The IUD is painful.An IUD is a small T-shaped piece of plastic or copper that’s inserted in the uterus by a nurse or doctor. Dr. Nagy says once an IUD is in place, you shouldn’t be able to feel it at all, but the insertion process can be a bit uncomfortable.
“It’s an in-office procedure, and I usually tell people to take Tylenol or ibuprofen beforehand because insertion can make you a little crampy, similar to having period cramps, but it should resolve in a few hours,” Nagy explains.
Once the initial cramps have passed, usually within a day, there should be no pain associated with the IUD.
Misconception 2: It’s only for women who don’t want children or who have already given birth.While one of the benefits of the IUD is how long it can stay in the body without being replaced, the idea that it has to stay in that long is simply not true, Dr. Nagy says.
“The IUD is great because it lasts as long as you want it to, and you can take it out at any time. If you decide after six months you’re interested in having children or you want a different contraceptive option, it’s very easy to remove the IUD,” Dr. Nagy says.
Fertility returns to normal right after the IUD is removed, making it a viable birth control option for women hoping to get pregnant in the future.
Misconception 3: There’s a risk of infertility or miscarriage after removal.If an IUD is inserted correctly, it will not cause any difficulty for future pregnancies, Dr. Nagy says.
“Within a month or two after removal, your pregnancy rate should be similar to what it was before inserting an IUD,” says Dr. Nagy. “[Women who had IUDs removed and became pregnant] have not shown an increase in miscarriage rates.”
Dr. Nagy explains the only risk of miscarriage comes on the very rare occasion that someone gets pregnant while the IUD is in place.
She emphasizes if this happens, you should call your doctor and have the IUD removed as soon as possible to decrease that risk.
Misconception 4: The IUD will make your period heavier and more painful.There are two types of IUDs available in the US: copper (Paragard) and hormonal. Paragard doesn’t have any hormones and is wrapped in a tiny bit of copper. Hormonal IUDs are made of plastic and use the hormone progestin to prevent pregnancy. If you choose to have Paragard inserted, Dr. Nagy says you can expect to have a similar experience with your monthly cycle as before insertion, and some women do report a slight increase in bleeding and cramping. She explains if your periods are regularly painful and heavy, the copper IUD may not be the best choice of contraception. But if you go the hormonal IUD route, a decrease in bleeding is more likely.
“10 to 20% of women don’t even have a period while on the IUD, which some women really enjoy not having to worry about, and that’s completely healthy and normal,” Dr. Nagy says.
Misconception 5: An IUD can fall out, making it ineffective.To be fair, this is not actually a misconception because it can happen, but Dr. Nagy assures it’s a small risk.
“Between 2 and 10% of IUDs can fall out, particularly in the first year after placement during a heavy period.”
Dr. Nagy says if you believe your IUD has fallen out, you can either check for the strings yourself or make an appointment with your doctor to ensure proper placement. If your IUD has been misplaced, Dr. Nagy recommends making an appointment with your doctor to either get a new one inserted or to choose a different form of contraceptive. She also suggests using a backup form of birth control until that time.
All things considered, Dr. Nagy highly recommends the IUD for the majority of women who are weighing their birth control options.
“It’s greater than 99% effective, which is the same as tubal litigation, but it’s reversible, which is what makes it so great for women of all ages,” Dr. Nagy says.