Intrauterine devices, or IUDs, are one of most popular forms of long-acting reversible contraception available. They can prevent unwanted pregnancies for years at a time without requiring any extra work on your part. If you’re thinking about getting an IUD, here are answers to the most common questions that can help you decide if an IUD is the best type of birth control for you.

What are IUDs?

IUDs are small, flexible devices that look like the letter T and are inserted into the uterus to prevent pregnancy. An IUD can remain in place for years, but you can have it removed at any time. Keep in mind that it’s possible to become pregnant during your first menstrual cycle after removal.

There are five brands of IUD in the United States that have been approved by the Food and Drug Administration (FDA): ParaGard, Liletta, Mirena, Skylar and Kyleena. There are some differences between these brands such as whether they contain hormones and how long they last.

How does an IUD work?

There are two types of IUD: hormonal and nonhormonal. Both are more than 99% effective at preventing pregnancy.

Hormonal IUDs

The majority of IUDs prevent pregnancy by releasing small amounts of the hormone progestin. This prevents eggs from leaving your ovaries and thickens your cervical mucus so that sperm can’t get through. Hormonal IUDs last for 3-7 years, depending on the brand. They start preventing pregnancy one week after insertion, or immediately if inserted during the first seven days of your menstrual cycle.

Nonhormonal IUDs

ParaGard is the only nonhormonal IUD – it’s made of copper, which is a natural spermicide. Nonhormonal IUDs can last for up to 12 years and protect against pregnancy immediately after insertion.

Does an IUD hurt?

Most women feel cramping or mild discomfort during the insertion process. If you feel pain, it usually only lasts a moment. After the IUD is inserted, you may feel dizzy or faint. Taking ibuprofen (Advil or Motrin) before and after your insertion appointment can help with discomfort. You can also schedule your appointment to take place during the last days of your period, when your cervix is naturally open.

How is an IUD inserted?

An IUD placement begins like a pelvic exam. A speculum, the metal instrument used during a pelvic exam, is inserted into your vagina to allow access to your cervix. A small tube with the IUD in it is inserted through your cervix. The IUD arms are bent back in the tube and open once it’s in your uterus. The process usually takes less than five minutes.

Do IUDs stop periods?

Some people’s periods can stop on an IUD. But like other forms of hormonal birth control, hormonal IUDs can help manage menstrual symptoms. In most cases, hormonal IUDs reduce period cramps, and make menstrual cycles more regular and lighter. However, copper IUDs don’t do any of these things. In some cases, a copper IUD can make periods heavier and cramps worse, but this usually goes away over time.

How soon after childbirth can I get an IUD?

You can get an IUD immediately after childbirth. However, it may be recommended that you wait six weeks because insertion after labor requires a different technique.

I’ve been told IUDs are unsafe. Is this true?

There are some risks to getting an IUD, but they’re very small. Rare complications include malposition and perforation. Malposition is when the IUD has an abnormal position in the uterus. Perforation is when the IUD passes through the wall of the uterus. Your care provider will be careful during placement to avoid these complications, and in some cases, an ultrasound may be used to confirm the IUD’s position.

Many concerns about the safety of IUDs date back to the 1970s. At the time, an IUD called the Dalkon Shield was shown to be ineffective at preventing pregnancy, and also caused very serious pelvic infections. But the Dalkon Shield had major design flaws that modern IUDs do not have.

That said, there are some conditions that can make an IUD an inappropriate choice of birth control. You shouldn’t get an IUD if you:

  • Have or might have an STD or other infection
  • Think you might be pregnant
  • Have vaginal bleeding that’s not related to your period
  • Have cervical cancer that hasn't been treated
  • Have cancer of the uterus
  • Have a bleeding disorder or Wilson’s Disease – an allergy to copper (in the case of the copper ParaGard IUD)

Find out if an IUD is right for you

Overall, IUDs are a very convenient form of birth control for many people. You can get the benefits of hormonal birth control without needing to take a pill or change a ring, and you aren’t at risk of using it incorrectly. Of course, with all the types of birth control that are available, it can still help to talk to an OB-GYN or midwife about whether an IUD is the method that best fits your needs.