The world is constantly evolving, and with it, new methods and possibilities for women’s health are emerging. Contraceptive methods, which used to be so limited, are now expanding in type and options to suit any woman and any need. Thinking about these different needs among women, the contraceptive method known as the IUD was developed.

What is the IUD?

The acronym IUD stands for intrauterine device, which refers to how it is used: a small device made of fully flexible plastic molded into a T-shape that is inserted into the uterus1, specifically to prevent an unwanted pregnancy. Unlike most other contraceptive methods, the IUD cannot be easily inserted at home or at a pharmacy, as is the case with birth control injections. It requires proper medical preparation and must be inserted at the gynecologist’s office, as well as removed there. Its main difference from other contraceptive methods is its 99% effectiveness and the long period of protection it provides, which can last from 5 to 10 years and can be removed at any time if desired. Its mode of action is also different from other methods that solely focus on preventing ovulation. The presence of the IUD in the uterine cavity triggers a type of inflammatory process, which hinders ovulation as it normally occurs and also interferes with the movement of sperm toward the uterine cavity, preventing fertilization. Another important point about using this method is that specialists assure it causes fewer side effects than other medicated methods.

Types of IUD

There are two types of IUD, the copper and the hormonal IUD, the latter also known as Mirena. They are made of different materials and have different costs, so it’s best to discuss with your gynecologist which type is best for your body and your budget.

Copper IUD

The copper IUD2, also known as Multiload, is made of plastic and has a stem coated in copper or, in some versions, copper and silver, in a T-shape. It works by releasing copper into the uterus, causing an inflammatory process that changes the production of the endometrium, cervical mucus, and the function of the fallopian tubes, creating a hostile environment for sperm, which cannot survive long nor reach the uterine cavity. Even though it is the cheapest and most accessible IUD option, its failure rate is 0.7%, which is almost negligible, guaranteeing great safety and comfort for women who do not wish to become pregnant. The copper IUD can be used for 5 to 10 years.

Hormonal IUD (Mirena)

The hormonal IUD, or Mirena3, is also made from durable, flexible material in a T-shape that contains a small reservoir of the hormone levonorgestrel. The difference between the copper IUD and Mirena is that, instead of releasing copper, the Mirena releases gradual doses of hormones, causing the same effect in the uterus that prevents fertilization. Its advantage is that the majority of women using the Mirena IUD have their menstruation suspended, which can be a solution for those who suffer from heavy menstrual flow, anemia because of heavy periods, and it also benefits women with endometriosis. The chance of a woman getting pregnant while using the Mirena IUD is 0.2%. Unlike the copper IUD, Mirena’s usage time is up to 5 years.

Side Effects of IUD Use

As with any contraceptive method, side effects may occur, though they are not very common, but it’s important to be aware of them. Side effects may appear right after the IUD is inserted, which is why it’s recommended to monitor any signs closely in the days following the procedure.

  • Heavy bleeding after the insertion procedure;
  • Vaginal discharge;
  • Abdominal pain;
  • Uterine cramps;

With the copper IUD, there may be longer menstrual bleeding than normal and stronger menstrual cramps shortly after insertion. With the Mirena IUD, it is more common to have no periods or only minor spotting. Cases of acne, breast tenderness, fluid retention, headaches, and weight gain can also be observed. If symptoms are so intense that they disrupt a woman’s daily life, a doctor should be consulted. Symptoms like fever, chills, genital swelling, pain, and bleeding during intercourse can indicate complications; seek your gynecologist for evaluation.

Questions About Using the IUD

Since this is a method that can only be placed in a doctor’s office and you can’t see its function or its proper position, it’s natural for women to have many questions about what care is needed while using the IUD.

Can I Use Tampons or Menstrual Cups with an IUD?

When it comes to IUD use, external pads are generally recommended more as a precaution than because of any real risks. That’s because, after insertion, the IUD leaves a couple of centimeters of threads (2.5 cm to 5 cm) outside the cervix, and using a tampon or menstrual cup may result in accidentally pulling these threads. Thus, internal absorbents can be used as long as extra care is taken during removal.

Can My IUD Fall Out on Its Own?

It’s unlikely, but yes, it can fall out on its own if it becomes dislodged from where it was inserted. The IUD may be naturally expelled from the body, especially during menstruation, which makes it even harder to notice it has moved. Always watch your menstrual flow—if it’s much heavier than usual, it may mean the IUD has shifted.

Can Using an IUD Interfere with Sexual Intercourse?

No, it should not interfere. Since it is a contraceptive method, its very purpose is to prevent unwanted pregnancy. The only recommendation is to avoid sex for 24 hours after the IUD has been placed. However, if you notice any discomfort during sex, bleeding, or if you or your partner can feel the intrauterine device, see your gynecologist immediately.

What If I Can’t Feel the IUD Strings, What Should I Do?

Gynecologists ask women to monitor for signs of possible IUD displacement, and this can be done by touch as well. When you insert your finger into the vagina, you should be able to feel the end of the IUD’s string, which should be exposed about 2 to 5 cm. More than that, or not being able to feel the strings at all, may indicate it has moved out of place. If you cannot feel the strings, see your doctor immediately. If the strings are not found during the appointment, an ultrasound may be ordered for further analysis. Photo: Robin Marty