Updated November 28, 2018.
Intrauterine devices (IUDs) have been gaining in popularity in the U.S.—and for good reason. They’re an effective, long-lasting, and low-maintenance way to prevent pregnancy. An IUD is a small T-shaped birth control device that is inserted into a woman’s uterus by her health care provider. The flexible plastic device sits just inside the uterus for the duration of use.
There are two types of IUDs:
- non-hormonal (Paragard)
- hormonal (Mirena, Kyleena, Skyla, and Liletta)
The main mechanism of both types of IUDs is the same: The presence of the device initiates a local inflammatory response that kills sperm and prevents fertilization from occurring.
Also known as the copper IUD, Paragard contains copper, which has spermicidal effects. Paragard is the longest-lasting reversible birth control method available—it is effective for 10 years. With Paragard, you have monthly periods, which can be heavier and crampier than what you’re used to, especially at first, as your body adjusts to the device. If you prefer a non-hormonal method and still want to get your period, this method may be right for you.
Mirena and Kyleena, which last at least five years, and Skyla and Liletta, which last three years, release a very low dose of the hormone progestin, which is also found in birth control pills. Unlike many birth control pills, they don’t contain estrogen. Progestin thickens cervical mucus, which creates a barrier to sperm entry and may prevent ovulation in some women. This can cause lighter periods, and some women stop menstruating altogether, which is completely safe. Unlike oral contraceptives, the progestin in these IUDs is primarily delivered locally (instead of passing through your body) and, thus, is associated with fewer side effects.
Many health care providers consider the IUD the gold standard when it comes to birth control. Here’s why.
Note: The word “IUD” below refers to all five types of IUDs unless otherwise noted.
1. They are highly effective.
The IUD is one of the most effective types of birth control currently on the market. The pregnancy rate for IUD users is less than one percent. In fact, it’s as effective as tubal ligation—“getting your tubes tied.” For this reason, it’s often recommended as an alternative to tubal ligation since it has the benefit of being easily reversible.
2. They are low-maintenance and may improve your sex life.
With an IUD, there is nothing to remember—no daily pill, no weekly change of the Ortho Evra patch or monthly change of the NuvaRing and no loss of spontaneity while searching for a condom.
3. Few hormones mean less concerning side effects.
Birth control methods containing estrogen—such as NuvaRing, the Ortho Evra patch, and most birth control pills—are contraindicated in some women. This includes women with hypertension, certain types of migraines, or an increased risk for blood clots, and women who smoke or are at risk for cardiovascular disease. Since the IUD lacks estrogen, it is a low-risk alternative. (Not to mention the fact that there is also significantly less progesterone than the alternatives).
In addition, common side effects of oral contraceptives (nausea, bloating, breast tenderness, etc.) are generally less common with the IUD.
4. They are the most economical.
Long-term, IUDs are considered to be the least expensive birth control method available. Unlike other methods, the IUD only costs money upfront. Without insurance, the cost of most IUDs is $500 to $1,000 out-of-pocket, which over time, is very cost-effective. In the case of Paragard, the initial cost is significantly lower than 10 years of monthly birth control prescriptions ($1,800 to $6,000). The upfront cost can be even lower due to IUDs being covered by more and more insurance plans. Many clinics with sliding fee scales, like Planned Parenthood, also offer reduced pricing for patients who are uninsured.
Many women who use hormonal IUDs stop menstruating while the IUD is in place, which adds the cost-savings of not needing to buy tampons or pads.
5. You have a rapid return to fertility.
The IUD can be removed at any time by a health care provider and fertility will return to normal very quickly.
6. They’re safe for teens and women who haven’t had children.
In the 1970s, IUDs had a very bad reputation. A device called the Dalkon Shield became infamous when it was found to have serious design flaws that made it unsuitable for adolescents and increased a woman’s risk of infection and infertility.
The IUDs of today are a world away from the Dalkon Shield. Considerable evidence suggests that Paragard, Mirena, Kyleena, Skyla, and Liletta are safe for most women, including teenagers, women who plan to become pregnant in the future, and women with multiple partners (although if you are at high risk for sexually transmitted infections, your provider may recommend a different method since contraction of an infection may require removal of the IUD). The American College of Obstetricians and Gynecologists recommends IUDs as a safe, appropriate, and highly effective method of birth control for the majority of women.
7. The most knowledgeable people are using it.
IUDs are the most popular choice for female health care providers who do counseling around family planning, such as obstetricians, gynecologists, midwives, and nurses. According to a study published in Obstetrics & Gynecology, of the health care providers surveyed who reported using contraception, 40 percent used IUDs. This contrasted with only 6.3 percent of women in the general population who used either an IUD or an implant (another long-acting form of birth control).
Need help deciding if an IUD is right for you? We’re available to talk through your options via phone or in person. Visit onemedical.com to contact your local One Medical office or to make an appointment.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.
Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. The One Medical Group entities and 1Life Healthcare, Inc. make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.
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