Intrauterine Device (IUD): Teen Version

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KEY POINTS

• An intrauterine device (IUD) is a T-shaped birth control device put into a woman's uterus by her healthcare provider. IUDs don’t keep you from getting HIV/AIDS or other sexually transmitted diseases.
• IUDs offer long-lasting birth control. Usually progesterone IUDs are replaced after 3 to 5 years, depending on the brand. Copper IUDs need to be replaced after 10 years.
• You need to see your healthcare provider regularly for checkups as long as you have the IUD in place.

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What is an intrauterine device (IUD)?

An intrauterine device (IUD) is a birth control device put into a woman's uterus by her healthcare provider. The uterus is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus, through the cervix. It is T-shaped with a string attached. There are 2 types of IUDs.

• IUDs that contain copper
• IUDs that contain the female hormone progesterone

The IUD prevents pregnancy in several ways:

• It kills or damages sperm to keep them from reaching your eggs.
• It can slow the movement of eggs to your uterus.
• It can make the eggs unable to be fertilized even if sperm are present.
• It may keep a fertilized egg from implanting in the uterus.

Talk to your healthcare provider about the risks of using an IUD if:

• You have cancer in the uterus or cervix
• You have unexplained vaginal bleeding
• You may be pregnant
• You have had pelvic inflammatory disease
• You have had a severe infection of the cervix
• You have growths called fibroids or other problems with your uterus that make it hard to insert the IUD
• You change sexual partners often or if you or your partner has more than 1 sexual partner
• You have had either a pregnancy or infection in the fallopian tubes that lead from the ovaries to the uterus

You should not use a copper IUD if you are allergic to copper or metals.

How is it used?

Your healthcare provider will put the IUD into your uterus through the vagina and cervix (the cervix is the opening of the uterus). The IUD is usually inserted during a menstrual period, when the cervix is slightly open and you are least likely to be pregnant. It takes only a few minutes to insert an IUD. You may feel some cramping pain while it is being put into place.

The copper IUD can also be used for emergency birth control. It can be inserted up to 5 days after unprotected sex. Studies have shown it works to prevent pregnancy 99.9% of the time when it is used in this way.

What happens after I get an IUD?

The IUD could come out accidentally in the first few months after its placement, possibly without your knowing it. You might want to use a backup method of birth control during the first few months, just to be safe.

Your healthcare provider may want to examine you within 3 months after the insertion of the IUD to be sure that everything is normal. You need to see your healthcare provider regularly for checkups as long as you have the IUD in place. Talk with your provider about this.

During the first few months after insertion of the IUD, check often for the string attached to it to be sure that the IUD is still in the uterus. The string passes from the IUD inside the uterus through the cervix and into the vagina. The end of the string usually stays out of the way at the top of the vagina. You can check for the string by putting a finger inside the vagina and feeling for the string near the cervix. Be careful not to pull on the string. Also check for the string after every menstrual period and before you have sex. As long as you can feel the string, the IUD is in position and it is unlikely that you will get pregnant. If you feel the hard plastic of the IUD, it is no longer in the right place and you need to see your healthcare provider to change it.

Usually progesterone IUDs are replaced after 3 to 5 years, depending on the brand. Copper IUDs need to be replaced after 10 years. Removal or replacement of an IUD must be done by your healthcare provider. Do not try to remove the IUD yourself.

What are the benefits?

• Fewer than 1 out of 100 women who use an IUD for birth control get pregnant during 1 year of use.
• It does not cost much.
• Sex does not need to be interrupted by putting on a condom, or using a diaphragm or spermicide.
• If you have a progesterone-containing IUD, you will have less bleeding and cramps during your periods. Sometimes you may skip menstrual periods with this type of IUD.
• An IUD starts preventing pregnancy as soon as it is inserted and continues to prevent pregnancy for 3 to 10 years, depending on the type.
• If you want to have children, your ability to get pregnant returns quickly after the IUD is removed.

What are the risks?

• You may have spotting between periods or increased menstrual bleeding and cramps, mostly during the first few months of use.
• The string may irritate your partner's penis.
• The IUD may get stuck in the uterine wall, or damage the uterus or other organs. Talk with your healthcare provider before you have deep heat treatment or therapeutic ultrasound while your IUD is in place. These treatments may increase the risk of injury to the tissues of the uterus.
• You may have a higher risk of pelvic inflammatory disease, which can lead to being unable to get pregnant.
• If the IUD falls out, you may have an unexpected pregnancy.
• IUDs don’t keep you from getting infected with HIV/AIDS or other sexually transmitted diseases.
• Latex or polyurethane condoms are the only method of birth control that can protect against HIV/AIDS.
• If you get pregnant with an IUD in place, tell your healthcare provider right away. The IUD should be removed right away to prevent a tubal (ectopic) pregnancy, miscarriage (loss of the baby), infection in the uterus, or premature birth of the baby.