The IUD (levonorgestrel intrauterine device) is a hormonal method. It is a small, T-shaped piece of plastic. The IUD is put into the uterus. Once there, it makes the lining of the uterus thinner and thickens the mucus of the cervix. This prevents the sperm from fertilizing the egg. IUDs offer 3, 4 or 5 years of protection (depending on the type). If you want to get pregnant, you can have the IUD removed.
Hormonal IUD
Summary
Quick Facts
- Easy to hide. A small plastic T-shaped device that’s put into your uterus (womb) and releases a progestogen hormone
- Effectiveness: IUD are one of the most effective methods. 99 in every 100 individuals using this method will manage to prevent pregnancy
- Side effects: you might have some cramping and spotting, and possible lighter periods.
- Effort: low. It is inserted once and lasts for up to 3, 4 or 5 years depending on the type
- Doesn’t protect against sexually transmitted infections (STIs)
- Doesn´t work for emergency contraception. Use a non hormonal IUD instead.
Details
Get it and forget it. If you do not want to worry about remembering your contraceptive method, the IUD just may be for you. Once it is in, you can leave it in for 3 to 7 years.
Hands-free. No packages or prescriptions to pick up at the pharmacy. There is nothing that could get lost or forgotten.
Total privacy. No one can tell when you have an IUD. There is no packaging, and nothing you need to do just before you have sex.
Safe and sound for female bodies. That is true even if you are young, have never been pregnant, or have never had kids.
Most experts agree, if you are healthy and have a uterus, you are probably a good candidate for the IUD. That is true even if you are young, have never been pregnant, or have never had kids. It is also a great method for new moms (even if you are breastfeeding).
The pregnancy question. You should be able to get pregnant quickly after you have the IUD removed. If you are not ready to get pregnant as soon as you have an IUD taken out, be sure to protect yourself with a different method.
Availability. Would you like to use this method? This method is available in many countries. Just ask in your local health facilities.
How To Use
- The first step to getting an IUD is to talk with your health care provider. She or he will ask you questions and give you an exam to make sure the IUD is right for you [8].
- You can get the IUD inserted any time of the month. Some providers like to insert it during your period, but any time is fine as long as you can be sure you are not pregnant. It may be the most comfortable to get it done during the middle of your period (that is when your cervix, the opening to your uterus – is open the most) [6].
- It is common to feel some cramps when you get an IUD inserted, but they will go away with rest or pain medication. Some women might feel dizzy, too. Once the IUD is in, you will notice a little string that hangs down into your vagina. That is there so that the IUD can be removed later. (The strings do not hang out of the vagina.)[4]
- Once it is in, you should check the ends of the strings a few times a year to make sure it is in place. This is how:
- Wash your hands with soap and water, then sit or squat down.
Put your finger in your vagina until you touch your cervix, which will feel firm and rubbery like the tip of your nose. - Feel for the strings. If you find them, congrats! Your IUD is good to go. But if you feel the hard part of the IUD against your cervix, you may need to have it adjusted or replaced by your provider.
- Do not tug on the strings! If you do, the IUD could move out of place.
If you are not comfortable checking for the strings, you can let your provider do that the month after insertion, and then yearly after that.
Side Effects
Everyone is different. What you experience may not be the same thing as another person.
The Positive: there are lots of things about IUDs that are good for your body as well as your sex life [3].
- Easy to use
- Does not interrupt the heat of the moment
- Long-lasting protection without much effort
- Safe for smokers and those with hypertension and diabetes
- You can use it while you are breastfeeding
- It may help protect against cervical and endometrial cancer
- It reduces the symptoms of endometriosis
The Negative: everyone worries about negative side effects, but for many women, they are not a problem. Most women adjust to having an IUD pretty quickly, but it could take a few months [7].
The most common complaints:
- Bleeding changes are common but not harmful. Typically, lighter and fewer days of bleeding, or infrequent or irregular bleeding
- Cramps and backaches
- Acne
- Mood changes
Other issues to watch out for [3]:
- IUS slipping out
- Infection
- IUD pushing through the wall of the uterus
If you feel the side effects are more than you can accept after three months, switch methods and stay protected. Remember, there is a method for everyone, everywhere!
*For a very small number of women, there are risks of serious side effects
References
[1] BATESON, D., & McNAMEE, K. (2016). Intrauterine contraception A best practice approach across the reproductive lifespan. Medicine Today. Retrieved from https://www.shinesa.org.au/media/2016/07/Intrauterine-contraception-A-best-practice-approach-Medicine-Today.pdf
[2] Dr Marie Marie Stopes International. (2017). Contraception. Retrieved from http://www.mariestopes.org.au/wp-content/uploads/Contraception-brochure-web-200417.pdf
[3] Faculty of Sexual & Reproductive Healthcare. (Amended 2019). Faculty of Sexual & Reproductive Healthcare Clinical Guidance: Intrauterine Contraception Clinical Effectiveness Unit. RCOG. Retrieved from https://www.fsrh.org/standards-and-guidance/documents/ceuguidanceintrauterinecontraception/
[4] Family Planning NT. (2016). Intra Uterine Contraceptive Device (IUD or IUCD). Retrieved from http://www.fpwnt.com.au/365_docs/attachments/protarea/IUD-46c2853c.pdf
[5] FSRH The Faculty of Sexual & Reproductive Healthcare. (Amended 2019). UK MEDICAL ELIGIBILITY CRITERIA. RCOG, London. Retrieved from https://www.fsrh.org/standards-and-guidance/documents/ukmec-2016/
[6] Nelson, A. L., & Massoudi, N. (2016). New developments in intrauterine device use: focus on the US. Retrieved fromhttps://www.dovepress.com/new-developments-in-intrauterine-device-use-focus-on-the-us-peer-reviewed-fulltext-article-OAJC
[7] Society of Obstetricians and Gynaecologists of Canada. (2016). Canadian Contraception Consensus: Chapter 7 Intrauterine Contraception. JOGC. Retrieved from https://www.jogc.com/article/S1701-2163(15)00024-9/pdf
[8] Tudorache, et al. (2017). Birth Control and Family Planning Using Intrauterine Devices (IUDs). Retrieved from
[9] World Health Organization Department of Reproductive Health and Research and Johns Hopkins Bloomberg School of Public Health Center for Communication Programs. (2018). Family Planning: A Global Handbook for Providers. Baltimore and Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-eng.pdf?sequence=1
[10] World Health Organization. (2016). Selected practice recommendations for contraceptive use. Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/252267/9789241565400-eng.pdf?sequence=1