- Easy to hide. A small plastic T-shaped device that’s put into your uterus (womb) and releases a progestogen hormone
- Effectiveness: IUSs 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 increased blood flow and cramping
- 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.
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.
Get it and forget it. If you do not want to worry about remembering your contraceptive method, the IUS just may be for you. Once it is in, you can leave it in for 3, 4 or 5 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 IUS. There is no packaging, and nothing you need to do just before you have sex.
Safe and sound for female bodies. Most experts agree, if you are healthy and have a uterus, you are probably a good candidate for the IUS. That is true even if you are young, have not ever been pregnant, have just had an abortion, do hard physical work, or have not had kids yet. 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 IUS removed. If you are not ready to get pregnant as soon as you have an IUS 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 IUS is to talk with your health care provider. She or he will ask you questions and give you an exam to make sure the IUS is right for you.
You can get the IUS 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).
It is common to feel some cramps when you get an IUS inserted, but they will go away with rest or pain medication. Some women might feel dizzy, too. Once the IUS is in, you will notice a little string that hangs down into your vagina. That is there so that the IUS can be removed later. (The strings do not hang out of the vagina.)
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 IUS is good to go. But if you feel the hard part of the IUS 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 IUS 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.
Everyone is different. What you experience may not be the same thing as another person.
The Positive: there are lots of things about IUSs that are good for your body as well as your sex life.
- 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 IUS pretty quickly, but it could take a few months.
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
- Mood changes
Other issues to watch out for:
- IUS slipping out
- IUS 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!
We are here to help you. If it still does not feel right, we have ideas for other methods. Just remember: If you decide to change methods, make sure to stay protected while you switch. Condoms offer good protection while you find a method that suits your needs.
Will my IUS hurt my partner?
The IUS should not hurt your partner. You may have heard that the IUS strings can bother men while having sex, but most partners cannot even feel the strings. If your partner can feel the strings, and that bothers him, your healthcare provider might be able to trim them. Plus, they usually soften over time.
What if my period cramps are worse?
Try it for a few months, and take ibuprofen the first few days of your period.
Still not working? If you like the ease of using an IUS, but find that the side effects do not get better with time or painkillers, try switching to an implant
Try a different method: implant
What if I want to get pregnant?
If you are ready to get pregnant, ask your provider to remove your IUS. Your body should go back to normal quickly, and you can start trying right away.
My IUS was expelled. What is the likelihood it will happen again?
IUS expulsion can occur in a small percentage of women in the first year after insertion. Expulsion can be more likely for women who:
- Have not been pregnant
- Are younger than 20 years
- Have a history of very heavy or very painful periods
- Had the IUS put in right after giving birth or have a 2nd-trimester abortion
Partial expulsion may mean that the IUS was not quite in the right position: it may have been too low in the uterus and just worked its way out. This could be something that happened around the time of insertion or may be related to uterine characteristics, such as size, angle, or presence of conditions like fibroids that can cause irregular shape. For women who have an IUS expulsion, the chance of expelling a 2nd IUS may be higher.
Still not working? If you like the ease of using an IUS but are having problems with expulsion, you could try switching to the implant – a long-acting and low-maintenance option
Try a different method: implant
Will getting the IUS inserted hurt?
IUS insertion pain can vary from person to person. Unfortunately, there is not a great drug to take to make insertion less painful.
You can try taking ibuprofen beforehand the insertion and make sure you get the IUS inserted when your cervix is open, such as when you are on your period or ovulating. Even if there is some pain, it might be worth it for years of pregnancy-free sex.
I want to get my IUS removed. Can I remove it myself?
You may be able to find some stories online about people removing their IUS. We do not recommend trying it. There is not enough research at this point to know if it is safe. If you are not happy with your IUS, going to your provider to get it removed will give you a chance to talk about other options for pregnancy prevention or about getting pregnant.
If you are ready to get pregnant, you can talk with your provider about things you should do to prepare for a healthy pregnancy.
Still not working? If you want something that lasts for a while and is easy to use, the implant might be another good option.
Try a different method: implant
Can I use an IUS if I live with HIV?
Women living with HIV can safely have an IUS inserted if they have mild or no clinical disease, whether or not they are on antiretroviral therapy.
Can I use tampons if I have an IUS?
You should be fine as long as you are careful not to pull on the IUS strings, which you should not need to worry about too much since the string of a tampon is outside of your vagina, and the strings of your IUS should be up near your cervix. (If you find that your IUS strings are anywhere near your tampon strings, you should see your health care provider because your IUS might be expelled.)