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IUDs or intrauterine devices are small plastic devices that a physician or nurse practitioner places inside the uterus to prevent pregnancy. The insertion is performed through the vagina and does not require surgery. IUDs are reversible and fertility returns shortly after removal. IUDs are effective for 5 to 12 years, depending on the brand. There are two brands that are common in the US, the ParaGard® and the Mirena®.
How Does It Work?
IUDs create changes in the internal environment of the uterus that prevent fertilization of the egg. They may also prevent implantation of a fertilized egg. The ParaGard® IUD contains a small amount of copper to enhance this effect. The Mirena® IUD contains a small amount of progesterone to enhance its effectiveness.
IUDs are very effective. For every 100 women using IUDs, fewer than one will become pregnant each year.
IUDs are a continuous, long acting, reversible birth control so that a woman does not have to remember to take a pill or put something in her vagina before intercourse. Other advantages of IUDs are:
IUDs have a high up front cost but when compared to the cost of a lifetime of birth control pills, they are much less expensive. There is also a cost to have them removed. Occasionally an IUD may fall out.
While pregnancy is rare with IUDs, when pregnancy does occur it is more likely to be ectopic or tubal. If a woman becomes pregnant or develops symptoms of pregnancy with an IUD in place, she should seek medical help immediately.
There may be increase cramping after the IUD is inserted and with periods. Some women experience heavier and longer periods with the ParaGard® IUD.
Less Common Side Effects
Infections of the uterus are rare with IUDs, but when they do occur, women should seek medical treatment immediately to prevent damage to the uterus. The IUD may need to be removed.
Rarely, the IUD may migrate or puncture the wall of the uterus, possibly requiring surgery.
Women who may be pregnant should not have IUDs inserted.