The intrauterine device (IUD) is a highly effective and convenient method of contraception. However, many women and providers in the United States are reluctant to use or recommend it because of the poor safety legacy of the Dalkon Shield IUD. Today, however, new IUDs are recognized by the Food and Drug Administration, the World Health Organization, the American Medical Association, and the American College of Obstetricians and Gynecologists as some of the safest and most effective reversible methods of birth control for women and potential alternative to sterilization. In addition to providing women with a viable option for family planning, these products offer a number of underreported benefits, including protection against disease.

Frequently Asked Questions About Intrauterine Devices (IUDs)

What are intrauterine devices (IUDs)?

How do IUDs work?

How effective are IUDs at preventing pregnancy?

Is an IUD the same as sterilization?

What types of IUDs are available?

What are some of the advantages associated with using the IUD?

What are some risks associated with using the IUD?

Who can use the IUD?

Who should not use an IUD?

When can the IUD be inserted?

How can a woman obtain an IUD?

Are IUDs covered by insurance?

Don't see your question here? Let us know.

What are intrauterine devices (IUDs)?
IUDs are a completely reversible form of a long-term contraception. These small devices are made of flexible plastic that contain either copper or a common synthetic hormone used in oral contraceptives. Once inserted by a medical professional into the uterus, they begin to prevent pregnancy immediately.

How do IUDs work?
IUDs usually prevent fertilization of an egg. Scientists are not entirely sure why. IUDs seem to affect the way the sperm or egg moves. They may release substances that immobilize sperm. Or they may cause the egg to move through the fallopian tube too fast to be fertilized. The copper in the ParaGard increases effectiveness in two other ways. It affects the enzymes in the lining of the uterus to prevent implantation. It also increases production of prostaglandins, the hormones that support pregnancy. The hormone in the Mirena also increases effectiveness. It thickens cervical mucus, which provides a barrier that prevents sperm from entering the uterus. It also affects the lining of the uterus to prevent implantation of a fertilized egg.

How effective are IUDs at preventing pregnancy?
Current data show that IUDs are 97.4 percent to 99.2 percent effective in preventing pregnancies; however, they are not effective against sexually transmitted infections. Since they are highly effective and long-acting, the IUD has sometimes been referred to as a method of "temporary sterilization."

Is the IUD the same as sterilization?
No. IUDs are completely reversible, and, therefore provide a viable contraception option for those women who believe they may want to have children at some point in the future as well as those who think they have completed their childbearing. However, some clinicians refer to as “reversible sterilization” because it works so well. For more information about the IUD as an alternative to sterilization, click here.

What types of IUDs are available?
Currently, there are two IUD products on the market – Mirena (a progestin-releasing IUD) and ParaGard (a plastic T-shaped device partially wrapped in copper wire).

What are the advantages associated with using the IUD?
IUDs offer several advantages. First and foremost, the IUD is a convenient and effective long-term contraceptive. Unlike many other contraceptives, once the IUD is in place, there is nothing else to do (i.e. nothing to insert before intercourse, no daily pill, etc.). In addition to providing an effective means of contraception, research suggests several other health benefits (depending on the type of IUD) including protecting against endometrial cancer, reducing excessive bleeding associated with uterine fibroids, and providing a non-hormonal or low-hormonal option for women who cannot tolerate hormone contraceptives.

What the risks associated with using the IUD?
Most risks associated with the IUD are during the insertion procedure, like cramping, possible infections, dizziness, and rarely, the wall of the uterus is punctured. As with all contraceptives, women report some side effects. With IUDs some side effects reported with IUD use include: uterine cramps or low backache pain, fainting, some bleeding, and heavier, longer periods with the copper IUD.

Who can use the IUD?
An IUD is an appropriate contraceptive choice for women who prefer a very effective method of contraception and want a long-acting method that is not linked to sexual intercourse or does not require doing something every day. It is especially appropriate for women who want a reversible method of birth control and who have only one sexual partner who is also monogamous. For women who do not want a hormonal method, the ParaGard IUD may be a good choice. The IUD may also be used both by women who have had children and those who have not. Additionally, young women can use this method of contraception if they are at low risk for sexually transmitted diseases and pelvic inflammatory disease.

Who should not use an IUD?
An IUD is not an appropriate contraceptive choice for women who may be pregnant, have had pelvic inflammatory disease, gonorrhea, or chlamydia within the past 12 months, or have heavy menstrual periods and severe cramps. Women who have multiple partners, or have a partner with multiple partners should consider using a condom to prevent STIs.

When can the IUD be inserted?
IUDs may be inserted at any time during the menstrual cycle, once lack of pregnancy is confirmed. If a woman has just delivered a child, an IUD may be inserted while at the hospital following delivery. The ParaGard IUD may also be inserted to prevent pregnancy up to five days following unprotected sex as a form of emergency contraception.

How can a woman obtain an IUD?
Licensed health care professionals prescribe IUDs. Unfortunately, many medical schools and residency programs currently do not offer training on IUD insertion techniques. A 1992 survey of chief residents in approved obstetrics and gynecology residency programs revealed that only 29 percent had inserted more than ten IUDs and 38 percent had never inserted one.

Are IUDs covered by insurance?
For insurance coverage purposes, the IUD is considered to be a reversible contraceptive and in the same category as the diaphragm and the pill. Currently, approximately 39 percent of conventional plans, 58 percent of HMO plans, 44 percent of PPO plans and 60 percent of POS plans cover the IUD. Forty-seven (47) states and the District of Columbia cover insertion and removal through Medicaid.