Table of ContentsView All
View All
Table of Contents
Pregnancy Prevention
Hormonal vs. Nonhormonal
Side Effects
What About Removal?
Aftercare
Period and Bleeding Changes
Penetration With IUD
Cost
An intrauterine device (IUD) is a small, T-shaped device that’s placed inside the uterus to prevent pregnancy. These devices, available in two types—hormonaland copper IUDs—are safe and alsoover 99% effective, offering a reliable and long-lasting birth control solution.
How IUDs Work to Prevent Pregnancy
Hormonal IUDs
Hormonal IUDs begin working within seven days of insertion and can stay in the uterus and effectively prevent pregnancy for between three and eight years.
Copper IUDs
Nonhormonal copper IUDs create an environment that is hostile to sperm, making it harder for them to move and survive, preventing the sperm from reaching and fertilizing an egg.The copper IUD starts working immediately after insertion and is effective in preventing pregnancy for up to 10 years.
How Effective Is an IUD for Pregnancy, PMS, and More?
Brands: Hormonal vs. Nonhormonal Types
There are five Food and Drug Administration (FDA)–approved IUD brands in the United States: four hormonal IUDs and one nonhormonal (copper). All five brands are highly effective in preventing pregnancy but have varying side effects and duration effectiveness.
Hormonal IUDs contain levonorgestrel—a synthetic progestin similar to the natural hormone progesterone—which IUDs release in small amounts each day to prevent pregnancy. The four hormonal IUDs available in the United States are:
Copper IUD
TheParagard IUDis the only copper, nonhormonal option in the United States. It starts working right away and prevents pregnancy for up to 10 years. Because it does not contain hormones, Paragard is an excellent choice for those looking for hormone-free birth control.
How Long Do IUDs work?IUDs offer long-term protection against pregnancy, though how long they last varies:Mirena: Up to eight yearsLiletta: Up to eight yearsKyleena: Up to five yearsSkyla: Up to three yearsParagard (copper IUD): Up to 10 years
How Long Do IUDs work?
IUDs offer long-term protection against pregnancy, though how long they last varies:Mirena: Up to eight yearsLiletta: Up to eight yearsKyleena: Up to five yearsSkyla: Up to three yearsParagard (copper IUD): Up to 10 years
IUDs offer long-term protection against pregnancy, though how long they last varies:
Side Effects Explained
Both hormonal and nonhormonal IUDs can cause side effects, though the severity and how long they last can vary from person to person. Some people experience no side effects, while others may experience side effects for a few months until their body adjusts to the IUD. All IUDs can cause spotting and cramping for the first few months after insertion.
Possible side effects of hormonal IUDs include:
Possible side effects of copper IUDs include:
Least Side Effects
Whencomparing IUDs, the copper IUD (Paragard) has fewer side effects because it is nonhormonal and does not affect your natural hormone balance or menstrual cycle. While it does not cause hormonal side effects, it can lead to heavier periods and more cramping, especially in the first few months after insertion.
Hormonal IUDs may have more hormone-related side effects, but they tend to be short-lived (three to six months) for most people. Up to 20% of people using hormonal IUDs stop menstruating within a year after the IUD placement, which is a benefit to some.
Ultimately, choosing between IUD types is a personal decision made between you and a healthcare provider.
IUD insertion can be uncomfortable, but the pain level varies from person to person. During the procedure, you might feel cramping or pressure. Fortunately, the insertion process only takes a few minutes. You may feel cramping or backaches for a few minutes or hours after the procedure, but this usually does not last long.
Some healthcare providers recommend taking a pain reliever, such as Advil (ibuprofen) or Tylenol (acetaminophen), before your appointment to help minimize discomfort. Your healthcare provider may also offer a local anesthetic to numb the area around your cervix to make the process more comfortable.
How painful IUD insertion is varies from person to person. Several factors can influence how painful the experience is, including:History of trauma or abuse: People with a history of trauma or abuse may have heightened sensitivity to gynecological procedures, which can amplify feelings of pain or discomfortPelvic floor dysfunction: People with pelvic floor dysfunction may experience more pain during IUD insertion due to muscle tension and sensitivity in the pelvic area.Medical conditions: Certain medical conditions, such as endometriosis, adenomyosis, or fibroids, can increase the risk of pain during IUD insertion.Uterine position: People with an anteverted uterus (tilted forward) may experience less pain than those with a retroverted uterus (tilted backward).
How painful IUD insertion is varies from person to person. Several factors can influence how painful the experience is, including:
IUD removal is generally quick and less painful than insertion for most people. The healthcare provider gently pulls on the IUD string, and the device comes out through the cervix and vagina. Some people experience mild cramping during removal, but the process is usually over in just a few seconds. Most people feel immediate relief after removal, and any lingering cramping typically goes away shortly after.
A Word From VerywellThough it may seem like you could pull out your IUD, it is not recommended. IUD strings come out of your cervix and are usually only about 2 centimeters long. Because an IUD sits so high in the vagina and is soft and flexible, it is difficult to grasp and pull out yourself. It is best to have a healthcare provider remove it.—RENITA WHITE, MD, MEDICAL EXPERT BOARD
A Word From Verywell
Though it may seem like you could pull out your IUD, it is not recommended. IUD strings come out of your cervix and are usually only about 2 centimeters long. Because an IUD sits so high in the vagina and is soft and flexible, it is difficult to grasp and pull out yourself. It is best to have a healthcare provider remove it.—RENITA WHITE, MD, MEDICAL EXPERT BOARD
Though it may seem like you could pull out your IUD, it is not recommended. IUD strings come out of your cervix and are usually only about 2 centimeters long. Because an IUD sits so high in the vagina and is soft and flexible, it is difficult to grasp and pull out yourself. It is best to have a healthcare provider remove it.
—RENITA WHITE, MD, MEDICAL EXPERT BOARD
It’s normal to experience some cramping and spotting for a few days after IUD insertion. Here are some tips to help you feel more comfortable:
After getting an IUD, you might experience changes in your period and bleeding patterns, depending on the type of IUD you have. With hormonal IUDs, you may experience:
With the copper IUD, you may experience:
Having an IUD does not typically affect penetration during sex. The IUD is inside your uterus, so neither you nor your partner should feel it during intercourse. However, some partners report feeling the IUD strings during penetration. If this happens, your healthcare provider can trim the strings to a more comfortable length.
There is also no risk of the IUD being pushed out or dislodged during intercourse. The IUD stays securely in place inside the uterus, and you can safely engage in all sexual activities.
Cost With and Without Insurance
The cost of an IUD can vary widely, depending on whether you have health insurance. Most health insurance plans cover the total cost of an IUD, including insertion and removal, as part of preventive care. This means you may not have to pay anything out of pocket, but it’s always a good idea to check with your insurance provider to confirm what your plan covers, as some plans may only cover certain types of IUDs and not others.
Without insurance, an IUD can range from $500 to $1,300, depending on the type of IUD. This includes the IUD itself, the insertion procedure, and follow-up visits. Some clinics offer sliding scale fees or financial assistance programs to help cover the cost, so it’s worth exploring these options if you don’t have insurance.
While the upfront cost of an IUD is high, it’s a long-termbirth controlmethod that can last for several years, making it a cost-effective option over time.
Summary
IUDs are small, T-shaped birth control devices that offer long-term, effective pregnancy prevention. Hormonal IUDs release progestin to thicken cervical mucus, prevent ovulation, and thin the uterine lining. Copper IUDs prevent sperm from reaching the egg.
Common side effects of hormonal IUDs include spotting and headaches, while the copper IUD may cause increased cramps and bleeding. Depending on the brand, IUDs can help prevent pregnancy for three to 10 years. All IUDs are safe and highly effective, and the type you choose is a personal decision to make with a healthcare provider.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Deciding about an IUD.Planned Parenthood.What are hormonal IUDs?Lanzola EL, Ketvertis K.Intrauterine device. In:StatPearls. StatPearls Publishing; 2024.Planned Parenthood.IUD.Reproductive Health Access Project.IUD information.American College of Obstetricians and Gynecologists.Long-acting reversible contraception implants and intrauterine devices.Planned Parenthood.What are the side effects of IUDs?Nelson AL, Massoudi N.New developments in intrauterine device use: focus on the US.Open Access J Contracept. 2016;7:127–141. doi:10.2147/OAJC.S85755Planned Parenthood.What are the disadvantages of IUDs?Merck Manual: Professional Version.Intrauterine devices (IUDs).Planned Parenthood.What’s an IUD insertion like?Rahman M, King C, Saikaly R, et al.Differing approaches to pain management for intrauterine device insertion and maintenance: a scoping review.Cureus. 2024;16(3):e55785. doi:10.7759/cureus.55785Gero A, Elliott S, Baayd J, Cohen S, et al.Factors associated with a negative Patient Acceptable Symptom State (PASS) response with intrauterine device placement: a retrospective survey of HER Salt Lake participants.Contraception. 2024;133:110385. doi:10.1016/j.contraception.2024.110385Moshesh M, Saldana T, Deans E, et al.Factors associated with low-lying intrauterine devices: a cross-sectional ultrasound study in a cohort of African-American women.Contraception. 2018;98(1):25-29. doi:10.1016/j.contraception.2018.02.01Planned Parenthood.How does IUD removal work?Hocaoglu M, Gunay T, Demircivi Bor E, et al.Comparison of intrauterine device insertion-related pain and ease of procedure at different times during menstruation.Medeni Med J. 2021;36(3):225-232. doi:10.5222/MMJ.2021.89633University of Washington.IUD aftercare instructions.Planned Parenthood.Can a guy feel an IUD?Planned Parenthood.How can I get an IUD?Centers for Medicare & Medicaid Services.Affordable Care Act implementation FAQs - set 12.Planned Parenthood.How much do IUDs cost without insurance?
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Deciding about an IUD.Planned Parenthood.What are hormonal IUDs?Lanzola EL, Ketvertis K.Intrauterine device. In:StatPearls. StatPearls Publishing; 2024.Planned Parenthood.IUD.Reproductive Health Access Project.IUD information.American College of Obstetricians and Gynecologists.Long-acting reversible contraception implants and intrauterine devices.Planned Parenthood.What are the side effects of IUDs?Nelson AL, Massoudi N.New developments in intrauterine device use: focus on the US.Open Access J Contracept. 2016;7:127–141. doi:10.2147/OAJC.S85755Planned Parenthood.What are the disadvantages of IUDs?Merck Manual: Professional Version.Intrauterine devices (IUDs).Planned Parenthood.What’s an IUD insertion like?Rahman M, King C, Saikaly R, et al.Differing approaches to pain management for intrauterine device insertion and maintenance: a scoping review.Cureus. 2024;16(3):e55785. doi:10.7759/cureus.55785Gero A, Elliott S, Baayd J, Cohen S, et al.Factors associated with a negative Patient Acceptable Symptom State (PASS) response with intrauterine device placement: a retrospective survey of HER Salt Lake participants.Contraception. 2024;133:110385. doi:10.1016/j.contraception.2024.110385Moshesh M, Saldana T, Deans E, et al.Factors associated with low-lying intrauterine devices: a cross-sectional ultrasound study in a cohort of African-American women.Contraception. 2018;98(1):25-29. doi:10.1016/j.contraception.2018.02.01Planned Parenthood.How does IUD removal work?Hocaoglu M, Gunay T, Demircivi Bor E, et al.Comparison of intrauterine device insertion-related pain and ease of procedure at different times during menstruation.Medeni Med J. 2021;36(3):225-232. doi:10.5222/MMJ.2021.89633University of Washington.IUD aftercare instructions.Planned Parenthood.Can a guy feel an IUD?Planned Parenthood.How can I get an IUD?Centers for Medicare & Medicaid Services.Affordable Care Act implementation FAQs - set 12.Planned Parenthood.How much do IUDs cost without insurance?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Deciding about an IUD.Planned Parenthood.What are hormonal IUDs?Lanzola EL, Ketvertis K.Intrauterine device. In:StatPearls. StatPearls Publishing; 2024.Planned Parenthood.IUD.Reproductive Health Access Project.IUD information.American College of Obstetricians and Gynecologists.Long-acting reversible contraception implants and intrauterine devices.Planned Parenthood.What are the side effects of IUDs?Nelson AL, Massoudi N.New developments in intrauterine device use: focus on the US.Open Access J Contracept. 2016;7:127–141. doi:10.2147/OAJC.S85755Planned Parenthood.What are the disadvantages of IUDs?Merck Manual: Professional Version.Intrauterine devices (IUDs).Planned Parenthood.What’s an IUD insertion like?Rahman M, King C, Saikaly R, et al.Differing approaches to pain management for intrauterine device insertion and maintenance: a scoping review.Cureus. 2024;16(3):e55785. doi:10.7759/cureus.55785Gero A, Elliott S, Baayd J, Cohen S, et al.Factors associated with a negative Patient Acceptable Symptom State (PASS) response with intrauterine device placement: a retrospective survey of HER Salt Lake participants.Contraception. 2024;133:110385. doi:10.1016/j.contraception.2024.110385Moshesh M, Saldana T, Deans E, et al.Factors associated with low-lying intrauterine devices: a cross-sectional ultrasound study in a cohort of African-American women.Contraception. 2018;98(1):25-29. doi:10.1016/j.contraception.2018.02.01Planned Parenthood.How does IUD removal work?Hocaoglu M, Gunay T, Demircivi Bor E, et al.Comparison of intrauterine device insertion-related pain and ease of procedure at different times during menstruation.Medeni Med J. 2021;36(3):225-232. doi:10.5222/MMJ.2021.89633University of Washington.IUD aftercare instructions.Planned Parenthood.Can a guy feel an IUD?Planned Parenthood.How can I get an IUD?Centers for Medicare & Medicaid Services.Affordable Care Act implementation FAQs - set 12.Planned Parenthood.How much do IUDs cost without insurance?
MedlinePlus.Deciding about an IUD.
Planned Parenthood.What are hormonal IUDs?
Lanzola EL, Ketvertis K.Intrauterine device. In:StatPearls. StatPearls Publishing; 2024.
Planned Parenthood.IUD.
Reproductive Health Access Project.IUD information.
American College of Obstetricians and Gynecologists.Long-acting reversible contraception implants and intrauterine devices.
Planned Parenthood.What are the side effects of IUDs?
Nelson AL, Massoudi N.New developments in intrauterine device use: focus on the US.Open Access J Contracept. 2016;7:127–141. doi:10.2147/OAJC.S85755
Planned Parenthood.What are the disadvantages of IUDs?
Merck Manual: Professional Version.Intrauterine devices (IUDs).
Planned Parenthood.What’s an IUD insertion like?
Rahman M, King C, Saikaly R, et al.Differing approaches to pain management for intrauterine device insertion and maintenance: a scoping review.Cureus. 2024;16(3):e55785. doi:10.7759/cureus.55785
Gero A, Elliott S, Baayd J, Cohen S, et al.Factors associated with a negative Patient Acceptable Symptom State (PASS) response with intrauterine device placement: a retrospective survey of HER Salt Lake participants.Contraception. 2024;133:110385. doi:10.1016/j.contraception.2024.110385
Moshesh M, Saldana T, Deans E, et al.Factors associated with low-lying intrauterine devices: a cross-sectional ultrasound study in a cohort of African-American women.Contraception. 2018;98(1):25-29. doi:10.1016/j.contraception.2018.02.01
Planned Parenthood.How does IUD removal work?
Hocaoglu M, Gunay T, Demircivi Bor E, et al.Comparison of intrauterine device insertion-related pain and ease of procedure at different times during menstruation.Medeni Med J. 2021;36(3):225-232. doi:10.5222/MMJ.2021.89633
University of Washington.IUD aftercare instructions.
Planned Parenthood.Can a guy feel an IUD?
Planned Parenthood.How can I get an IUD?
Centers for Medicare & Medicaid Services.Affordable Care Act implementation FAQs - set 12.
Planned Parenthood.How much do IUDs cost without insurance?
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