Hesperian Health Guides
Intra‑Uterine Devices (IUDs)
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An IUD is a small object inserted into the womb by a trained health worker or midwife. Once in the womb, the IUD prevents sperm from fertilizing the egg. An IUD can stay in the womb from 3 to 12 years, depending on the kind of IUD it is. An IUD can be used without others knowing (although sometimes a partner can feel the strings).
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Do not have an IUD inserted if you:
- are pregnant or might be pregnant.
- have an infection in your vagina, cervix, womb, or tubes. You can have an IUD inserted once the infection has been treated successfully.
- have unexplained bleeding from your vagina.
- have cancer of the womb.
IUDs can be used safely while breastfeeding
Copper IUDs (Paragard, Copper-T)
Copper IUDs are made of plastic and copper and can stay in the womb for up to 12 years. This method is safe for people who cannot use methods that contain any hormones, including estrogen.
Common side effects of Copper IUDs:
- longer, heavier, and more painful menstrual periods. This usually decreases after the first 6 months of use.
Hormonal IUDs (Kyleena, Liletta, Mirena, Skyla)
Hormonal IUDs are made of plastic and release the hormone progestin. They can stay in the womb for 3 to 7 years, depending on the amount of hormone they contain. Hormonal IUDs can be used by people who cannot use methods that contain estrogen. Do not use a hormonal IUD if you should not use any hormonal method.
Common side effects of hormonal IUDs:
Because hormonal IUDs contain the same hormone as implants, they have similar side effects.
How to use the IUD:
An IUD must be inserted by a trained health worker after a pelvic exam. The best time to have the IUD put in is during your menstrual period, when you know you are not pregnant and the cervix is most open. An IUD can be inserted the same day as or the day after childbirth. If an IUD is not put in right after delivery, it is best to wait at least 4 weeks before having it inserted.
If an IUD slips out of place, it will not be effective in preventing pregnancy. So it is important to check that your IUD is still in place. Most IUDs have 2 thread-like strings attached which hang down into the vagina. Check the strings after each period (or about every 4 weeks if you use a hormonal IUD and your periods have stopped) to make sure the IUD is in place.
How to check the IUD strings:
- Wash your hands.
- Squat down and reach as far as you can into your vagina with 2 fingers. Feel for the IUD strings, but do not pull them.
- Take out your fingers and wash your hands again.
If you cannot feel the strings, or if you feel part of the IUD that is not the strings, use condoms or another barrier method until you can have the IUD checked by a health worker.
Warning signs for problems with an IUD:
If you have any of the following signs, see a health worker trained to insert IUDs and treat complications, or go to a hospital immediately:
- You have unusual belly pain.
- You have unusually heavy bleeding from the vagina (soaking one or more sanitary napkins or cloths in an hour).
- You have pain or bleeding during sex.
- You have unexplained fever or chills.
- Your period is late.
To stop using an IUD:
When you want to stop using an IUD, have it removed by a trained health worker. Do not try to remove your IUD yourself if you have not been shown how.
If you do not want to become pregnant right away, start using another family planning method as soon as your IUD has been removed.