10 IUD Questions You Were Too Shy to Ask
10 IUD Questions You Were Too Shy to Ask
With the help of Insider.com, we’ve curated a list of the most important things you’re dying to know about the IUD, but probably far too shy to ask. We’d love to know if you have more!
Intrauterine devices (IUDs) are pretty much the gold standard when it comes to birth control. They're more effective than the pill and easier to use — mostly because you don't have to use them at all. You simply visit a doctor for a brief insertion procedure, and that's it: You've got hassle-free contraception for the next three to 10 years, depending on which brand you choose.
But if you're new to IUDs, you probably have lots of questions — after all, implanting a foreign object in your uterus is not something you do every day. That's why INSIDER spoke with gynaecologist Alyssa Dweck, MD, author of "The Complete A to Z for your V," to answer all of your most embarrassing IUD questions.
1) Why does the insertion hurt — and how bad is it really?
You've probably read online horror stories about painful insertion. Yes, there is some pain — like a really bad menstrual cramp — but it only lasts a few seconds. In order for the IUD to reach your uterus, the doctor must push it through the narrow opening in your cervix. That stretching of the cervix accounts for a lot of the discomfort. And in some cases, the doctor might put a small clamp on your cervix to hold it steady, which can create a pinching sensation.
2) Why does my doctor want to insert the IUD during my period?
It ensures that somebody's not pregnant. The last thing we want to do is put an IUD in someone who might be pregnant and not recognize it.
Also, doctors think that the cervix might be a bit more open during menstruation, which can make insertion a bit easier.
3) How much cramping and bleeding is normal after the insertion?
You may have cramping that's notable for about 30 minutes after insertion. Usually the cramping will be present for a day or so.
Irregular bleeding can last longer. With the hormonal IUDs it's common to see even up to three to six months of erratic bleeding with or without your regular period.
So how do you know if your cramping and bleeding have become ab normal? Use these guidelines:
After a day or two, requiring medication for pain is not expected. If the pain is that bad, make an appointment to see your doctor.
Foul-smelling bleeding should be checked out, because that could be a kind of infection. Very heavy bleeding, where you're soaking or saturating a pad or two every hour — that's way too much and should be checked out.
4) How long until I can have unprotected sex?
First, remember that the IUD does not protect against sexually transmitted infections, so keep using condoms to avoid those. In terms of preventing pregnancy, here's how it breaks down:
The copper IUD (known by the brand name ParaGard or CopperPearls IUB LINK) starts preventing pregnancy immediately upon insertion.
For the hormonal IUDs (Skyla, Mirena, Liletta, and Kyleena), it depends on when you had your insertion. If the IUD was put in place within 7 days of the start of your period, it'll prevent pregnancy right away. But if you get the IUD inserted at any other time in your cycle, you'll need to use backup birth control, like a condom, for 7 days.
5) Can I still use tampons?
Yes! Putting a tampon in is not going to dislodge your IUD or move your strings or anything like that,.
6) Will my partner feel the strings during sex?
It's possible. But the strings should get softer and less noticeable with time. If it's really causing an issue after a few months, call your doctor — you might want to ask her to trim the strings a bit shorter.
7) How can I tell if my IUD perforated my uterus?
Perforation is really rare — it happens in about 1 in 1,000 IUD insertions. Basically it means that the IUD attaches to or pushes through the wall of your uterus. If this happens, you may need surgery to get the IUD removed. If the IUD has traveled outside your uterus, you'll probably have significant pain or discomfort. Also, do a self-check on your strings. If you can't find them, it could indicate that your IUD has moved.
When in doubt, trust your instinct and call your doctor.
8) Is it possible to pull out my IUD on accident?
It would be really tough. It's important to know that by checking your own strings, you're not going to pull your IUD out. That would be like a physical impossibility, pretty much. Just don't tug on the strings and you'll be fine.
9) Will an IUD affect my fertility?
Nope. IUDs have long suffered from a bad reputation because of the Dalkon Shield, an IUD used back in the 1970s that increased the risk of pelvic inflammatory disease— a condition that can lead to infertility. But things have changed. The newer IUDs don't seem to make people prone to the bad type of pelvic infections of the past. So that's really important, fertility doesn't seem to be affected.
10) How will I know if my IUD failed and I'm pregnant?
IUDs are really effective, but no form of birth control prevents pregnancy 100% of them time. Pregnancy is highly unlikely but still possible.
First, watch for early pregnancy symptoms, like fatigue, swollen or tender breasts, and nausea.
Then you want to look out for irregular bleeding.
"After the first six months, when you're used to what your IUD bleeding habits are like, start to reassess your symptoms. If you're suddenly getting spotting when you never did, do a pregnancy test. If you always get a monthly period with your IUD and now you don't, do a pregnancy test. It's [about] getting used to what usually happens and then picking up on a difference."