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Intrauterine Device (IUD) for Birth Control
Risks of using an intrauterine device (IUD) include:
- Menstrual problems. About 12% of women have the copper IUD removed because of increased menstrual bleeding or cramping.2 Women may also experience spotting between periods. But after about 3 months of increased bleeding or spotting, the LNg IUD reduces menstrual cramps and bleeding by an average of 90%.2
- Perforation. In 1 out of 1,000 women, the IUD will get stuck in or puncture (perforate) the uterus.1 Although perforation is rare, it almost always occurs during insertion. The IUD should be removed if the uterus has been perforated.
- Expulsion. About 2% to 10% of IUDs are pushed out (expelled) from the uterus into the vagina during the first year. This usually happens in the first few months of use. Expulsion is more likely when the IUD is inserted right after childbirth or in a woman who has not carried a pregnancy.1 When an IUD has been expelled, you are no longer protected against pregnancy.
Disadvantages of IUDs include the high cost of insertion, no protection against STDs, and the need to be removed by a doctor.
Disadvantages of the LNg IUD
The LNg IUD may cause noncancerous (benign) growths called ovarian cysts, which usually go away on their own.
The LNg IUD can cause hormonal side effects similar to those caused by oral contraceptives, such as breast tenderness, mood swings, headaches, and acne. This is rare. When side effects do happen, they usually go away after the first few months.
Pregnancy with an IUD
If you become pregnant with an IUD in place, your doctor will recommend that the IUD be removed. This is because the IUD can cause miscarriage or preterm birth (the IUD will not cause birth defects). Taking out an IUD early in a pregnancy lowers risks of miscarriage or preterm birth. But IUD removal can also cause a miscarriage. As a pregnancy progresses, miscarriage risk is lower if an IUD is removed than if it is left in place.1
When to call your doctor
When using an IUD, be aware of warning signs of a more serious problem related to the IUD.
Call your doctorimmediately if you have any of the following symptoms. Remember the word "PAINS." Each letter stands for a word associated with a problem:
- Period is late with a copper IUD, or you have abnormal spotting or severe bleeding
- Abdominal pain, severe cramping, or abdominal pain with sexual intercourse
- Infection with or exposure to a sexually transmitted disease (STD) or symptoms of a vaginal infection, such as abnormal vaginal discharge
- Not feeling well or having a fever of 100.4°F (38°C) or higher
- Strings from IUD are missing or are longer or shorter than normal
Call your doctor to schedule an appointment if you:
- Cannot feel the strings of your IUD. (Use condoms as backup birth control until your doctor has checked your IUD.)
- Have severe or prolonged vaginal bleeding.
- Miss a menstrual period, unless you have the LNg IUD. It is normal to miss a period or stop menstruating while you are using the LNg IUD, and this is not a cause for concern. If you have an LNg IUD and miss your period and wonder if you are pregnant, talk with your doctor. IUDs are highly effective, but if you are concerned, you may want to have a pregnancy test to find out for sure.
| Author: | Bets Davis, MFA | Last Updated: May 22, 2008 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology | |
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