There are many forms of birth control available at Choices Women’s Medical Center. However, if you are looking for the longest acting, lowest maintenance, and most effective birth control options, then the Intrauterine Device (IUD) may be the right choice for you.  

What is an IUD?

The IUD is a tiny t-shaped device made of plastic (hormonal IUD) or copper (Paragard copper IUD) that gets inserted into your uterus to prevent pregnancy. Once inserted, the IUD can last for several years, so it is a long term option for birth control. However, it can be removed at any time should you decide you want to get pregnant or just don’t want it anymore. Other birth control options like the pill, the patch, the ring, and the shot decrease in effectiveness if you don’t take or use them as prescribed. For example, the pill is only 99% effective when you take it as prescribed at the same time daily, and goes down to only 93% effective when you do not use it as prescribed.  The IUD continues to be over 99% effective and is completely hassle free-once it’s in – you don’t have to think about it for years!

At Choices, we developed the ESPC (Effectiveness, Safety, Personality, Cost) model to help you make sure you are choosing the best form of birth control for your needs, whether it’s an IUD or other options. E–Effectiveness: Some methods are less than 50% effective; and others, like the IUD are over 99% effective. How important is it for you to avoid pregnancy? S-Safety: There are benefits and risks to every type of birth control depending on your medical history, and every patient reacts differently. A Choices health care professional will recommend the safest type of birth control after discussing this with you. P-Personality: The Choices counseling staff and dedicated health care providers will take the time to get to know you in order to help select the method of birth control that best suits your needs, likes, dislikes and lifestyle. (For example, if you don’t have extra time to visit the pharmacy and call in prescriptions every month, the IUD may make more sense for your lifestyle). C-Cost: Birth control ranges in price from $0-$1,000 depending on which method you choose. Most insurances will cover the cost of your birth control. If you qualify, you can get free birth control by enrolling on-site at Choices for the New York State Family Planning Benefit Program or Family Planning Extension Program. What are the types of IUD I can get, and which IUD is best for me? At Choices, we offer 4 different IUDs, so it’s important to know the difference to determine which IUD might be best for you. There are two types of IUDs, hormonal IUDs and non-hormonal IUDs. Hormonal IUDs: Mirena, Kyleena, and Skyla are all types of hormonal IUDs (meaning they work by releasing hormones into your uterus that work to prevent pregnancy) and are made of plastic and become effective 7 days after they have been inserted. Mirena:

• Lasts up to 5 years
• Considered the most effective of all hormonal IUDs (lowest chance of pregnancy at .1%)
• Treats heavy periods and PMS symptoms for up to 5 years

Kyleena:

• Lasts up to 5 years
• Lower dose of hormones than Mirena (less chance of hormonal side effects)
• May be less painful to insert than Mirena because of its smaller size (1.18 inches)

Skyla:

• Skyla releases the lowest amount of hormones of all hormonal IUDs (less hormonal side effects than Mirena and Kyleena, but slightly less effective)
• Can only last up to 3 years
• May cause lighter and irregular bleeding, but only 1 in 16 women will stop having periods
• May be less painful to insert than Mirena because of its smaller size (1.18 inches)

Possible IUD side effects (hormonal IUD):

• You may have increased cramping and bleeding for up to 3-6 months after you get the hormonal IUD inserted.
• Possibility of hormonal side effects, including acne, sore breasts, low libido and weight gain. (However, since they only release hormones in the uterus, there are usually less side effects than with the birth control pill.)

Non-hormonal Copper IUD: Paragard The Paragard is a non-hormonal IUD that is wrapped in copper. The copper kills any sperm so that it can’t fertilize eggs.

• It is over 99% effective, and can be used for 10-12 years, which is 2x as long as the longest term hormonal IUD!
• The only IUD that starts working immediately after being inserted.
• Paragard is a tiny bit bigger than the hormonal IUDs, but is still smaller than 1.5 inches.
• Paragard is the only IUD that can also be used as emergency contraception! If you have had unprotected sex, you can get the Paragard inserted up to 5 days after and it will be effective in preventing pregnancy (it is even more effective than the Plan B morning after pill!).

IUD Side Effects (non-hormonal Paragard IUD):

• Can cause longer periods and heavier bleeding, especially after the first few months.

Hormonal IUD vs Non-hormonal IUD? The biggest difference between hormonal and non-hormonal IUDs is that hormonal IUDs prevent pregnancy while helping with period and PMS symptoms, while non-hormonal IUDs only prevent pregnancy. You should think about getting a hormonal IUD if you have heavy or painful periods, want a shorter term option, or if you are allergic to copper. You should think about getting a non-hormonal IUD (Paragard) if youhave lighter, manageable periods, want a longer term option, were sensitive to hormonal forms of birth control in the past and don’t want the possibility of hormonal side effects, need emergency contraception, or have any cardiovascular disease or a history of blood clots (the hormone progestin in hormonal IUDs rarely increases the risk of blood clots). Pros and Cons of IUD vs other Birth Control Methods: Pros:

• Lasts for years without any intervention, you don’t need to do anything after insertion goes in!
• Is over 99% effective at preventing pregnancy, and stays over 99% effective consistently

• (Less than 1 pregnancy for every 100 women compared to almost 10 pregnancies in 100 women when using the oral birth control pill)
• No need to remember to take a daily pill or change out ring
• No need to take monthly trips to the pharmacy as you would with other birth control options
• Hormonal IUD only releases hormones in the uterus, which means less hormonal side effects than the oral birth control pill
• Can be removed at any time by your healthcare provider
• You will not feel the IUD in your uterus once it is inserted
• It is reversible, so you can become fertile again right after it is removed
• May help with heavy, painful periods and can make them disappear temporarily

Cons:

• Some IUDs can cause cramping, spotting, and heavier bleeding for up to 6 months
• Discomfort/Pain during insertion
• Requires visit to the clinic to insert/remove IUD
• Increased risk of ectopic pregnancy (very rare, less than 1% chance)
• Can cause mild ovarian cysts that usually don’t cause any symptoms and go away on their own

Remember that IUDs do not protect against and STDs or STIs, so you should still always use condoms for protection. Get tested for infections before getting an IUD inserted, and NEVER try to pull the IUD out yourself!  How does an IUD get inserted, and does it hurt? The entire process of getting an IUD inserted can be as little as 10-15 minutes at Choices. The health provider will insert the IUD through your cervix and into your uterus using a plastic inserter. You may feel cramping, nausea, dizziness, or faint during and right after the insertion. The sensation may be similar to your normal period cramps, or worse; however, studies have shown that getting an IUD inserted hurt much less for patients than what they expected. If you are worried about the pain and discomfort during the insertion of the IUD, you can choose to be asleep during the whole process! We offer the option to go under general anesthesia during the insertion, so you won’t feel anything during insertion and will only wake up after the IUD is already inserted. Most insurance will cover the anesthesia to be asleep during the IUD insertion process. Can I get pregnant with an IUD? Since the IUD is one of the most effective forms of birth control at over 99% effective, it is extremely rare, meaning that fewer than 1 out of 100 women who have an IUD will end up getting pregnant (less than 1% of women). However, if you do suspect you could be pregnant, it’s important to let your healthcare provider know right away as there is a higher risk of ectopic pregnancy associated with IUDs. How much does an IUD cost and how can I pay for it? The IUD should be completely covered by your insurance. Most health insurance plans are required to cover all methods of birth control (including IUDs) under the Affordable Care Act. If you do not currently have health insurance, the IUD is completely covered along with other birth control methods in New York state under the Medicaid Family Planning Benefit Program, which also covers other family planning services, screenings, checkups, education, and counseling. To find out if you qualify for the program, click here. If you’re still unsure if the IUD will be completely covered by insurance or have any questions about it, you can click here for help on getting the IUD for free. What if the IUD isn’t for you? Nexplanon is another LARC (Long-acting Reversible Option) that is a low maintenance hormonal contraceptive device inserted into the arm instead of the uterus, and lasts up to 3 years.

• Nexplanon is over 99% effective like the IUD
• May make periods longer or shorter
• Usually less hormonal side effects than IUD
• Must be inserted and removed at the clinic
• 1/10 women chose to have Nexplanon removed because of unfavorable changes to their periods
• Usually less painful than IUD insertion, only slight pinching or stinging during the numbing shot!
• Arm may be sore for up to a week after insertion

If you want to explore other birth control options available at Choices, click here. To schedule an IUD or Birth Control Consultation visit at Choices, click here.