Intrauterine devices, or IUDs, are a great birth control option, but many women choose other forms of birth control because they have reservations about IUDs. A Houston Methodist OB-GYN answered common questions patients ask her about this very effective form of birth control.
The biggest advantage of IUDs is there is zero chance of user error. Even with perfect use of birth control pills, which means never missing a dose, the pills are 99% effective. Most women are going to forget a pill from time to time, which brings the effectiveness rate down to 96%. IUDs are more than 99% effective, making them the best birth control option for many women."
M. Kathleen Borchardt, M.D., Houston Methodist OB-GYN
Borchardt said many of her patients have heard rumors or myths about IUDs that just aren't true, so she wants every woman to know these five facts about IUDs:
Fact: Placement of the IUD may be uncomfortable, but most agree it is tolerable.
"A woman will feel some mild to moderate pain, similar to intense cramps, for about 30 seconds during IUD placement, but there are ways to make you more comfortable," Borchardt said. "First, your doctor can ease anxiety by walking you through each step of the procedure. Taking an over-the-counter pain medication, such as ibuprofen, before placement can help. In some cases, your doctor can also prescribe something to help make placement easier. We do not want women to avoid IUDs because of these fears, so please talk to your doctor about your concerns and ways they can help decrease discomfort."
Fact: There are two main types of IUDs, hormonal and a non-hormonal copper form. They each have different benefits and side effects.
"As with any birth control, there will always be an adjustment period," Borchardt said. "With the hormonal IUD, some women experience side effects such as irregular bleeding and spotting for three to six months, but then many women experience lighter or no periods at all. Some report changes in mood or acne, but these are less common and there are ways your doctor can help with these possible side effects."
With the non-hormonal copper IUD, women might experience heavier, longer periods and spotting for two to three months. If you experience side effects that continue or become severe, ask your doctor how to best address these concerns.
Fact: While some women fear that IUDs are dangerous, complications are rare.
"Expulsions, or the IUD falling out of place, occurs in less than 0.5-8% of women who have an IUD," Borchardt said. "The risk of pelvic inflammatory disease is rare, occurring in 1% of women. The most serious complication is perforation of the uterus, which occurs when the IUD punctures the uterine wall. However, this complication is rare, occurring in 0.1 % of women, and it can be easily prevented by checking IUD location immediately after placement using an ultrasound."
Fact: Having an IUD will not affect your fertility later on.
"In a study comparing pregnancy rates between former IUD users and former users of other contraceptive methods, there was no difference between the two groups in the time it took to become pregnant," Borchardt said. "When you have your IUD removed, your fertility will return to what is normal for your body, just like any other form of contraceptive."
Fact: IUDs can also help with heavy periods.
"The hormonal IUD is also approved for the treatment of heavy menstrual bleeding," Borchardt said. "It is the only form of birth control that can help with heavy bleeding and is often used an alternative to surgical treatment for heavy periods."
Borchardt encourages women to visit their OB-GYN for a well women exam every year and to ask about birth control methods at their next appointment.
"Every woman should pick the birth control option that is right for her, but I don't want women to be afraid of IUDs," Borchardt said. "They are a fantastic option for busy women who want effective birth control that they don't have to think about or remember to take."