An IUD (intrauterine device) is a small, T-shaped device with two threads hanging off the ends. A doctor inserts one in the uterus to prevent pregnancy. An IUD can stay inside the uterus for 3 – 10 years, and it’s one of the most effective kinds of birth control.
How do IUDs work?
There are two types of IUDs, copper and hormonal, and they work in different ways.
Copper IUDs (like Paraguard) contain copper as the main agent. Copper can damage sperm, which prevents them from fertilizing eggs.
Hormonal IUDs (like Mirena and Skyla) contain a hormone called levonorgestrel. Levonorgestrel mainly thickens the lining of the cervix (the lower part of the uterus), which prevents fertilization. It can also thin the lining of the uterus, which prevents a fertilized egg from attaching to the uterus.
A doctor inserts an IUD into the uterus. Once it’s inside, the two thin strings attached to the end will hang out of your cervix and partway into your vagina.
IUDs are over 99% effective.
Who can use an IUD?
IUDs can be a good option for people of any age. Some doctors say that people who are young or haven’t given birth shouldn’t have one, but this isn’t true anymore. According to the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), they’re safe for young people and people who’ve never given birth.
However, IUDs are not a good idea for you if you:
- Have pelvic inflammatory disease (PID)
- Have an untreated STI
- Are currently pregnant
- Have problems with your uterus
You can talk to a doctor to learn if an IUD is a good option for you.
How much does an IUD cost?
You typically need to get a prescription for an IUD from a clinic, pick it up at a pharmacy, and go back to the clinic.
A copper IUD can cost $45 – $350, while a hormonal IUD can cost $250 – $550. The hormonal one is often covered by private health insurance, while the copper is not.
Hormonal IUDs are also covered by the Quebec Public Prescription Drug Insurance Plan, which you may have even if you don’t know it. This plan covers makes it so you pay a maximum of $88 each month. This means that for a hormonal IUD, you’d pay a maximum of $88, rather than up to $550.
How do I get an IUD?
If you want to get an IUD, you first have to visit a doctor for a consultation. The doctor will do a physical exam, including an STI test, to make sure one will work for your body. They might also explain to you the advantages and disadvantages of both types of IUDs.
After the consultation, if the doctor decides an IUD is safe for you, they will give you a prescription. You can use the prescription to buy one from a pharmacy.
After the consultation, you’ll have to schedule another appointment for the IUD insertion. Some doctors can do both appointments, while others will refer you to a specialist after the consultation. Some doctors will only do the insertion when you’re on your period, while others might do it at any time. Some doctors might tell you to take pain medication like Advil before the insertion. It’s important not to take any drugs for the insertion unless the doctor has explicitly told you that it’s okay.
You might feel pain and cramping during the insertion, and for a few days afterward. You might also be told not to put anything inside your vagina for a few days after the insertion.
To find a clinic close to you that does insertions, you can call Info-Santé at 811. If you’re 25 or under, you can also visit Head and Hands, a youth clinic in the NDG area of Montreal.
What do I do when I have an IUD?
Once the IUD has been inserted, you should put a finger into your vagina to check for the strings about once a month. This makes sure it hasn’t moved out of place. It’s also a good idea to see your doctor if you have pain or notice anything unusual.
Other than that, that’s it! There’s no need to do anything until it’s time for a doctor to remove the IUD. Many people prefer them because they don’t need to remember to take a pill at the same time every day or to change a patch or ring.
What are the benefits of using IUDs?
There are many benefits to IUDs. Some of these might apply to you:
- Low long-term cost: Since you can use an Intrauterine device for 5-10 years, they’re cheaper over time.
- Lighter periods: The hormonal IUD can make your periods lighter, shorter, and less painful.
- Fewer side effects: The hormonal IUD usually has fewer side effects compared to other forms of hormonal birth control. The copper IUD has no side effects associated with hormones.
- The copper IUD can be used as emergency contraception (like the morning-after pill) if it’s inserted within 5 days after unprotected vaginal sex.
- No need to do anything aside from check for the strings every month!
What are the drawbacks of using IUDs?
Like with any other form of birth control, IUDs can also have drawbacks. It’s important to keep these in mind when considering your preferred form of birth control:
- No STI protection: They only protect against pregnancy. Only barrier methods, like condoms and dental dams, can prevent STI transmission.
- Pain: Some people find that the insertion is painful. This is because it’s inserted past the cervix, which can be very sensitive. Some doctors will give you an appointment for insertion during your period. At this time, the cervix is usually more open, which may minimize pain.
- Expulsion: Sometimes the uterus will reject it, and it will fall out.
- Heavier periods: The copper IUD can make periods heavier, longer, and more painful.
- Perforation: Very rarely, insertion can poke through the wall of the uterus. In serious cases, you might need surgery.
In spite of these drawbacks, there are also many benefits to an IUD. Many people find that it’s perfect for them! It’s a good idea to talk to a doctor about all of your options for birth control. You might consider one, or you might want to use another form of birth control, like condoms, injections, the patch, the pill, the pull-out method, or the ring.
Check out the resources below for more on IUDs and other birth control options.
ABCs of IUDs
Planned Parenthoods website covers the basics on IUD, and provides a basic understanding of what it is, how it is inserted, and what are some of the health benefits and disadvantages.
Head & Hands Health Services
Head & Hands is a health clinic for youth ages 12-25 near the Vendome metro station. They offer free, anonymous STD testing, even if you’re not covered by RAMQ. Head & Hands also has a lot of other services, including medical check ups, getting contraception, transitioning, and more.
They offer a walk-in clinic on most Tuesdays and Thursdays starting at 4:45pm. Everyone who comes in for the clinic is given a name card and entered into a draw. At 5:00pm, they draw 10 names to decide who sees the doctor.
They recommend bringing your Medicare card if you have it, but you can still see someone if you don’t have it.
Birth Control Comparison Chart and Pregnancy Rates
US-based Kidhealth.org lists and compares different types of birth control including information on how effective they are and if they also protect against STIs.