The number of women who are choosing to use an intrauterine device (IUD) as their birth control method is quickly growing. But IUD use is still not as popular as the pill or condoms. In preventing pregnancy, IUDs are just as effective as a vasectomy (surgery to cut and seal the tubes that carry sperm). However, unlike a vasectomy, IUDs are completely reversible.
IUDs are considered a highly effective, safe, and long-acting birth control method, but there are a few risks to using them. This article will look at the risks and complications of IUDs.
IUD Birth Control: What Is It And How Does It Work?
Past IUD Risks and Concerns
Unfortunately, IUDs have a history of questionable safety, which has stigmatized IUD use. In the 1970s, a time when the Food and Drug Administration (FDA) had limited authority over the medical device industry, the first popular IUD, called the Dalkon Shield, was introduced.
The design of the Dalkon Shield included a multifilament string (a cable-type string made of hundreds of fine nylon fibers wrapped around each other). The manufacturer used this string because it felt it was strong and wouldn't break. But, at the same time, this type of string made it easier for bacteria to enter the uterus.
As a result, the Dalkon Shield was responsible for pelvic infections, miscarriages (spontaneous loss of a pregnancy), sepsis (serious blood poisoning), infertility (inability to conceive), and hysterectomies (surgical removal of the uterus). The company that made the Dalkon Shield, A.H. Robins, knew about these problems, withheld research results, and lied about the IUD's safety instead of spending money to fix the problem.
Thousands of women were injured by the Dalkon Shield. As a result, the risks and injuries from the Dalkon Shield led to thousands of lawsuits.
The FDA put pressure on A.H. Robins, and the Dalkon Shield was removed from the market. The FDA recommended that all women who were currently using the Dalkon Shield have the device removed.
Two years after this IUD was taken off the market (and much more had become known about the damage caused by the Dalkon Shield), the FDA changed the Food, Drug, and Cosmetic Act to require more detailed testing and FDA approval before any medical devices could be sold.
The Dalkon Shield has caused women to this day to question the safety of IUDs. However, today's IUDs are safer than the ones in the past and all are FDA approved.
There are five IUD brands available in the United States: Mirena, ParaGard, Skyla, Kyleena, and Liletta. They are considered safe and reliable long-term contraceptive methods.
As with many birth control methods, you may have some side effects after having your IUD inserted. But in most cases, side effects go away after the first few weeks to months.
Although serious complications are rare, it is possible for them to occur. So if you experience any problems, it's very important that you report them to your healthcare provider right away.
Possible Risks and Complications
Understanding the risks and possible complications can help you make an informed choice. Risks include the following items.
Rarely, an IUD can be pushed through the wall of the uterus during insertion, and this is usually discovered and corrected right away. If not removed or adjusted, the IUD can move into other parts of the pelvic area and may damage internal organs. Surgery may then be needed to remove the IUD.
There is some risk of pelvic inflammatory disease (PID) linked to IUD use. But the risk is very low after the first 20 days after insertion. PID is usually sexually transmitted. You have a higher risk of getting PID if you or your partner have sex with multiple partners.
Pelvic infection can be caused by bacteria getting into the uterus during insertion. Most infection develops within three weeks of insertion. Infection due to the IUD after three weeks is rare. If you get an infection after this time, it is most likely because you have been exposed to sexually transmitted infections (STIs) during sex. Studies show that IUDs don't cause PID or infertility.
The IUD could partially or completely slip out of the uterus, known as expulsion. This is most likely to occur during the first few months of use (although it can also happen later on). It can also happen during your period. With Mirena or ParaGard, there is a slightly higher risk for expulsion if you have never had a baby, or if you're a teenager or young adult.
Because Skylais a tiny bit smaller than the other two IUDs,it is a little less likely to be expelled in women who have never given birth, although expulsion of the Skyla IUD can still happen.
If your IUD comes out, you can become pregnant. So if this happens, make sure to use a backup birth control(like a condom), and call your healthcare provider. If your Mirena or Skyla IUD only partially comes out, it must be removed(so please don't try to shove it back in).
To be cautious, check your pads and tampons during your period to make sure that your IUD has not fallen out.
Risk Factors for Complications
Most women will not have any problems using an IUD. But if you have some health conditions, you may be more at risk of developing serious complications while using an IUD. These include being at risk for STIs at the time of insertion. Other complications can occur if you:
- Have serious blood clots in deep veins or lungs
- Have had PID in the past 12 months
- Have diabetes or severe anemia
- Have blood that doesn't clot or if you take medication that helps your blood to clot
- Have had two or more STIs within the past two years
- Have or had ovarian cancer
- Take daily medication(s) containing a corticosteroid (such as prednisone)
- Have a history of tubal infection (this does not apply to women who had a pregnancy in their uterus since the infection)
- Have uncontrolled infections of the cervix or vagina, such as bacterial vaginosis
- Have a uterus positioned very far forward or backward in the pelvis
- Have a history of impaired fertility and the desire to get pregnant in the future
How to Be a Candidate for Getting an IUD
Be Your Own IUD Advocate
If you feel an IUD is right for you, talk to your healthcare provider and discuss any concerns you may have about IUD risks and safety. If you don’t get the answers you were hoping for, it’s perfectly fine to get a second opinion. It’s also helpful to know the following:
- Teenagers can use IUDs.
- You can use an IUD even if you have never given birth.
- You do not need a new IUD if you have switched sexual partners.
- You do not need to be in a monogamous relationship to use an IUD.
A Word From Verywell
For many people, the IUD can be a great contraceptive choice. It's convenient, effective, eco-friendly, doesn't interfere with sexual spontaneity, and it doesn’t require you to do anything for it to work.
As with other prescription birth control, there are some risks and potential complications linked to IUD use, but most people are happy with this long-term contraceptive option. Talk to your healthcare provider if you have any questions.
Frequently Asked Questions
What are the side effects of a copper IUD?
Potential side effects of a copper IUD (ParaGard) include lower abdominal pain, cramps, back pain, spotting between periods, and a moderate increase in menstrual flow in some women. In many cases, these side effects disappear after a few weeks to months.(Video) IUD Side Effects | Birth Control
What are the possible complications of using an IUD?
Possible complications of using an IUD include perforation, pelvic infection, and expulsion (when the IUD partially or completely comes out of the uterus). Since IUD insertion is performed by a health professional, perforation is very rare. Additionally, the risk of pelvic infection becomes much lower after 20 days following IUD insertion.
Are IUDs safe?
Today's IUDs are a safe, effective method of birth control for most women, but they may not be the right choice for everyone. Having a discussion with your healthcare provider can help you decide whether an IUD is right for you.
Can you get pregnant with an expired IUD?
It is possible to get pregnant with an expired IUD, although how easily pregnancy occurs depends on the type of IUD. Becoming pregnant with an IUD has potential dangers associated with it. Examples of this include an increased risk for miscarriage, infection of the uterus, infection of fluids around the fetus, low birth weight, and more.
Learn More:Can You Become Pregnant With an IUD In?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sivin I. Another look at the Dalkon Shield: Meta-analysis underscores its problems. Contraception. 1993;48(1):1-12.
Wu CM, Noska A. Intrauterine device infection causing concomitant streptococcal toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus bacteraemia. BMJ Case Rep. 2016;2016. doi:10.1136/bcr-2015-213236
Kerger BD, Bernal A, Paustenbach DJ, Huntley-fenner G. Halo and spillover effect illustrations for selected beneficial medical devices and drugs. BMC Public Health. 2016;16:979. doi:10.1186/s12889-016-3595-7
Rowlands S, Oloto E, Horwell DH. Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 2016;7:19-32. doi:10.2147/OAJC.S85546
Hubacher D. Intrauterine devices & infection: review of the literature. Indian J Med Res. 2014;140 Suppl:S53-7.
Jatlaoui TC, Riley HEM, Curtis KM. The safety of intrauterine devices among young women: a systematic review. Contraception. 2017;95(1):17-39. doi:10.1016/j.contraception.2016.10.006
Johnson BA."Insertion and removal of intrauterine devices."American Family Physician. 2005; 71:95-102.
Shelton JD. "Risk of clinical pelvic inflammatory disease attributable to an intrauterine device."The Lancet. 2001 Feb; 357(9254):443.
Thiery M."Intrauterine contraception: fromsilverring to intrauterine contraceptive implant."European Journal of Obstetrics & Gynecology and Reproductive Biology.2000 June; 90(2): 145–52.(Video) IUD Birth Control│Types, Benefits, Side Effects, and More
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Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.
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What is a serious complication of IUD use? ›
Infection. One of the most serious complications that can arise because of an IUD is infection. IUD infections are generally a result of the insertion process. The risk of infection is very minimal, and if an infection occurs, it can be treated without removing the IUD.Can IUD cause complications? ›
What are the possible complications of using an IUD? Possible complications of using an IUD include perforation, pelvic infection, and expulsion (when the IUD partially or completely comes out of the uterus). Since IUD insertion is performed by a health professional, perforation is very rare.Can IUD be life threatening? ›
An IUD can increase your risk of having a serious infection of the female organs, called pelvic inflammatory disease (PID) or endometritis (pregnancy-related), which can be serious, even life threatening.How do you know if your IUD has complications? ›
Spotting and bleeding are common after you get an IUD, but heavy or abnormal bleeding could mean it's in the wrong spot. “Heavy vaginal bleeding may accompany a uterine perforation,” Nwegbo-Banks says. You have severe cramping, abnormal discharge, or fever. These are other signs that your IUD has moved.Can an IUD damage your uterus? ›
The major health risks associated with IUD use are perforation of the uterus, pregnancy (both intrauterine and ectopic), and pelvic inflammatory disease. Perforation of the uterus by an IUD is a serious complication and this is possible both during the insertion and later.Can your body reject an IUD? ›
The rates of IUD expulsion fall somewhere between . 05% and 8%. There are a few different factors that can affect the possibility of expulsion, like your age and pregnancy history, how long it's been since the IUD was inserted, and even how well your health care provider inserted the IUD in the first place.Is an IUD safer than the pill? ›
Both the pill and IUDs are extremely effective in preventing pregnancy. The IUD is 99% effective, while the pill is 91% effective. The reason the pill is sometimes less effective is due to improper use, such as failure to take it regularly.What are the disadvantages of an IUD? ›
Disadvantages: Your periods may become heavier, longer or more painful, though this may improve after a few months. It does not protect against STIs, so you may need to use condoms as well. If you get an infection when you have an IUD fitted, it could lead to a pelvic infection if not treated.What can you not do with an IUD? ›
Immediately after insertion, it is important not to insert anything into the vagina for 48 hours (i.e. no tampons, bath, swimming, hot tub, sexual intercourse). There is about 1% chance of the IUD slipping or being expelled, and the chance is highest in the first few weeks.What is the most common side effect of IUD insertion? ›
Common IUD side effects include: irregular bleeding for several months. lighter or shorter periods or no periods at all. symptoms of premenstrual syndrome (PMS), which include headaches, nausea, breast tenderness, and skin blemishes.
Which IUD is safest? ›
Mirena is the hormonal IUD that's been around the longest, and it's one of the longest lasting (it's been proven effective for up to 7 years in practice, though it's officially FDA-approved for up to 5 years). It's perfectly safe and effective for people who've never given birth.How often should your IUD be checked? ›
You can check that your IUD is in the right position by putting a finger in the vagina to feel the IUD threads coming out of the cervix. You should not be able to feel the IUD itself. It is advisable to check your IUD in this way once a month, ideally just after your period finishes.How do you know if your IUD has perforated my uterus? ›
More serious IUD perforation symptoms arise if the device punctures the uterine wall and affects other organs, or if it causes an infection or internal bleeding: Severe or sudden pelvic or abdominal pain. Shortness of breath. Bruised or swollen abdomen.Can IUD cause permanent infertility? ›
Will an IUD Impact Your Fertility After You Take It Out? The simple answer is no, it will not. IUDs are one of the least disruptive ways to control your fertility cycles. Although some women may experience differences in menstrual cycles after removal, the effects are typically temporary.Can IUD get stuck in cervix? ›
If an IUD is expelled only partially, it may become lodged in the cervix or vaginal canal, which can cause pain, discomfort, or heavy bleeding. Instead of trying to move the device back into place yourself, call your healthcare provider right away.Who should not get an IUD? ›
You also shouldn't get a Paragard IUD if you have a copper allergy, Wilson's Disease, or a bleeding disorder that makes it hard for your blood to clot. And you shouldn't get a hormonal IUD if you have had breast cancer. Very rarely, the size or shape of someone's uterus makes it hard to place an IUD correctly.Can a dry tampon pull out an IUD? ›
What's the bottom line? Although it's theoretically possible for a tampon to dislodge or pull out an IUD, cases are extremely rare. So there's really little need to worry. If you're concerned, just remember to check your IUD strings each month.Can you feel if your IUD has moved? ›
If your IUD has only shifted slightly, you might not notice any signs. However, if your IUD becomes displaced, the signs and symptoms will typically include: not being able to feel the IUD strings with your fingers. feeling the plastic of the IUD.What I Wish I Knew Before getting an IUD? ›
Insertion Can Hurt
It's common to feel pain or discomfort when your doctor inserts an IUD. Some women feel mild pressure. Others have more intense pain. “I wish I'd known how much it hurts,” says Melissa James, a copy designer in Yorktown, VA.
People usually feel some cramping or pain when they're getting their IUD placed. The pain can be worse for some, but luckily it only lasts for a minute or two. Some doctors tell you to take pain medicine before you get the IUD to help prevent cramps.
Can you use a tampon with an IUD? ›
Yes, you can use a tampon if you have an IUD (intrauterine device). When the IUD is placed, it is guided through your vagina and cervix and then into the uterus. The IUD stays in the uterus—not in the vagina, where a tampon is used. See Long-Acting Reversible Contraception to learn more about the IUD.What are 5 Side Effects of IUDs? ›
- Breast tenderness.
- Irregular bleeding, which can improve after six months of use.
- Mood changes.
- Cramping or pelvic pain.
Weight gain can happen with hormonal IUDs due to the hormone, progestin. Any IUD weight gain is likely not an increase in body fat, but instead an increase in water retention. The hormone progestin may increase water retention that causes bloating, typically adding about five pounds.How effective is an IUD without pulling out? ›
How effective are IUDs when used as birth control? IUDs are one of the best birth control methods out there — more than 99% effective. That means fewer than 1 out of 100 people who use an IUD will get pregnant each year. IUDs are so effective because there's no chance of making a mistake.Does the IUD make u dry? ›
It may cause a slight increase in the likelihood of vaginal dryness, flushing, headaches, nausea and acne.Why do you have to wait a week after IUD? ›
Abstaining from sex helps protect you from developing a serious pelvic inflammatory disease. Also, you may experience uncomfortable side effects that occur for a day or two after your IUD is inserted.Can you feel an IUD with your fingers? ›
All IUDs have strings on them so your nurse or doctor can pull it out of your uterus when you want it removed. When an IUD is in the right place in your uterus, about 1-2 inches of that string sticks out through your cervix — you may be able to feel it if you put your finger deep into your vagina and touch your cervix.Should I shave before an IUD? ›
You don't have to groom down there.
“So many women worry about whether they've waxed or shaved before they come in for an exam, but honestly, I never even notice!” Hill says. Also, as much as you'd like to smell sweet down there for your doc, it's a bad idea to douche before an appointment -- or ever.
On average, it can take anywhere from 6 to 8 months before your body fully adjusts to the IUD. Whether this means no bleeding, constant leakage, or something in between comes down to the type of IUD you have and your own body's reaction to the device. Hormonal IUDs tend to cause a lighter period or no period over time.How long does it take for IUD strings to soften? ›
If it is bothersome, you have a couple of options—the strings often soften after the IUD has been in place for a few months, but if it is still an issue your provider may be able to cut the strings shorter.
Why is the Mirena IUD being recalled? ›
Beginning in 2012, women who previously inserted Mirena IUDs began filing lawsuits against Bayer alleging that the Mirena IUD caused idiopathic intracranial hypertension (IIH), a dangerous fluid build-up in the brain, or perforation of the uterus.Which is better copper T or Mirena? ›
Copper IUDs last the longest. Paragard can last for up to 10 years before needing to be replaced or removed, while hormonal IUDs last between 3 and 6 years. Of the hormonal options, Skyla lasts the shortest (3 years) and Mirena lasts the longest (7 years). Liletta lasts for 6 years and Kyleena lasts for 5 years.What is the safest form of birth control for a woman? ›
Abstinence is the only birth control that is 100% effective. It means you never have sexual intercourse. It's also the only way to protect yourself from STDs.Where does sperm go with an IUD? ›
The IUD works by creating an environment in your uterus that's inhospitable to sperm and conception. Depending on the type of IUD, your uterine lining thins, your cervical mucus thickens, or you stop ovulating. However, the IUD doesn't block semen and sperm from passing into your vagina and uterus during ejaculation.Can IUD slip out of place? ›
Intrauterine devices (IUDs) are considered a safe, convenient and effective method of birth control. But occasionally these small devices can slip out of place.When is the best time to insert an IUD? ›
Insertion of the IUD can take place at any time during the menstrual cycle provided the woman is not pregnant. Before insertion, a bimanual examination and a sounding of the uterus are necessary to determine the uterus position and the depth of the uterine cavity.What happens if your IUD punctured uterus? ›
If the IUD has perforated your uterus wall, you'll have to have it surgically removed in the hospital. But if it's simply out of place or has partially expelled, your doctor will remove it during your appointment. First, your cervix will be dilated, or opened. This can be done with a medication called misoprostol.How do you know if your IUD is embedded? ›
Check That Your IUD Is in the Right Place
If the strings are in place, so is the device. You can also check yourself by feeling for these thin strings every month, after your period, or if you feel unusual cramping during your period. You should feel just the strings and not the device itself.
Embedded. Part or all of the IUD is embedded in the myometrium. Generally, embedded IUDs require removal, although not emergently. If the IUD is minimally embedded, it may be able to be removed with the standard procedure.What happens if you leave an IUD in too long? ›
If your IUD is left in your uterus past the expiration date, the most serious danger would be infection. Serious infections can cause infertility. The other risk is that an expired IUD will not be an effective birth control method.
Why do you have to wait a week after IUD? ›
Abstaining from sex helps protect you from developing a serious pelvic inflammatory disease. Also, you may experience uncomfortable side effects that occur for a day or two after your IUD is inserted.How do I know if my uterus is perforated? ›
severe pelvic pain after insertion (worse than period cramps) pain or heavy bleeding after insertion which continues for more than a few weeks. sudden changes in periods. pain during sex.Who is at risk for IUD perforation? ›
Although the levonorgestrel-releasing IUD can be inserted in a nonpregnant woman at any time, including immediately postpartum, the risk of perforation is greatest during the 12 weeks after giving birth and while the patient is lactating.How often should your IUD be checked? ›
You can check that your IUD is in the right position by putting a finger in the vagina to feel the IUD threads coming out of the cervix. You should not be able to feel the IUD itself. It is advisable to check your IUD in this way once a month, ideally just after your period finishes.Can you feel if your IUD moved? ›
An intrauterine device or IUD is a popular birth control device. Symptoms of a moved IUD include being able to feel the IUD with your fingers or during sex, painful intercourse, abdominal cramping, foul-smelling vaginal discharge and fever.What can cause an IUD to shift? ›
- Strong cramping during your period.
- Placement in a tilted uterus.
- Placement in a small uterine cavity.
- Your IUD was inserted improperly.
- Your IUD was inserted shortly after you gave birth.
- You are currently breastfeeding.
- You are under 20 years old.
There's a slight chance that your IUD won't come out easily. It may get stuck in the wall of your uterus. If this happens, your doctor may need to widen your cervix with medicine and use forceps to pull it out. They may use a thin, lighted scope to look inside your vagina and uterus to remove the IUD.What is a low lying IUD? ›
We identified low-lying IUDs, defined as IUDs located in the lower uterine segment and/or cervix, during a screening ultrasound examination systematically conducted at study enrollment for a large prospective study of uterine fibroid development .Where does sperm go with an IUD? ›
The IUD works by creating an environment in your uterus that's inhospitable to sperm and conception. Depending on the type of IUD, your uterine lining thins, your cervical mucus thickens, or you stop ovulating. However, the IUD doesn't block semen and sperm from passing into your vagina and uterus during ejaculation.Does IUD cause weight gain? ›
Weight gain can happen with hormonal IUDs due to the hormone, progestin. Any IUD weight gain is likely not an increase in body fat, but instead an increase in water retention. The hormone progestin may increase water retention that causes bloating, typically adding about five pounds.
How long does it take for IUD strings to soften? ›
If it is bothersome, you have a couple of options—the strings often soften after the IUD has been in place for a few months, but if it is still an issue your provider may be able to cut the strings shorter.