IUD side effects: What changes to expect

Intrauterine devices, also known as  IUDs, are among the most common forms of contraception available. They’re low maintenance, long-lasting, and incredibly effective. Sounds lovely! And for many women, it is. If you’re considering, or have recently got one, here are some things you need to know about IUD side effects and other changes you may experience.

What is an IUD?

Before jumping in, let’s make sure we’re all on the same page here.

An IUD is a T-shaped device with thin strings at the bottom. It’s made of either copper or plastic and is inserted into your uterus, via the vagina, by a trained medical professional – usually a gynecologist, but also a trained nurse or family doctor. Usually, the goal is to prevent pregnancy, but IUDs may also help with acne, irregular periods, and heavy periods.

IUDs are a popular choice for women of all ages – yes, even teens – because they’re highly effective and, once implanted, very little maintenance is required.

How does it work? And how long will it last?

There are two types of IUDs: the copper IUD and hormonal IUDs. They work differently and are effective for different lengths of time, but they’re both really good at preventing unwanted pregnancy.

The copper IUD

The copper IUD is a nonhormonal form of birth control widely available in the U.S. under the brand name ParaGardⓇ. It starts working immediately because copper is a spermicide. So, when the copper IUD is placed in the uterus, it becomes a hostile environment for the sperm, and they die. With typical use, the chances of pregnancy drop to less than 1% when using the copper IUD. And get this: The copper IUD can last for up to 10 years. 

Hormonal IUDs

In the U.S.,  MirenaⓇ, LilettaⓇ, KyleenaⓇ , and SkylaⓇ are the four most readily available hormonal IUDs. And they all work the same way. They release small amounts of the synthetic hormone, Progestin, which thickens the cervical mucus, making it difficult for sperm to reach the egg. Hormonal IUDs can also stop ovulation, further preventing pregnancy. Again, the likelihood of pregnancy with typical use is less than 1%. However, it takes about seven days for hormonal IUDs to start working. And on average, they need to be replaced every three to five years to remain effective.

Does it hurt?

In short, yes. It can hurt.

We’re not trying to scare you, but at Hormona we believe you should have access to all the facts before you make decisions about your body.

Some women describe the insertion process as extremely painful, while others describe it as merely uncomfortable. Everyone is different and tolerates pain differently, but there it is. It can hurt.

Recently, though, there has been a call to action from women worldwide saying that women should be offered pain medication to help deal with the pain of the IUD insertion. So, awareness is increasing, but many doctors will not offer pain medication or will only recommend taking Ibuprofen, Acetaminophen, or both before your appointment. 

The pain of having an IUD inserted can be a deal-breaker for some women. So, talk to your doctor about pain management before your appointment. The last thing you want is to show up expecting hospital-grade pain management only to get absolutely nothing.

Will I feel the strings? What about my partner?

While your IUD is in place, you may be able to feel the strings by inserting a clean finger into the vagina and feeling for the cervix. You should feel the strings coming out of the cervix. However, if you’re having penetrative sex, your partner should not feel them, and you can proceed as usual.

To ensure your IUD is in place, your doctor may ask you to come back for a follow-up appointment a few weeks after insertion. Your doctor may also teach you to check for the strings on your own. That brings us to our first group of IUD side effects.

Dislodged IUD

It’s rare, but IUDs can become dislodged. They can also fall out or cause damage to the uterus and other organs if it cuts through the uterus. Or they may not have been positioned properly in the first place. Some signs that your IUD may not be where it’s supposed to be include:

• No longer being able to locate the strings
• The strings feel longer or shorter
• You or your partner can easily feel the strings
• You or your partner can feel the IUD itself
• Severe cramping
• Heavier bleeding than normal
• Fever
• Abnormal discharge

If you experience any of these, do not try to solve the issue yourself. Make an appointment with your doctor immediately, and use a backup form of birth control in the meantime. Depending on the severity of your symptoms and how long it takes for you to see your doctor, you may want to head to the nearest urgent care center.

What to expect after insertion

Okay. So, insertion hurts.

Well, we’re sorry to tell you that you will likely experience some discomfort for the next few days as well. Many women experience spotting and cramping for a few days after insertion. The good news is that it’s typically not too bad. So, keep your favorite period products and pain management strategies on hand for a while, and you should be fine.

What to expect while the IUD is in place

What happens after the IUD has been in for a while is really going to depend on the specific IUD you have and your body. Your doctor is the best person to talk to, but here are some general things you might see.

Copper IUD

You will still get a period if you’ve chosen a copper IUD. Some women don’t notice any significant changes in their periods. However, it is quite common to experience heavier bleeding and more severe cramping, particularly in the first six months. After that, it typically gets better. 

Your discharge may change while your copper IUD is in place. Some women report having more discharge. You may notice that the smell of your discharge is different. If this is the case, check for other signs of infection, such as grey or green discharge, discharge that has a chunky texture, vaginal itchiness or burning, etc. If you’re worried, you can always check in with your doctor.

Hormonal IUDs

There is a variety of reactions you can experience with hormonal IUDs, depending on the brand. Typically, your periods will probably be lighter in terms of both blood flow and pain. With some brands, you may even stop having your regular period after a few months. However, because it’s a hormonal IUD, you may experience some weight gain.

Like copper IUDs, hormonal IUDs may also cause changes to your discharge. Remember how we said the Progestin released by hormonal IUDs changes your cervical mucus? Well, it’s natural that your discharge may change as well. But, again, if anything seems a little too out of the ordinary, see your doctor.

Other side effects

Frankly, we’re talking about inserting a foreign object into the body. And because everyone’s body is different, everyone reacts differently. 

For example, some women report that using an IUD improves their acne. After all, like the pill, hormonal IUDs are, well, hormonal birth control. But, some report that it made their acne flare up. Other reported side effects of IUDs include:

• Breast tenderness
• Headaches
• Mood changes
• Irregular bleeding

While most of these side effects are more common with hormonal IUDs, it’s also possible to experience them with the copper IUD.

It’s also important to remember that IUDs only protect against pregnancy. They do not protect against STIs. And if you do happen to contract something, you’ll have a whole other set of side effects to deal with. Yikes!

What to expect during removal

Though many women choose IUDs because they are easy to maintain long-term – and often end up being less expensive than birth control pills in the long run – IUDs can be removed anytime.

When it’s time for your IUD to come out or be replaced, head into the doctor’s office again. Those strings that we talked about earlier? Your doctor will use them to gently pull the IUD out of your uterus, through the cervix, and out of the vagina – basically, the same way it went in. However, this is usually less painful and takes less time than insertion. You may experience cramping and some brief discomfort, but it shouldn’t feel as bad as having it inserted.

Choosing the right IUD for you

While one IUD brand will work for your bestie or sister, sadly, that doesn’t mean it’ll definitely work for you. Your doctor is the best person to help you choose which version is right for you. And a good doctor will look at your medical history alongside any other concerns you have and make a recommendation based on all of that. 

In the U.S., IUDs can cost anywhere from $500 to $1,300 without insurance. So, you want to do everything you can to make sure you choose the one that seems to best suit you and your body.

Conclusion

As with any medication or procedure, there are always risks involved. However, IUDs are generally considered safe and are largely effective at preventing unwanted pregnancies. They also last a long time, are low maintenance, and can be economical if you plan to keep them in for a long time. 

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