On Monday I got an IUD.

As I have found is often the case when I make an informed decision about my own reproductive health, I was told it was a good choice and I was brave by some, and told it was unnecessary, dangerous, or slutty by others. I got it anyway and I’d like to tell you all about it.

What is that?

An IUD, or intrauterine device, is a small, typically T-shaped contraceptive device that is inserted into the uterus to avoid unwanted pregnancy.

There are two types of IUDs perscribed in the US: a non-hormonal IUD (ParaGard) which contains copper and lasts up to 12 years, and a hormonal IUD (Mirena or Skyla) which  releases a low dose of progesterone and lasts 3-5 years. 

Oh. Gross. How Does It Work?

The IUD, no matter which type, acts to prevent the sperm and egg from joining. For some women that means the egg never descends into the uterus, while for some it’s a response in thickened cervical mucus which won’t allow the sperm to pass into the uterus.

How Effective Is It?

The official studies say that less than 1 in 100 women will get pregnant in a year of using an IUD. So, less than 1%.

Compare this to condoms where 2 in 100 women in a year get pregnant, when using condoms correctly every time. That’s important. Of the ones not using them totally perfectly, 18 in 100 of them get pregnant.

In comparison to birth control pills, the efficacy is rate is so close it’s almost the same. However, like with condoms, women who don’t use the pill exactly as directed have a 9% rate of pregnancy.

IUDs remove the user error entirely: once that baby’s in, you’re safe. Well, not baby, no babies actually.

About That: Does It Hurt to Have It Inserted?

The disclaimer here is that it’s 100% different for everyone. Overall though, I’ve heard that it’s relatively unpleasant. Like menstrual cramps.

Mine, however, was extremely unpleasant. While I’m proud to announce that I have a “perfectly tilted uterus,” apparently my cervix is a wily minx. The second she figured out what was going on, she was not interested.

So I had to have all manner of clamps and whatnot involved. I can say that while it was a long and painful experience, it was worth it. Plus, my experience was not normal, so yours would likely be much better.

What, exactly, happens when it’s inserted?

The doc/gyno/midwife will put you on the table, in a gown, in the stirrups. They will insert a speculum to open the vagina:


They will cleanse the cervix with a swab of iodine and use a uterine sound to assess the length of the uterus.

Uterine Sound

The provider might also use a uterine tenaculum to hold the cervix gently in place (this is what was used for my procedure).

Uterine Tenaculum

For me, the next part was a lot of deep breathing and waiting for my cervix to behave. Typically it’s a little difficult for women who have never given birth to have the IUD placed because the cervix has not experienced such trauma.

However, eventually the sound will enter the uterus, check the size and shape, and then the real fun begins. The IUD is inserted with a tube that is similar in shape to the sound.

The process is fairly simple: the provider places the T-shaped IUD in the uterus, ejects it slowly and removes the longer tubing. They will then trim the strings so that they descend 1.5-2 inches into the vagina and viola…you’re done and probably cramping at least a little.

Besides not getting pregnant, how does this change my body?

I know you’ve probably heard the horror stories of uterine implantation and women who nearly died from surgical removal. I want you to know that there is very slim chance of that happening.

You have a greater chance of dying in your car (1 in 85) than having a serious complication with your IUD (1 in 100).

There are some other effects that depend on your body, your hormones and which IUD type you get.

However, common side effects include cramping, heavier periods, spotting throughout the month, and decreased sex drive. One thing that has never been proven is any link between the IUD and decreased fertility once it is removed, so don’t worry about that.

What’s It Cost?

If you have Medicaid (most forms of Obamacare) and are young and healthy, there’s a good chance the consult, insertion, and any necessary medications will be covered in full or at 95%.

If you have private insurance, don’t lose hope, it may still be covered.

Out of pocket, the cost of the IUD itself and insertion ranges from $600-$1000.

Bottom Line?

If you are in a monogamous relationship and know you don’t want to get pregnant any time soon, get in IUD. If you have no history of Pelvic Inflammatory Disease, Heart Disease, or Stroke, get in IUD. If you have insurance, definitely look into and then get an IUD.

If you are looking for birth control with STD protection, this is not it. If you might want children in the near future, this is probably not for you. If you are very young, have a very low pain tolerance, or have a history of fainting, this might not be the right road.

Bottom Line: so far, this is a good choice for me, but you should talk to your primary care provider about your body so you can make informed choices.

And also buy some IUD earrings here.

Best of luck!

****Planned Parenthood has some good info here, and Bedsider has even more here****