IUD Insertion and Removal: What to Know

What is an IUD?

An IUD, or intrauterine device, is a small, T-shaped piece of flexible plastic that is inserted into the uterus to provide long-term birth control. It's one of the most effective forms of contraception available and has become increasingly popular due to its reliability, ease of use, and minimal daily maintenance.

There are two main types of IUDs: hormonal and non-hormonal (copper). Hormonal IUDs release progestin to thicken cervical mucus and thin the uterine lining, while copper IUDs use copper’s natural sperm-repelling properties to prevent fertilization.

How Does an IUD Work?

Hormonal IUDs release progestin, which thickens cervical mucus and thins the uterine lining. Copper IUDs release copper ions that are toxic to sperm, creating an environment that prevents fertilization. Both are over 99% effective and last 3–10 years depending on type.

Who is a Good Candidate for an IUD?

• Those who want long-term, reliable contraception
• People finished having children or not planning them soon
• Individuals preferring hormone-free options (copper IUD)
• Breastfeeding individuals seeking non-estrogen contraception
• Anyone wanting a reversible method

Certain conditions (pelvic infections, uterine abnormalities, unexplained bleeding) may require further discussion before placement.

What Should You Expect During an IUD Insertion?

The procedure takes under 10 minutes. Steps include preparation, cervical cleaning, optional anesthetic, uterine measurement, insertion, and string trimming. Discomfort varies from mild cramping to stronger sensations. Numbing and OTC pain relief can help.

How Long Does the Insertion Take?

Insertion itself takes minutes. The full appointment usually lasts 20–30 minutes, and most people return to normal activities the same day.

What are the Immediate Side Effects After Insertion?

• Mild to moderate cramping
• Light spotting or bleeding
• Pelvic pressure

These usually subside within days. Copper IUDs may cause heavier periods and cramping initially; hormonal IUDs may cause irregular bleeding for weeks to months.

When Should You Contact Your Provider After Insertion?

• Severe or persistent pain
• Heavy bleeding
• Fever or chills
• Foul discharge
• Missing or changed string length
• Pregnancy symptoms

How Do You Check if the IUD is Still in Place?

Check the strings with a clean finger periodically. If strings feel unusual or are missing, contact your provider. Do not attempt removal yourself.

How Soon is the IUD Effective?

• Hormonal IUDs: Effective immediately if inserted within first 7 days of menstruation; otherwise use backup for 7 days.
• Copper IUDs: Effective immediately and usable as emergency contraception if placed within 5 days of unprotected sex.

What is Life Like with an IUD?

Most people don’t notice it after adjustment. Hormonal IUDs may lighten or eliminate periods, while copper IUDs may cause heavier, crampier cycles initially. Both provide long-term, low-maintenance contraception.

Can an IUD Affect Your Fertility?

No. Fertility typically returns quickly after removal, with ovulation resuming within weeks.

What is IUD Removal Like?

Removal is faster and usually less uncomfortable than insertion. A provider gently pulls the strings, removing the device in seconds. Rarely, specialized techniques may be needed if strings are not visible.

What are the Risks of IUD Use?

• Perforation (rare)
• Expulsion, especially in first months
• Infection risk within 20 days of insertion
• Irregular bleeding

Most risks are rare and manageable.

Can You Use a Menstrual Cup with an IUD?

Yes, but care is needed to avoid dislodging. Break suction before removal and consult your provider if unsure.

What Should You Know About IUD Use During Perimenopause?

Hormonal IUDs help control bleeding and provide contraception until menopause. Copper IUDs are hormone-free options. Once menopause is confirmed, IUDs can be removed if expired.

How Does the IUD Compare to Other Birth Control Methods?

• Effectiveness: Less than 1% failure rate, comparable to sterilization.
• Maintenance: “Set it and forget it,” unlike pills or patches.
• Hormonal vs. Non-Hormonal: Options for both preferences.
• Reversibility: Fertility returns quickly upon removal.

What Are the Emotional Considerations Around IUD Use?

Contraception decisions can bring empowerment or anxiety. Concerns about pain, hormones, or fertility are valid. Emotional support and open dialogue enhance the experience.

Can an IUD Help With Medical Conditions Beyond Birth Control?

• Heavy bleeding: Hormonal IUDs can significantly reduce or stop bleeding.
• Endometriosis: Helps reduce pelvic pain.
• Adenomyosis: Controls pain and bleeding.
• Perimenopausal bleeding: Provides bleeding regulation without systemic hormones.

What If You’ve Had an IUD in the Past and Want Another?

Re-insertion is common and straightforward. Switching types is possible based on evolving needs.

Can Teens or Young Adults Use IUDs?

Yes. They are safe, effective, and appropriate for adolescents and young adults. Privacy, convenience, and low-maintenance benefits make them appealing.

What Should You Know About IUDs and STI Prevention?

IUDs do not prevent STIs. Use condoms for protection, especially in non-monogamous relationships.

How Often Should You Follow Up With Your Provider?

Check-up in 4–6 weeks, then annual exams unless symptoms arise. Communicate changes in bleeding, pain, or strings promptly.

Does Insurance Cover IUDs?

Most insurance plans cover IUDs, including device, insertion, and follow-ups. Assistance programs may be available for those uninsured.

Summary: Understanding the Journey with an IUD

From insertion to removal, IUDs provide safe, effective, and reversible contraception. Informed decisions, emotional support, and ongoing care help ensure the best outcomes for each individual.