Sometimes Googling comes in handy—like before traveling to an international destination, or when you’re trying to find a hidden bar in New York City’s Chinatown. Your phone has the answer within a speedy 30 seconds. For medical questions, it’s not always as reliable, nor the best option. You come across horror stories about someone’s best friend’s sister's aunt, or you land upon a WebMD page where you self-diagnose yourself with 15 different potentially life-threatening illnesses. When it comes to reproductive health and specifically deciding to get an IUD, neither is a good thing.
To save you the agony, we spoke with two different gynecologists to find out a few facts about the process and the contraception method before you get one. And yes, we debunked a few myths along the way, too.
It’s Incredibly Effective
"I think it’s the best birth control out there. It’s the most effective at preventing pregnancy. There are studies that show it has the highest patient satisfaction—the IUD,” says Dr. Sherry, an OBGYN and author of she-ology: The Definitive Guide to Women’s Intimate Health. Period. According to Planned Parenthood, they are more than 99% effective at preventing pregnancies.
It's a one-time insertion (so you don't have to worry about taking a pill every day at a certain time) and it works for various years, depending the type of hormonal or non-hormonal IUD you get. And according to Dr. Sherry, because the hormones are contained within the uterus, there may be less systematic side effects as the pill.
It Doesn't Cause Infertility
If your mom or friend's moms have you freaked out about the IUD preventing you from having children in the future, listen up. "I think one of the biggest misconceptions is that it causes infertility, and I think this has to do with the Delkon Shield, which was the IUD of choice in the 70s," says Dr. Sherry. "Women were getting these horrible pelvic infections because of the design of the IUD. The string [of the IUD] was sort of like a bungee cord for STDs and STIs that would find their way—they’d go up the string." Because of this, she explains that STD infections like chlamydia and gonorrhea ultimately caused certain women to lose their uteruses. Over time, the design has been perfected and advanced, and she reveals that "we have never seen an IUD causing these same type of horrific pelvic infections as we did in the 70s."
In fact, gynecologists will tell you that you can get pregnant the same month you remove the IUD.
The Pain of Insertion Will Vary
So you've read that it's the worst pain "Jessie from Arizona" has ever felt in her life. That doesn't mean your experience will be the same. "It’s not worse than childbirth, A.," says board-certified OBGYN, Dr. Rebecca Brightman. "B., everyone is different. People have different pain thresholds. Some patients just like lie there, and I look at my medical assistant and I can’t believe how good they are," she adds.
In a normal insertion situation, Dr. Brightman says she'll tell patients to take a nonsteroidal like Advil or Aleve within an hour of the procedure. "It varies from person to person, but it's not worse than labor."
You also might feel pain at two different times—during and after. "I always tell my patients they are going to feel two cramps," says Dr. Sherry. The first is when the cervix is grasped with an instrument. Often, the lip of the cervix is numbed to get rid of that cramp. "The second cramp is the insertion where you have that jolt of, 'Oh my god—I felt that,' and then it tapers down."
You might cramp afterwards because Dr. Brightman explains that the uterus recognizes that there is a foreign body within it.
There Are Different Types
The hormonal IUDs, like Mirena, use a small dose of hormones to make your cervical mucus thicker so the sperm essentially can't get in and fertilize an egg, notes Dr. Sherry. It also makes the uterus an uninviting environment for the sperm. There are different types of hormonal IUDs and each last a different amount of time. The non-hormonal IUD, most popularly known as the Paraguard, which lasts up to 10 years, uses copper. She says it prevents sperm from entering but also makes the uterus an inhospitable environment for the sperm. You should consult your doctor when deciding which one is best for you. And for both, doctors recommend a screening of chlamydia and gonorrhea.
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There Is an Adjustment Period After Insertion with Side Effects
Depending on the type of IUD you choose, you might have to deal with side-effects like cramping or irregular bleeding or spotting, and there is no hard and fast rule for how long. With the hormonal IUD, Dr. Sherry says a common side is irregular bleeding or spotting. "It’s usually the first three to six months is what we tell patients, and then usually you have a really light period or no period at all, which is a really great side effect."
The most common side effect for those who opt for the Paraguard is reportedly heavier, longer periods. "Assuming its been inserted correctly, that one is a little bigger than the one the Skyla for example or the Kyleena, it can cause heavier periods and more cramps as a result of it," explains Dr. Sherry.
You might read a three-month adjustment period on the Internet, but our pros tell us that the time you deal with side-effects is really up to your individual person and facts like its placement and the size of your uterine cavity. "Essentially, you have to figure out when to call your doctor—if you have severe cramping that’s not relieved by Advil or Aleve, or something like that, or you have heavy bleeding that continues. You have to call to make sure it’s in the right position. Women, particularly those who have not had children, are more likely to reject an IUD," recommends Dr. Brightman.
The Weight Gain Question?
"It’s much, much, much less so," says. Dr. Brightman. "I have had a handful of patients complain of fluid retention and other side effects, but they are really few and far between. Most people don’t really notice anything hormonal as a result of having a hormonal IUD."
Dr. Sherry also adds that because the hormones are supposedly contained within the cavity, there shouldn't be "systematic absorption" that results in weight gain.
As for Skin?
Similar for weight gain, it's not a common side-effect. "I never say never in medicine because things happen, but it’s not your classic benefit or side effect, it’s just not," Dr. Sherry says.
Dr. Sherry says she's often asked if partners will be able to feel the string, or if the IUD can be shifted in sex. "If the string is not cut properly, it can definitely affect his sensation if he gets poked, but it won’t get displaced with different positions or more forceful sex, related to position. It shouldn’t really be a shifted as a result of sex," she says. If the string is an issue, she recommends going to your gynecologist to have them examine it.