An intrauterine system (IUS), also known as an intrauterine device (IUD), is a small, T-shaped piece of plastic inserted into the uterus to help prevent pregnancy. Many people are confused about how IUDs work, which has caused some myths to persist. Although not exactly known, IUDs are thought to work by stopping sperm from fertilizing an egg and preventing fertilized eggs from implanting in the uterus. However, despite the efficacy of IUDs, there is still a lot of misinformation circulating about this form of birth control, Dr. Danielle Jones, an OB/GYN based in Austin, Texas, tells SheKnows.
“Many things in the field of gynecology and pregnancy are subject to misinformation, including IUDs,” says Dr. Jones. “Some of these myths are leftover truths from previous versions of IUDs which have since evolved to the models we currently use. Some of the myths come from selection bias—what you read online or hear about in the news is naturally going to be the select few who may have severe complications or bad experiences. But I would say, overall, IUDs are the form of contraception that I recommend to my patients who are seeking a long-term option for pregnancy prevention.” Depending on what you’re looking for in birth control, an IUD may be an option for you. But, in order to find out, we have to do some IUD myth debunking first.
Myth #1: IUDs Cause Infertility
One of the common myths Dr. Jones hears surrounding IUDs is that they cause infertility. The fact is, IUDs are a reversible form of contraception and women can become pregnant as soon as an IUD is removed says Dr. Jones. That’s why women who have their IUD removed should discuss with their doctor an alternative birth control if they do not wish to become pregnant as the new method may need to be started at least 7 days before the IUD is removed to prevent pregnancy.
Myth #2: IUDs Are Permanent
Another common myth associated with IUDs is that they’re permanent, meaning if you get one, you won’t be able to have it removed. But the fact of the matter is that IUDs are a reversible form of birth control approved for women who have and women who have not given birth. An IUD can last for years (up to 3 to 10 years depending on the IUD), but in the event you want it removed, your doctor or nurse can take it out. Keep in mind that it has to be removed after the product’s approved duration of use is up, but a new IUD can be placed during the same office visit if you choose to continue to use this reversible, long-term option for pregnancy prevention.
Myth #3: An IUD Can Hurt Partners
An IUD is placed in the uterus, not in the vagina, so your partner shouldn’t feel your IUD, according to The American College of Obstetricians and Gynecologists. In some instances, your partner may feel the threads. If this occurs, or if you or your partner experiences pain during sex, talk with your healthcare provider to check whether your IUD has moved or needs to be replaced. Additionally, persons with an IUD should not feel the plastic part of an IUD. While it is normal to feel the threads with your fingers (it is recommended that you feel for the threads each month to check that the IUD is in proper position), if you feel more than just the threads or you can’t feel the threads at all, the IUD may have moved and you should make an appointment with your doctor. In this case, the IUD may not be in the right position and may not prevent pregnancy, so you should use nonhormonal backup birth control such as condoms until your doctor can check that the IUD is still in the right place.
Myth #4: IUDs Aren’t That Effective
“Many people with a uterus can safely use an IUD,” says Dr. Jones. “Your age or how many children you’ve had is usually not a limiting factor. IUDs are among the most effective birth control methods for preventing pregnancy and have been recommended as an option for anyone with a period who needs effective contraception.” That being said, the IUD’s efficacy rate is over 99 percent at preventing pregnancy. That’s in part due to the fact that it’s placed in the uterus by a healthcare provider, so there is no daily routine, like remembering to take a pill. There is, however, a need to feel for the threads every month to check that the IUD is still in position.
Myth #5: You Can’t Use a Tampon With an IUD Inserted
An IUD stays in the uterus—not in the vagina, where a tampon is used. If so please, you can use a tampon if you have an IUD. In addition, tampons cannot go past your cervix, so they should not affect your IUD, which is placed inside your uterus.
Benefits of Choosing an IUD
The most obvious benefit of an IUD is that it is >99 percent effective at preventing pregnancy and requires minimal maintenance. However, you should return to your healthcare professional for a follow-up visit 4 to 6 weeks after the IUD is placed to make sure it is in the right position. It is a good habit to check monthly that the IUD is in proper position by feeling the threads.
“People always ask me, ‘What form of contraception is best?’ or ‘What do you recommend?’ and the answer is simple: This is very individual,” says Dr. Jones. “What is best for you may not be best for me. What is best for my patient today may not be best for a new patient tomorrow. The most important thing is knowing that there are many contraceptive options and one of them may work for you, so if you’re reconsidering your current method, come and chat with us! We want to help you make an informed decision.”
Know Your Options
As Dr. Jones said, the key to choosing a birth control method that is appropriate for you is knowing what’s available. If you’re considering an IUD, there are a few choices out there, with one being LILETTA (levonorgestrel-releasing intrauterine system) 52 mg. LILETTA is a hormonal, reversible IUD option, which was the first approved in the U.S. for up to six years of pregnancy prevention. It has been found to be more than 99 percent effective at preventing pregnancy in different types of women of childbearing age. It can be used by women who have had children and women who have never given birth or been pregnant. LILETTA is a small, flexible, plastic, T-shaped device that, when inserted into the uterus by a healthcare provider, slowly releases 52 mg of a progestin hormone called levonorgestrel. This is the same kind of hormone that is often used in birth control pills. Only a small amount of levonorgestrel enters your bloodstream. It does not contain estrogen. Of course, LILETTA may not be appropriate for all patients, including those who are or may be pregnant, have a pelvic infection, untreated genital infection, certain cancers, unexplained vaginal bleeding, fibroids, or short-term liver disease, get infections easily, or are allergic to its ingredients. See additional Important Risk Information about LILETTA below.
If you have questions or want to know more about LILETTA, it’s important to talk with your doctor and have a good sense of what to expect. For example, LILETTA insertion can be done during a routine office visit. Common side effects during and after insertion are pain, bleeding, or dizziness. If your side effects become severe or last for more than 30 minutes, contact your healthcare provider immediately. LILETTA may not have been placed correctly, or these may be symptoms of perforation or expulsion. Your healthcare provider will examine you to see if LILETTA needs to be removed or replaced. You can read about what to expect after LILETTA insertion here.
• Do not use LILETTA if you:
— Are or might be pregnant; LILETTA cannot be used as an emergency contraceptive
— Have a serious pelvic infection called pelvic inflammatory disease (PID) or endometritis unless you have had a normal pregnancy after the infection went away (PID occurs in less than 1% of users)
— Have an untreated lower genital infection now
— Have had an infection from an abortion within the last 3 months
— Can get infections easily; for example, if you: have problems with your immune system, have multiple sexual partners or your partner has multiple sexual partners, or use or abuse intravenous drugs
— Have or suspect you might have cancer of the uterus or cervix
— Have bleeding from the vagina that has not been explained
— Have short-term (acute) liver disease or liver tumor
— Have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past
— Have an intrauterine system (IUS) in your uterus already
— Have a condition of the uterus that changes the shape of the uterine cavity, such as large fibroid tumors
— Are allergic to levonorgestrel, silicone, polyethylene, or barium sulfate
• Call your healthcare provider right away if you think you are pregnant. If you get pregnant while using LILETTA, you may have an ectopic pregnancy, which means the pregnancy is not in the uterus. Unusual vaginal bleeding or abdominal pain especially with missed periods may be a sign of ectopic pregnancy. Ectopic pregnancy can cause internal bleeding. There are also risks if you get pregnant while using LILETTA and the pregnancy is in the uterus. Severe infection and premature labor or delivery can occur with pregnancies that continue with an IUS
• Although uncommon, pregnancy while using LILETTA can be life threatening and may result in loss of pregnancy or fertility
• Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter or may stop
• Life-threatening infection can occur within the first few days after LILETTA is placed. Call your healthcare provider immediately if you develop severe pain or fever shortly after LILETTA is placed
• Some IUS users get a serious pelvic infection called pelvic inflammatory disease (PID) or endometritis. These are usually sexually transmitted. You have a higher chance of getting PID or endometritis if you or your partner has sex with other partners. PID or endometritis can cause serious problems such as infertility, ectopic pregnancy or pelvic pain that does not go away. More serious cases of PID or endometritis may require surgery. Removal of the uterus (hysterectomy) is sometimes needed. In rare cases, infections that start as PID or endometritis can even cause death. Tell your healthcare provider right away if you have any of these signs of PID or endometritis: long-lasting or heavy bleeding, unusual vaginal discharge, low abdominal pain, painful sex, chills, or fever
• LILETTA may partially go into (become embedded) or go completely through (perforate) the wall of the uterus. If perforation occurs, LILETTA may move outside the uterus and can cause internal scarring, infection, or damage to other organs. You may need surgery to have LILETTA removed if it is embedded or perforation occurs. Risk of perforation is increased in breastfeeding women
• LILETTA may come out of your uterus (expulsion). Expulsion occurs in about 4 out of 100 women, most often in the first year of use. You may become pregnant if LILETTA comes out. If you think that LILETTA has come out, use another birth control method like condoms and spermicide or do not have sex (vaginal intercourse) until you are seen by a healthcare provider
• Ovarian cysts may occur but usually disappear
LILETTA does not protect against HIV or STDs.
Available by prescription only.
Please also see full Prescribing Information.
1. LILETTA (levonorgestrel-releasing intrauterine system) 52 mg [Prescribing Information]. Irvine, CA: Allergan USA Inc, and San Francisco, CA: Medicines360; 2020.
2. Glossary of Sexual Health Terms. Planned Parenthood Federation of America, Inc. http://www.plannedparenthood.org/learn/glossary. Accessed June 1, 2021.
This article was created by SheKnows for AbbVie.