If it seems like everyone you know is talking about IUDs (intrauterine devices), is thinking about getting one, or has one, that’s because IUDs are becoming popular again. After the 2016 presidential election, Planned Parenthood reported a 900% increase in people requesting IUDs. Many women are choosing a long-acting reversible contraception (LARC) due to fear of rising copays, lack of access to abortion and other potentially negative changes to women’s healthcare under the current administration.
IUDs are a one of the most effective means of birth control (99.9%), but what should you know about them when in terms of the day to day? Is sex affected with an IUD? What about IUDs and your period? Can you use a menstrual cup with an IUD? No fear – we’ve got you covered.
IUD 101
First of all, an IUD is a tiny t-shaped device that is implanted in your uterus. It has strings, about 2 inches each, that extend down the vaginal canal. Some clinicians choose to insert the IUD during your period. IUDs come in two types: the copper IUD, which doesn’t involve any hormones and will keep you protected for up to 12 years, and the hormonal IUD (Mirena, Skyla, etc), which releases levels of progestin into your body in order to prevent pregnancy. How long you can use the hormonal IUD depends on which one you use; Mirena lasts up to 7 years, and Skyla up to 3. Both the copper and the hormonal IUDs impact the way sperm move, and in doing so, prevent them from being able to fertilize an egg.
You should talk to your health care provider before you decide if the IUD is right for you, and if it is, which one you should get. For example, if you’ve had issues with hormonal birth control in the past, Mirena might not be right for you. Both IUDs can generate minor side effects when they’re first implanted, such as cramping, backaches, spotting, irregular periods, or heavier periods. These side effects should ease up within 3-6 months.
Hormonal vs. non-hormonal
Both types of IUDs impact your period. Hormonal IUDs don’t impact ovulation, but they can make your period lighter and less painful, because the hormones prevent the endometrial lining from getting as thick. With Mirena, it might take up to a year to see the IUDs impact on your period, and you also might experience irregular periods after the implantation, but when you remove it, your period should return to normal. Btw, you should NEVER take your IUD out yourself.
The copper IUD, because it’s non hormonal, doesn’t stop your period. Possible side effects of the copper IUD include: heavier and longer periods, heavier cramping and spotting in between periods. If you are someone who already has a heavy period, considering what makes sense for your body, including alternative options.
Using a menstrual cup with an IUD
IUD expulsion can happen, although it’s rare. The good news is that there’s no scientific evidence to suggest that menstrual products such as the menstrual cup and tampons enhance the risk of IUD expulsion. Michelle Heins, a Women’s Health Nurse Practitioner, says that one should be aware of the length of the strings on their IUD, in case they are too long. “Most IUD strings are cut to about 2 centimeters in length and the strings tend to soften and curl around cervix so there would be nothing to worry about when removing the cup. However, if the strings are long, there would be a slight increased risk of accidentally pulling the strings with the removal of the menstrual cup which could pull the IUD out of place. The risk though would still be low.”
Sex and masturbation with an IUD
The efficacy of the IUD has a lot to do with the fact that it’s inserted, and that’s it – no remembering to take a pill, make an appointment for an injection, renewing a prescription, etc. That being said, if you’re nervous that sex might put the placement of your IUD in jeopardy. To get some answers about sex and IUDs, we turned again to Michelle Heins, NP, a Women’s Health Nurse Practitioner.
“A common misconception about IUDs and sex,” says Heins, “is that it can fall out during sex or masturbation. An IUD can be expelled, often for reasons unknown, but it won’t happen from having sex. Another myth is that your partner will be able to feel the IUD. Your partner may be able to feel the strings of your IUD, but not the t-shaped part of it that sits inside your uterus. If your partner can feel it, it’s because it wasn’t inserted correctly. If you or your partner are ever in pain during sex, you should definitely consult your doctor.”
