How To Choose An IUD

First of all, what is an IUD?..

IUD stands for “intrauterine device” and it is a small T-shaped device that inserted in the uterus to prevent pregnancy. You can’t feel the device, and it can stay there for several years depending how long you want to keep it in.

The IUD is becoming one of the most popular forms of birth control that I see in practice. All of the IUDs are considered over 99% effective for preventing pregnancy – which is even higher compared to oral birth control pills which are the most common form of birth control.

How to get the IUD…

Before you can have the IUD inserted, you will need to be up-to-date with your pap-smear, and you should have vaginal cultures done to make sure there is no infection – this will need to be done at a first and separate appointment from the IUD insertion appointment. Your provider will also want to perform an ultrasound to check your uterus – sometimes this can be done the same day as your IUD insertion appointment.

The placement of the IUD is a very simple non-surgical procedure, it only takes a few minutes. That being said, it can cause cramping and pain, and also sometimes dizziness. I always advise that patients take the day off from work after getting the IUD inserted.

Types of IUDs…

The two most common IUDs are the Mirena and the Paragard. Both are considered to be equally effective for preventing pregnancy, but they work in very different ways and have vey different side effect profiles. Before you choose and IUD, it is important to take into consideration the differences between the two primary types.

Below lists the key attributes to consider between the two most common IUDs


This is by far the most common type of IUD that I see in practice and I hear almost always positive things from women who have the Mirena. The Mirena can stay in for up to five years, but it can be taken out at any time before this.

How it works:

The Mirena contains a progestin hormone called levonorgestrel, it does not contain any estrogen or any other hormones. The progestin is released directly into the uterus and only small amounts of hormone are released to the blood. In this way, the Mirena works very locally, which is a good thing to know if you are someone who does not like to take hormones.

Who can benefit:

The good thing about the Mirena is that after a couple of months periods become very light or they go away completely – at least this is true for the majority of women. For this reason, the Mirena is great for women who have heavy and/or long periods.


What about when breastfeeding?

Women must wait at least 6 weeks after giving birth to get the Mirena, but after that point the Mirena is considered safe with breastfeeding. 

Possible cons:

I do not hear about too many negative experiences from women using the Mirena. The most common reason I’ve seen for a woman to have the Mirena removed was due to cramping/spotting that never stopped even after several months.

Another reason women don’t choose this IUD might be because they don’ want to take any hormones. But the good thing is this IUD releases only progestin almost exclusively to the uterus, and very little is released to the blood.

One more reason to not choose this IUD is that it does not help with acne, and I’ve had a few patients who said their acne got worse when using this IUD.

Learn more about the Mirena IUD here.


The ParaGard is the most only form of prescription birth control that does not use hormones, and instead it uses copper to prevent pregnancy – it is literally 100% hormone-free. This IUD can be used for up to 10 years! but it can be taken out anytime before this.

How it works:

The copper interferes with sperm movement to prevent fertilization, and may also prevent implantation of the egg.

Who can benefit:

This is the best option for women who don’t want to take hormones and want to have a monthly period.

The Paragard can be placed immediately after a woman gives birth, and is safe to have during breastfeeding.

Possible cons:

This type of IUD does tend to cause heavier and longer periods, and heavy periods is definitely the number one complaint I get from women who have it. This means that if you already have heavy periods, using this IUD could possible make your periods even worse.

Learn more about the Paragard here.

About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California with an expertise in women’s health and preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab

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