Update: IUD Birth Control Is Safe and Effective

Decades ago, early versions of the intrauterine device (IUD) caused infections and other problems, and patients have heard horror stories about this form of birth control from older friends and relatives. Now, modern IUDs are safe, effective and convenient for almost all women, including teens and patients who have never had a child.

An IUD (intrauterine device) is a long-acting reversible contraceptive (LARC) method and is a convenient form of birth control for many women. The device can last up to 12 years (depending on the brand) and is over 99 percent effective in protecting against unwanted pregnancy. According to the American Congress of Obstetricians and Gynecologists, IUDs are 20 times more effective than birth control pills, the patch or the ring.

Despite its ease of use and high success rate, the IUD has had a slow rate of adoption in the United States due to long-standing misconceptions and a lack of awareness about the device. Fortunately, modern research and updated technology have discredited these original fears. Now, most patients – including teens and patients who have never had a child – can use an IUD safely.

What is an IUD?

An IUD is a birth control device placed inside a woman’s uterus by their OB-GYN. The device is shaped like a T and has strings attached at the end for removal. These strings hang along the cervix and are not noticeable during sex or when looking at the vulva. The IUD releases either copper or the hormone progestin, both of which are highly effective in preventing pregnancy.

A promising future and an unfortunate past

The IUD emerged as early as 1950, and its popularity boomed with the release of a version called the Dalkon Shield in the 1970s. This form of the IUD was plagued with risks: difficult insertion, incorrect placement, infections, pregnancy and an increased risk of pelvic inflammatory disease (PID). In addition, manufacturers and doctors did not know that the IUD needed to be removed if a patient became pregnant, and over a dozen patients died after miscarrying with a Dalkon Shield in place.

Following a barrage of lawsuits and an order by the Department of Health, Education and Welfare for federally funded clinics to stop prescribing the device, the Dalkon Shield’s manufacturer voluntarily pulled the product from the market. TIME reported that by 1986, due to consumer skepticism and manufacturer fear of liability, virtually no IUDs were available in the U.S. market.

Eventually, safer and more effective forms of the IUD made their way to market. Today the IUD has become one of the most prevalent and advanced methods of birth control for patients around the world. Data from the Centers for Disease Control (CDC) estimates that over 4.4 million U.S. patients rely on intrauterine devices and contraceptive implants for birth control.

So, is IUD birth control safe?

Despite its troubled past, the modern IUD has become very safe and effective. Serious complications from the device are rare and include perforation of the uterine wall, ectopic pregnancy (pregnancy that occurs outside the uterus) and the device becoming embedded in the muscle wall of the uterus. The risk of PID is only slightly increased in the first 20 days of insertion and occurs for fewer than 1 in 100 women.

Mild side effects include spotting, irregular bleeding or cramping, which often decrease after the first year of use. Some patients may have side effects related to hormones, including headaches, nausea and depression. This will not occur for patients using the copper IUD, although the copper IUD can cause slightly increased bleeding and cramping with periods.

The benefits of the IUD often outweigh the minor risks for women. These benefits include:

• Long-term convenience and no daily action needed
• More than 99 percent effectiveness in preventing pregnancy
• No hormones in the copper IUD (and it can be used as an emergency contraception)
• Use after miscarriage, abortion or childbirth
• Use during breastfeeding
• No interference with sex or other activities
• Simple removal if a patient wishes to become pregnant or switch to a different form of birth control.