While the Paragard and hormonal methods that don’t contain estrogen—the shot, the Mirena IUD, the implant and the mini-pill—are safe for people who are postpartum to use immediately after giving birth, combination pills, which contain estrogen, shouldn’t be used until three weeks after giving birth, since estrogen can increase a postpartum person’s risk of blood clots.
It’s true that the up-front cost of an IUD can be high depending on your insurance, but even paying full price it ends up being pretty cheap considering how long it lasts. Mirena IUD can stay in your body for up to five years, costing you the equivalent of just $9 a month if you pay full price. The Paragard IUD can stay in your body for up to 10 years, costing you the equivalent of just $4 a month if you pay full price.
If you’re on Medicaid or have private insurance, the IUD might be free for you, or at least very cheap, since Medicaid and private insurance often pay for birth control.
If those aren’t options for you, check with the family planning clinics around you and find out if they offer discounts or payment plans for IUDs.
Check out our IUD page for more information about the cost of the IUD.
The IUD is among the most effective methods out there. In fact, both types of IUD—Paragard and Mirena—are over 99% effective.
In other words:
Fewer than 1 out of 100 women will experience an accidental pregnancy during the first year of using an IUD.
The hormonal IUD (Mirena) dramatically reduces blood loss during one’s period, protecting against anemia. It can also reduce menstrual symptoms in women who have fibroids. And, if you’re a woman who can’t use estrogen, both the hormonal IUD and the copper IUD (Paragard) are good options.
In a word, no. The best way to guard against sexually transmitted infections (STIs) if you’re having sex is still the good ol’ condom. If you’re concerned about both pregnancy and STIs, doubling up with the IUD and condoms is a great option.
IUD expulsion can occur in 2-10% of people in the first year after insertion. Expulsion can be more likely for people who:
1. Haven’t been pregnant
2. Are younger than 20 years
3. Have a history of very heavy or very painful periods (though be mindful that these are reasons doctors recommend the hormonal IUD in the first place…)
4. Had the IUD put in right after giving birth or having a 2nd trimester abortion.
A partial expulsion may mean that the IUD was not quite in the right position: it may have been too low in the uterus and just worked its way out. This could be something that happened around the time of insertion, or may be related to uterine characteristics, such as size, angle, or presence of conditions like fibroids that can cause irregular shape. For people who have an IUD expulsion, the chance of expelling a 2nd IUD may be higher—in the 20% range (up to 30% in some studies).
If you want a second IUD after the first one came out, consider asking your health care provider about inserting the 2nd IUD while using an ultrasound machine to make sure the IUD is inserted all the way to the fundus.
Unless you’re in a totally exclusive relationship and you and your partner have both been tested recently for every single STI, you should definitely use condoms with whatever other birth control method you choose. Using a condom with another form of birth control is called dual protection. It means you’re being super-safe and protecting yourself against both pregnancy and STIs.
The pill is the most popular in the United States, but that doesn’t mean it’s a bargain in the long run. For women who know that they don’t want to have a baby for at least a few years—you’re in school, starting a career, or are just not ready—an IUD, the shot, or the implant can save you a bundle of money.
No, most forms of birth control are not effective immediately, so you want to check with you doctor before having unprotected sex. Until then, use a condom for added protection.
Using a method of birth control with estrogen increases a young woman’s risk of forming a blood clot by several times, but for women who have no history of stroke, blood clots, or heart attack, and whose family members have never experienced a blood clot, the risk is still quite low. Women with a history of these medical conditions in their family have a higher risk of forming a new blood clot; adding birth control with estrogen to the mix increases that risk to an unacceptable level.
Progestin-only methods like the implant, mini-pill, the shot, and Skyla and Mirena IUDs don’t increase your risk. If you’re worried about blood clots, we recommend talking to your doctor about which birth control options are best for you.
Some methods are much easier to hide than others. The shot and the implant are invisible, so nobody will know you’re using birth control. The IUD is also very discrete, so that’s another possibility, though some guys may be able to feel the strings during sex. And if you are looking for a permanent solution, sterilization surgery is also undetectable, but there may be age restrictions and waiting periods for this procedure.
Yes. The American Congress of Obstetricians and Gynecologists—an association whose members make up 90% of doctors specializing in women’s health in the U.S.—has declared IUDs safe for women of all ages. They also noted that the IUD and the implant, another long-acting method, are more effective than any other form of reversible birth control.