Hormonal IUD

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, where your IUD comes part of the way or all the way out of your uterus, happens in 2 to 10% of people with an IUD (that’s 2 to 10 out of every 100 people using an IUD) in the first year after insertion. If your IUD has come out of your uterus completely or partially (is sticking out of your cervix), it is no longer going to be effective as birth control, so if you don’t want to get pregnant, make sure you’re using a backup method of birth control, like condoms, if this happens.

Expulsion is more likely if you: 



1. Haven’t been pregnant
2. Are younger than 20 years old

3. Have very heavy or very painful periods (though these are reasons to use a hormonal IUD in the first place)

4. Had your IUD put in right after giving birth or right after having a 2nd trimester abortion.

5. Have a uterus that is an irregular shape (which can be something you’re born with or something caused by fibroids).

It could also happen if the IUD was placed too low in the uterus and just worked its way out. For people who have an IUD expulsion, the chance of expelling another IUD may be higher—around 20% (and up to 30% in some studies), meaning that 20 to 30 out of every 100 people who’ve expelled an IUD in the past will expel another IUD.
If you want to try an IUD again, consider asking your health care provider about inserting the IUD while using an ultrasound machine to make sure it’s inserted in the correct place.

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.

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.

There are two kinds of IUDs available in the U.S.—with hormones and without. Mirena, LILETTA, and Skyla IUDs release a small amount of the synthetic hormone progestin to help your body keep sperm from reaching your cervix. Both Mirena and LILETTA last up to 8 years; Skyla is slightly smaller than Mirena and lasts up to 3 years.

The Paragard IUD is hormone-free and doesn’t alter your periods. It’s made of plastic and a small amount of natural, safe copper and can work for up to 12 years.

It depends which kind you get. Skyla is approved for up to 3 years and Kyleena is approved for up to 5 years. Mirena and LILETTA are both approved for up to 8 years. The non-hormonal Paragard IUD is approved for up to 10 years but lasts for 12 to 20 years.

For about 1 in 2,000 women, the IUD can get stuck in or puncture the uterus—also known as perforation. Perforation only happens when the IUD is being put in. Highly skilled providers who have inserted many IUDs are less likely to have perforations. Women who are breastfeeding or have given birth within the last month are more likely to experience perforations because the muscle of the uterus is softer at those times.

What does it mean if there is a perforation? If it’s recognized immediately, the health care provider will stop the insertion. It takes about a week for the uterus to heal, and then a woman can have another IUD inserted if she wants. More than half of perforations may go unrecognized at the time of insertion. That may mean that a woman thought she had great birth control when she may not have. If undiagnosed for months, a perforation can make removing the IUD difficult, and can sometimes require surgery. Even in the worst-case scenario of an undiagnosed perforation that requires surgery, it shouldn’t have an impact on the woman’s future fertility.

You may be able to find some stories online about people removing their own IUD, but we wouldn’t recommend trying it. There just isn’t enough research at this point to know if it’s safe.

Plus, if you’re not happy with your IUD, going to your health care provider to get it removed will give you a chance to ask about other options for birth control. Or if you’re ready to get pregnant, you can talk with your provider about things you should do to prepare for a healthy pregnancy.

Levonorgestrel is one of the longest-studied types of progestin, and all the scientific evidence to date shows it is super safe. It’s used in hormonal IUDs, some emergency contraception pills, and certain birth control pills.

Skyla and Mirena are pretty similar, but Skyla lasts for up to 3 years while Mirena lasts for up to 8 years. Also, Skyla is slightly smaller than Mirena and was FDA-approved for women who’ve never had a child, though both IUDs are totally safe for most women to use, regardless of their parental status.

As far as tampons and IUDs go, Planned Parenthood puts it like this: “Tampons and IUDs are kind of like next-door neighbors. They’re close but they live in different parts of the reproductive system. An IUD and a tampon are separated by the cervix, and don’t interfere with each other’s business.”

You should be fine as long as you are careful not to pull on the IUD strings, which you shouldn’t need to worry about too much since the string of a tampon is outside of your vagina and the strings of your IUD should be up near your cervix. (If you find that your IUD strings are anywhere near your tampon strings, you should go see your health care provider because your IUD might be expelled.)