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How do IUDs Work?

Tricia Christensen
By
Updated: Mar 03, 2024

IUDs or intrauterine devices are a type of birth control method with a high rate of success in preventing unwanted pregnancies. There are two types present on the market, the standard IUDS are T-shaped devices covered with coiled copper that are inserted directly into the uterus. The insertion process means dilating the cervix, in a doctor’s office, so that the device can be fitted into the uterus. It can be an uncomfortable procedure, producing heavier periods thereafter, and runs some risk of pelvic inflammatory disease and of infection. This risk is minimal, and most women tolerate intrauterine devices very well. They are very popular forms of birth control in European countries and in China.

The second type of IUD is sometimes called an intrauterine system or IUS. The blockage mechanism is approximately the same but the device also releases a steady flow of progestin, which helps to chemically lower chances of pregnancy. It tends to reduce frequency, length, and heaviness of periods, in contrast to standard or inert intrauterine devices. It does have greater side effect factors and warnings that apply to taking any type of hormonal birth control equally apply to IUDs of this type.

With the first type of IUD, after insertion into the uterus, the presence of the copper around the IUD frame acts as a natural spermicide. Additionally, intrauterine devices cause the uterus to produce white blood cells (leukocytes), and prostaglandins within the uterus. These make the uterine environment hostile to sperm and eggs, greatly reducing potential pregnancy.

Over the lifetime of the inert IUD, usually five to ten years, total risk for becoming pregnant is approximately 4%, though for most, there is only a 1% chance of becoming pregnant.

There is a chance that the uterus can expel the IUD, particularly in the first year after insertion, and especially by women who have never had children. Normally, when IUDs stay in place, a physician must remove them, and no one should attempt to remove an IUD on their own. There are two strings that hang from the IUD, which some men do feel during intercourse. If these become problematic, they can be trimmed.

intrauterine devices that release hormones are plastic and have an interior cylinder that releases hormones at a controlled level. These work for approximately five years, at about a 99% effectiveness rate, but can be removed anytime. Hormonal birth control methods tend to reduce or eliminate ovulation. Progestin increases uterine mucus, which lowers speed of sperm and makes it very difficult for sperm to reach an egg if and when ovulation does occur. In the event of fertilization of an egg, progestin tends to prevent implantation, meaning a woman would naturally miscarry a fertilized egg.

It’s important to remember that an IUD is not considered a barrier birth control method, though it does provide a barrier of sorts. They will not protect against sexually transmitted diseases (STDs), and some studies suggest that the IUDs may heighten the risk for contracting HIV. It is therefore extremely important to continue use of barrier contraception like male or female condoms to not only prevent pregnancy but also to prevent contraction of STDs.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Tricia Christensen
By Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia Christensen is based in Northern California and brings a wealth of knowledge and passion to her writing. Her wide-ranging interests include reading, writing, medicine, art, film, history, politics, ethics, and religion, all of which she incorporates into her informative articles. Tricia is currently working on her first novel.
Discussion Comments
By anon328731 — On Apr 05, 2013

I have had a copper IUD for birth control for about two years. I had used variations of the pill for eight years prior to getting the IUD until I could no longer tolerate the hormones.

I paid roughly $600 for the device and insertion since insurance didn't cover any of the cost.

The side effects are increased menstrual cramps and longer periods. I also get more cramps during ovulation around the middle of my cycle. I personally don't care for the side effects and would remove the IUD, but my husband and I don't want to have children.

By mutsy — On Sep 02, 2010

Moldova- I heard that the Paragard IUD is not a hormonal IUD. This non hormonal IUD is good for a period of ten years.

I heard though that one of the IUD side effects for this IUD results in heavy cramping along with heavy blood flow during your period.

I think that an IUDs birth control should be considered after you are done having kids. The doctor’s will usually ask you that.

You could have the IUD removed, but it is better to consider this option when you are looking for long term birth control, because otherwise it can be expensive. These copper IUDs offer protection for a long time.

By Moldova — On Sep 02, 2010

Bhutan-

The IUD prices range from a fee of about $750 to $1,000 for insertion and another fee of a few hundred dollars for removal at the end of the five years.

Also because there are small amounts of hormone in the device, when you have it removed, you might feel like vomiting and feel a little dizzy for the first day after removal if you don’t have a new one inserted immediately after the Mirena expires.

That is what happened to a friend of mine because she chose a different type of birth control after having the Mirena IUD removed. She did not like the side effects of this hormonal IUD.

By Bhutan — On Sep 02, 2010

The Mirena IUD offers birth control protection for a period of five years. It is supposed to be as effective as sterilization if properly inserted.

It virtually removes all periods, but it can have some IUD side effects. Some women experience headaches and bouts of irritability.

In addition, some women experience fatigue and feel tired from time to time. If having an IUD inserted it is important to take an Advil about an hour before the procedure in order to ease the discomfort.

It is usually inserted in a period of minutes, but without this precaution, you will feel uncomfortable.

Also, most insurance companies do not cover the cost of an IUD conceptive.

Tricia Christensen
Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia...
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