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    23 Things Everyone Should Know About IUDs

    If you're interested in a long-term relationship with your birth control, here are the main things to keep in mind.

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    1. They’re one of the most effective methods of birth control.

    There are two main kinds: hormonal IUDs and copper IUDs.

    2. The hormonal IUD is a tiny plastic device that contains the hormone levonorgestrel, which is slowly released into the uterus.

    3. The copper IUD is a tiny device made of plastic and copper, and it’s totally free of hormones.

    4. They’re super popular among female doctors.

    5. And they’ve been suggested as a safe and effective birth control method for teens.

    6. IUDs got a bad rap after an earlier version caused serious health problems.

    7. IUDs are good options for pretty much anyone who wants lasting pregnancy protection.

    8. But obviously, they’re not for everyone.

    9. They don’t actually stop you from ovulating.

    If the thought of putting your ovulation on hold kind of freaks you out, the IUD might be a good option. Even the progestin in the hormonal IUD stays mostly in your uterus, with very little getting absorbed into your bloodstream. For some women, these hormones may impact ovulation a little bit in the first year or so, but that will balance out after a while, says Gunter. And if you're on the copper IUD, it won't affect ovulation at all.

    10. They start working pretty much immediately.

    11. And you can get pregnant as soon as you take them out.

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    With both the copper IUD and the hormonal IUD, it's possible to get pregnant as soon as you get it removed, says Perriera.

    12. Some people report worse periods and cramps on the copper IUD.

    13. With the hormonal IUD, you may have little to no period.

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    After about six months on the hormonal IUD, about half of women report minimal bleeding, with many of them having no period at all, says Gunter. For most people, this is the best benefit of all time, but others might actually miss that monthly reassurance that they're not pregnant.

    14. But beware: You might bleed A LOT when you first get the hormonal IUD.

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    "With [the hormonal IUD] a significant amount of people will have a lot of irregular bleeding for the first six months," says Gunter. "Like, you're ruining a lot of underwear." But the good news is that the bleeding will gradually decrease over time. And remember that most people have lighter or nonexistent periods after the half-year point.

    15. Insertion is typically quick, but it can be uncomfortable for some and super painful for others.

    16. Here’s what it’s actually like to get an IUD:

    Keith Brofsky / Getty Images / Via

    We asked Gunter and Minkin to give us a play-by-play so you know exactly what to expect. First your doctor will insert a speculum into your vagina (like when you get a Pap smear). Then they clean the cervix and examine your uterus to see how long it is and what direction it is. Then they load the IUD into a tiny tube like a straw (with the arms collapsed in), and push it through, so it releases into your uterus and the arms open up. Finally, they cut the strings that hang off the end of it, so that you and your partner can't feel them unless you really go looking for them. The whole process typically only takes a few minutes.

    Most doctors will schedule a follow-up visit after your next period so they can make sure everything's going well. "If something is going to happen, that would be the time frame where we would see it," says Minkin.

    17. Your doctor will explain how to check for the strings periodically — just to make sure it’s still in place.

    Spike Mafford / Getty Images / Via

    Talk to your doctor about how often to do a self-check and how exactly to do it. Minkin explains that feeling for the strings almost feels like using your finger to touch a string on the tip of your nose. It's very rare for the IUD to slip out of place, but if you don't feel the strings, you should still call your doctor to see what's up.

    18. You should get an STI test before you get the IUD.

    19. There are a few other serious side effects associated with IUDs, but they’re very rare.

    One risk is perforation, which is when the IUD attaches to or goes through the wall of the uterus. It's very rare, with studies showing it occurs in less than 1% of people with IUDs, says Gunter. It's slightly more common if you're breastfeeding, if you have an oddly shaped uterus, or if you just have an inexperienced provider. If you have severe pain during or after insertion, be sure to tell your doctor.

    Another risk is expulsion, where the IUD comes out partially or completely. Talk to your doctor if you think this has happened or if you're experiencing any pain. It's also possible to develop ovarian cysts with the hormonal IUD, but these typically disappear on their own.

    These side effects are all very uncommon, and they're explained in the prescribing information for your IUD. Even though they're rare, talk to your doctor about them at your appointment so you know if you're at risk and what to watch out for.

    20. If you can't take birth control pills for some reason, you might still be able to use an IUD.

    21. Your insurance should cover IUDs, but it might not.

    22. If you get pregnant while you have an IUD (which is incredibly unlikely), it’s more likely to be ectopic.

    IUDs have a failure rate of less than 1%, but that still means there's a very small chance of getting pregnant. If you do get pregnant with an IUD, it's more likely to be an ectopic pregnancy (one where the embryo implants outside the uterus, often in the fallopian tubes), says Gunter. However, it's important to note that having an IUD doesn't raise your risk of having an ectopic pregnancy in general. If you think you may be pregnant, contact your doctor immediately.

    23. IUDs have the highest satisfaction rate of all reversible birth control options.

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