IUD (Intrauterine Device): Frequency Asked Questions

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.

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.

For most people, the risk of blood clots when using the ring, the patch, or the combined birth control pill (which is the most common type of pill) is low. But smoking increases this risk. If you are over 35 and smoke 15 or more cigarettes a day, the combination pill, patch, and ring are not safe options for you. If you’re over 35 and you smoke less than 15 cigarettes a day, talk to your provider about whether these birth control methods are safe options for you. People who smoke can always use the IUD, the implant, the shot, the mini-pill (progestin-only pill), and any method that is hormone free (like condoms, for example).

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.

IUDs are safe for most people with a uterus, and copper toxicity is super rare. That said, it can happen, especially in people with Wilson’s Disease, a rare genetic condition (about 1 in every 30,000 to 40,000 people have it) that affects your body's ability to process copper. Given how low the daily dose of copper is from the non-hormonal IUD, it is extremely unlikely that someone who does not have Wilson's Disease would experience copper toxicity.

The IUD shouldn’t hurt your partner. You may have heard that the IUD strings can bother partners while having sex, but most partners can’t even feel the strings. If your partner can feel the strings, and that bothers them, your healthcare provider might be able to trim them. Plus, they usually soften over time.

For women with high blood pressure, methods with estrogen–the pill (except for the mini-pill), the ring, and the patch–may make their blood pressure even higher, increasing the risk of a heart attack or stroke. Fortunately there are lots of highly effective birth control options that are safe and estrogen-free like the IUD, the implant, or the shot. Talk to your doctor about your condition and what birth control is best for you.

Using a method of birth control with estrogen, like the pill, patch, or ring, increases the risk of forming a blood clot, but the risk is so low that if you don't have any factors that increase your chances of having a blood clot, you can safely use all types of birth control. If you do have an increased risk of blood clots because you've had one before you've had a stroke or heart attack, or you have a medical condition that increases your risk of a blood clot, like high blood pressure, then adding birth control with estrogen to the mix increases your risk too much and it's not recommended that you use birth control with estrogen in it. But that doesn't mean there isn't a birth control method for you!

If you can't take estrogen, you have quite a few options available to you. First you have the non-hormonal methods, like the copper IUD. You can also use any of the hormonal methods that only contain progestin, not estrogen, like the implant, mini-pill, shot, and hormonal IUDs, like Mirena, Skyla, Liletta, and Kyleena. These don't increase your risk of blood clots and are all really good at preventing pregnancy.

If you're worried about blood clots or don’t know if you have risk factors, talk to a health care provider about which birth control methods are options for you.

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.)

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.