IUD facts, real answers & what to expect

IUDs (intrauterine devices) are one of the most effective forms of birth control we have — over 99% effective, long-lasting, low-maintenance, and completely reversible the moment you remove them. You get years of protection (3–12 years depending on the type), without daily pills or monthly pharmacy runs. And if you ever want to try for a pregnancy? You simply take it out, and your fertility returns quickly.

Below are the IUD facts you actually need — what IUDs are, how they work, how to choose the right one for your body, and (thanks to 2025 ACOG guidelines) how to make insertion as comfortable as possible.

What is an IUD?

An intrauterine device, known as an IUD, is a tiny, T-shaped device that sits inside your uterus and prevents pregnancy. There are two types: hormonal and non-hormonal (copper).

Hormonal IUDs: Mirena, Liletta, Kyleena, Skyla

Hormonal IUDs release a very small dose of levonorgestrel (a type of progestin) directly into the uterus. This thickens cervical mucus so sperm can’t get through, thins the uterine lining, and sometimes prevents ovulation. Together, these actions make it extremely difficult for sperm to reach an egg or for a pregnancy to implant.

Why so many people love them:

Hormonal IUDs don’t just prevent pregnancy — they can completely transform periods. About 80–90% of users see lighter bleeding, and 20–30% stop having periods altogether within a few months. For people with heavy, painful periods, suspected endometriosis, or adenomyosis, this kind of relief can be a true game-changer.

How long they last:

• Mirena: up to 8 years

• Liletta: up to 8 years

• Kyleena: up to 5 years

• Skyla: up to 3 years

Possible side effects:

Some people experience mild hormonal side effects (mood shifts, acne, breast tenderness, or headaches) and inconsistent spotting in the first 1–3 months. This should improve over time. If not, you can always switch to a different IUD or have it removed entirely.

Non-Hormonal IUD: Copper IUD (ParaGard)

The copper IUD is completely hormone-free. It works because copper is toxic to sperm — it disrupts their ability to swim and makes fertilization very unlikely. It lasts 10–12 years, making it the longest-acting non-permanent contraceptive on the market.

How long it lasts:

• 10–12 years, the longest of any reversible birth control.

Why some choose it:

• Zero hormones

• Longest duration

• Can be used as emergency contraception if placed within 5 days of unprotected sex

Possible side effects:

ParaGard can make periods heavier and crampier — especially in the first 3–6 months. For some, that improves; for others, it doesn’t. But if hormones don’t work for your body or you simply prefer a non-hormonal option, it’s a strong and effective choice.

Who Can Get an IUD?

Short answer: almost anyone.

• You do not need to have had kids

• You do not need to be on your period

• You do not need a pelvic exam that day unless medically necessary

• You do not need to “prepare” for it

Old myths kept people who had never been pregnant from getting an IUD. Current medical guidelines are crystal clear: IUDs are safe for people of all ages, including those who have never given birth. 

How to choose the right type of IUD

It comes down to your body, your period, and your preferences. Think about your period patterns, hormone preferences, and what matters most to you.

• Heavy or painful periods?
  A hormonal IUD will likely make bleeding lighter and cramps easier.

• Want hormone-free birth control?
  The copper IUD lasts the longest and contains zero hormones.

• Want long-term with almost no maintenance?
  Either works — it just depends on how you feel about hormones and the flow of your period.

Pain management for IUD insertions

Fear of pain is one of the biggest reasons people hesitate about getting an IUD — and for years, pain management depended entirely on the provider you happened to get. The 2025 ACOG guidelines finally change that by recommending that all patients be offered pain-management options for IUD insertions. That means you now have more power and more choices.

carafem offers a variety of pain management options for your IUD insertion. We will talk through your options with you. 

 The most effective option is a paracervical block, a quick numbing injection around the cervix that significantly reduces insertion pain. carafem also offers lidocaine gel or spray, which is less effective but can still help, and medications to soften the cervix before the procedure — especially useful for people who haven’t given birth. Over-the-counter pain relievers like ibuprofen or naproxen can help with cramping afterward, but ACOG notes they don’t do much during the actual insertion.

Because anxiety and pain are closely linked, calming strategies (breathing, music, a support person) or even a one-time anti-anxiety medication can make a difference. Bottom line: you deserve pain management, and at carafem health centers we will talk through your options with you. 

IUDs Are Reversible Anytime

An IUD gives you long-term protection, but it’s never a long-term commitment. You can have your IUD removed whenever you want — whether that’s a few months after insertion, years down the line, or simply because your needs or preferences have changed. Removal is quick, usually takes only a few minutes, and can be done by a clinician at any time. Once the IUD is out, your body doesn’t need time to “reset.” Fertility returns to baseline quickly, which means you can try for a pregnancy right away if and when you choose. You’re always in control.

Ready to get an IUD — or just want to talk through the options? You can learn more about IUD types, effectiveness, and what to expect during an IUD insertion on our service page.

You can also get started anytime online or give us a call at (855) SAY-CARA.