IUD Risks and Complications

Holding an IUD birth control device in hand
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The good news is that the number of women who are choosing to use IUDs as their birth control method is quickly growing. For some reason, though, IUD use is nowhere as popular as the pill or condoms. Did you know that IUDs are just as effective as a vasectomy? But, unlike a vasectomy, IUDs are completely reversible!

So why are so many of you not taking advantage of this super effective and long-acting birth control method? There seems to be a lot of misconception about IUD risks and safety. Let's take a quick look at why this may be the case.

IUD Risks and Concerns Haunting Us From the Past

IUDs have a checkered past. This has left IUD use to be stigmatized as being unsafe. In the 1970s, (mind you, at that time the FDA had limited authority over the medical device industry), the first popular IUD, called the Dalkon Shield, was introduced.

The design of the Dalkon Shield included a multifilament string (a fancy word for a cable-type string made of hundreds of fine nylon fibers wrapped around each other). They used this string because it was stronger and wouldn't break. But, this type of string made it easier for bacteria to enter into the uterus. So, the Dalkon Shield was responsible for pelvic infections, miscarriages, sepsis (blood poisoning), infertility and hysterectomies. And the company that made the Dalkon Shield knew about these problems, withheld research results and lied about the IUD's safety (because it would have cost too much money to fix). So thousands of women were injured from Dalkon Shield, which could have been prevented if the company had been honest and not participated in this huge "cover-up."

These IUD risks and injuries from the Dalkon Shield lead to thousands of lawsuits. The FDA cranked up the pressure, and the Dalkon Shield was removed from the market. The FDA recommended that all women who were currently using the Dalkon Shield have the device removed. Two years after this IUD was taken off the market (and much more had become known about the damage caused by the Dalkon Shield), the FDA changed the Food, Drug and Cosmetic Act to require more detailed testing for and FDA-approval before any medical devices could be sold.

This is how the IUD's past left a negative impact. Many women may still be afraid that there are still huge IUD risks. They don't realize that today's IUDs are safer than the ones from the past. And, they are also FDA-approved.

Today's IUDs

There are five IUD brands available in the US: Mirena, ParaGard, Skyla, Kyleena, and Liletta. These are not like your grandmother's IUD from the past. These IUDs are safe and reliable long-term contraceptive methods. Like with many birth control methods, you may have some side effects after having your IUD inserted. But in most cases, these go away after the first few weeks to months.

Although serious complications are rare, it is possible for them to occur. So if you experience any problems, it's very important that you report them to your doctor right away.

Possible Risks and Complications

  • Perforation: Rarely, an IUD can be pushed through the wall of the uterus during insertion. This is usually discovered and corrected right away. If not, the IUD can move into other parts of the pelvic area and may damage internal organs. Surgery may then be needed to remove the IUD.
  • Infection: There is some risk of PID (pelvic inflammatory disease) linked to IUD use. But the risk is very low after the first 20 days after insertion. PID is usually sexually transmitted. You have a higher risk of getting PID if you or your partner have sex with multiple partners. Pelvic infection can be caused by bacteria getting into the uterus during insertion. Most infection develops within 3 weeks of insertion. Infection (due to the IUD) after 3 weeks is rare. If you get an infection after this time, it is most likely because you have been exposed to STD's during sex. Studies show that IUDs don't cause PID or infertility.
  • Expulsion: The IUD could partially or completely slip out of the uterus – this is most likely to occur during the first few months of use (although it can also happen later on). It can also happen during your period. With Mirena or ParaGard, there is a slightly higher risk for expulsion if you have never had a baby, or if you're a teenager or young adult. Because Skyla is a tiny bit smaller than the other two IUDs, it is a little less likely to be expelled in nulliparous women (medical word for women who have never given birth) – though, expulsion of the Skyla IUD can still happen. If your IUD comes out, you can become pregnant. So if this happens, make sure to use a backup birth control (like a condom), and call your doctor. If your Mirena or Skyla IUD only partially comes out, it must be removed (so please don't try to shove it back in). To be cautious, check your pads and tampons during your period to make sure that your IUD has not fallen out.

Increased Risk Factors

Most women will not have any problems using an IUD. But, if you have certain conditions, you may be more at risk of developing serious complications while using an IUD. These include being at risk for sexually transmitted infections at the time of insertion or having:

  • Serious blood clots in deep veins or lungs.
  • Had PID in the past 12 months.
  • Have diabetes or severe anemia.
  • Have blood that doesn't clot/take a medication that helps your blood clot.
  • Have had two or more sexually transmitted infections within the past 2 years.
  • Have or had ovarian cancer.
  • Take daily medication(s) containing a corticosteroid (such as prednisone).
  • Have a history of tubal infection (this does not apply to women who had a pregnancy in their uterus since the infection).
  • Have uncontrolled infections of the cervix or vagina, such as bacterial vaginosis.
  • Have a uterus positioned very far forward or backward in the pelvis.
  • Have a history of impaired fertility and the desire to get pregnant in the future.

Be Your Own IUD Advocate

Like many women, there are a lot of doctors that still have misbeliefs about IUD risks and safety. These doctors may also have outdated ideas about who can and cannot use an IUD. So, in order to be your own advocate... if your doctor gives you any trouble, know that:

  • Teenagers can use IUDs.
  • You CAN use an IUD even if you have never given birth.
  • You do not need a new IUD if you have switched sexual partners.
  • You do not need to be in a monogamous relationship to use an IUD.

For many women, the IUD can be a wonderful contraceptive choice. It's convenient, effective, eco-friendly, and it doesn’t require you to do anything for it to work or interfere with sexual spontaneity. Just like with other prescription birth control, there are some risks and potential complications linked to IUD use, but most women are happy with this long-term contraceptive option.

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Article Sources
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Additional Reading
  • Johnson BA. "Insertion and removal of intrauterine devices."American Family Physician. 2005; 71:95-102.

  • Shelton JD. "Risk of clinical pelvic inflammatory disease attributable to an intrauterine device."The Lancet. 2001 Feb; 357(9254):443.

  • Thiery M. "Intrauterine contraception: from silver ring to intrauterine contraceptive implant."European Journal of Obstetrics & Gynecology and Reproductive Biology. 2000 June; 90(2): 145–52.