IUD Risks and Complications

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The number of women who are choosing to use an intrauterine device (IUD) as their birth control method is quickly growing. But IUD use is still not as popular as the pill or condoms. In preventing pregnancy, IUDs are just as effective as a vasectomy (surgery to cut and seal the tubes that carry sperm). However, unlike a vasectomy, IUDs are completely reversible.

IUDs are considered a highly effective, safe, and long-acting birth control method, but there are a few risks to using them. This article will look at the risks and complications of IUDs.

Holding an IUD birth control device in hand
flocu / Getty Images

Past IUD Risks and Concerns

Unfortunately, IUDs have a history of questionable safety, which has stigmatized IUD use. In the 1970s, a time when the Food and Drug Administration (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 cable-type string made of hundreds of fine nylon fibers wrapped around each other). The manufacturer used this string because it felt it was strong and wouldn't break. But, at the same time, this type of string made it easier for bacteria to enter the uterus.

As a result, the Dalkon Shield was responsible for pelvic infections, miscarriages (spontaneous loss of a pregnancy), sepsis (serious blood poisoning), infertility (inability to conceive), and hysterectomies (surgical removal of the uterus). The company that made the Dalkon Shield, A.H. Robins, knew about these problems, withheld research results, and lied about the IUD's safety instead of spending money to fix the problem.

Thousands of women were injured by the Dalkon Shield. As a result, the risks and injuries from the Dalkon Shield led to thousands of lawsuits.

The FDA put pressure on A.H. Robins, 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 and FDA approval before any medical devices could be sold.

The Dalkon Shield has caused women to this day to question the safety of IUDs. However, today's IUDs are safer than the ones in the past and all are FDA approved.

Today's IUDs

There are five IUD brands available in the United States: Mirena, ParaGard, Skyla, Kyleena, and Liletta. They are considered safe and reliable long-term contraceptive methods.

As with many birth control methods, you may have some side effects after having your IUD inserted. But in most cases, side effects 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 healthcare provider right away.

Possible Risks and Complications

Understanding the risks and possible complications can help you make an informed choice. Risks include the following items.

Perforation

Rarely, an IUD can be pushed through the wall of the uterus during insertion, and this is usually discovered and corrected right away. If not removed or adjusted, 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 pelvic inflammatory disease (PID) 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 three weeks of insertion. Infection due to the IUD after three weeks is rare. If you get an infection after this time, it is most likely because you have been exposed to sexually transmitted infections (STIs) during sex. Studies show that IUDs don't cause PID or infertility.

Expulsion

The IUD could partially or completely slip out of the uterus, known as expulsion. 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 women who have never given birth, although 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 healthcare provider. 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.

Risk Factors for Complications

Most women will not have any problems using an IUD. But if you have some health conditions, you may be more at risk of developing serious complications while using an IUD. These include being at risk for STIs at the time of insertion. Other complications can occur if you:

  • Have serious blood clots in deep veins or lungs
  • Have had PID in the past 12 months
  • Have diabetes or severe anemia
  • Have blood that doesn't clot or if you take medication that helps your blood to clot
  • Have had two or more STIs within the past two 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

If you feel an IUD is right for you, talk to your healthcare provider and discuss any concerns you may have about IUD risks and safety. If you don’t get the answers you were hoping for, it’s perfectly fine to get a second opinion. It’s also helpful to know the following:

  • 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.

A Word From Verywell

For many people, the IUD can be a great contraceptive choice. It's convenient, effective, eco-friendly, doesn't interfere with sexual spontaneity, and it doesn’t require you to do anything for it to work.

As with other prescription birth control, there are some risks and potential complications linked to IUD use, but most people are happy with this long-term contraceptive option. Talk to your healthcare provider if you have any questions.

Frequently Asked Questions

  • What are the side effects of a copper IUD?

    Potential side effects of a copper IUD (ParaGard) include lower abdominal pain, cramps, back pain, spotting between periods, and a moderate increase in menstrual flow in some women. In many cases, these side effects disappear after a few weeks to months.

  • What are the possible complications of using an IUD?

    Possible complications of using an IUD include perforation, pelvic infection, and expulsion (when the IUD partially or completely comes out of the uterus). Since IUD insertion is performed by a health professional, perforation is very rare. Additionally, the risk of pelvic infection becomes much lower after 20 days following IUD insertion.

  • Are IUDs safe?

    Today's IUDs are a safe, effective method of birth control for most women, but they may not be the right choice for everyone. Having a discussion with your healthcare provider can help you decide whether an IUD is right for you.

  • Can you get pregnant with an expired IUD?

    It is possible to get pregnant with an expired IUD, although how easily pregnancy occurs depends on the type of IUD. Becoming pregnant with an IUD has potential dangers associated with it. Examples of this include an increased risk for miscarriage, infection of the uterus, infection of fluids around the fetus, low birth weight, and more.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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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.