Intrauterine Devices

Small, t-shaped birth control devices inserted into a woman's uterus to prevent pregnancy

In the United States, they are available in two forms: nonhormonal copper-containing devices and plastic devices with progestogen hormones.

Inserted through a quick clinical procedure

Individuals must be tested for pregnancy and STIs before insertion.

Copper intrauterine device: see “Intrauterine device” in “Nonhormonal contraception.”

Progestin intrauterine device: a progestin-releasing (e.g., levonorgestrel-releasing) contraceptive device that is placed into the uterus

• Mechanisms [6]

  • Produces local inflammatory reaction → prevents fertilization and implantation

  • Interferes with sperm function and transport

  • See “Progestin” in “Pharmacodynamics” below.

• Characteristics

  • ≥ 99% effective in preventing pregnancy [7]

  • Provides long-term, reversible contraception: contraceptive activity lasts up to 5 years if kept in place after insertion.

  • Less menstrual bleeding or amenorrhea compared to copper IUDs

Abnormal uterine bleeding and/or menstrual changes

Dysmenorrhea

Pelvic pain following insertion

Uterine perforation

Active PID

Known or suspected pregnancy

Anatomical uterine abnormalities

Gestational trophoblastic disease

Cervical or endometrial precancerous lesions or carcinoma

Symptomatic STIs within the last 3 months

Breast cancer (progestin IUD)