Dear Dr. Vanessa: What’s the Low Down on IUDs? Part 1

Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America, will be answering your questions here. To ask her your own question, click here.

Dear Dr. Vanessa, I heard IUDs can cause infertility.  Is that true?

It’s a common myth, but it’s not true.  IUDs (intrauterine devices) — increasingly referred to as IUCs (intrauterine contraceptives) — are among the safest, most effective, and least expensive methods of birth control available.  In fact, they are the most popular form of reversible birth control in the world.  More than 85 million women use IUDs.

An  IUD is a small plastic device that a doctor can put in the uterus. One type — Paragard —contains copper and lasts for 12 years.  The other — Mirena — slowly releases a hormone and lasts for five years.  IUDs work by keeping sperm from joining with eggs.  They are more than 99 percent effective at preventing pregnancy.

The myth about IUDs and infertility started in the 1980s.  An insufficiently tested, defective brand of IUD — the Dalkon Shield — had to be removed from the market because of the damage it caused, including infections that led to infertility.  Today’s IUDs are safe, effective, and do not cause infertility.

Sexually transmitted infections (STIs) cause infertility, not IUDs.  If you have an IUD inserted while you have an STI, you increase your chance of infertility.   That’s why most clinicians test for STIs before inserting IUDs.

IUDs do not protect against STIs. That’s why women who use methods such as IUDs, hormones, diaphragms, sponges, or cervical caps need to protect themselves with condoms whenever there’s a risk of infection.


Best wishes for your good sexual health,

Planned Parenthood

Vanessa Cullins, MD, MPH, MBA, is a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America.


  1. IUD’s are not safe! I had to go to the ER last Saturday night because I was in so much pain and found out my IUD Mirena is embedded in the lining of my uterus. If I dont get it removed zi was told I could become infertil. So this artical is not true. I am now on 5 different medications and have to get it taken out tomorrow but the obgyn. I have hospital records that say what happened to me. They took an ultrasound and everything. Now I am starting to contact lawyers to make a case against Mirena for what has happened to me.

  2. Nancy I feel for you. That’s quite an ordeal… I’m glad both you and baby made it 🙂

    I just wanted to point out that since your story sounds pretty scary to someone considering an IUD, IUD’s do not cause placentia previa. It could be interpreted from your story that they do.

    I had an IUD for about three years. Loved it. Only cons were harder period cramps. Considering my psycho moments from the pill they were welcome.

    I took the IUD out when my last boyfriend had a run-in with it. It scraped the tip of his penis during intercourse. Hated taking it out, but he refused to have sex with me until I did – understandably.

    We had a baby since then and my pregnancy was perfectly normal and healthy. I highly recommend an IUD.

  3. First of all I would like to say that yes, the IUD is one of the most effective contraceptives out there, but, there have been many women who have become pregnant while having one in place. I happen to be one of those women. I had the Mirena for a little over a year when I got pregnant(sometime in feb or march). First of all, I never would have imagined getting pregnant any time soon, second, I had no idea I was pregnant, I got my period for 4 months (while pregnant and with Mirena) I had gained only about 5 lbs. After the fifth month I started noticing a little bump, as if I was bloated all the time, it was tiny! So when my period didn’t come in July, I decided to pay the Dr a visit. He then told me I was a little over 5 months pregnant, and removed my IUD. I had no complications for the first couple of weeks. In one of our follow ups (August), we discovered I had placenta previa. He put me on bed rest for the rest of my pregnancy. Two weeks later (September), all I remember was sitting on my bed and feeling as if I was leaking, and thought my water broke, again (with my 1st pregnancy). As I reached down to make sure it was not a urine leak I saw BLOOD. I walked as fast as I could to the restroom and immediately called my husband to work. I felt so much blood come out and so many “chunks” I would say, it was the worst feeling. As I sat there crying I kept thinking it was a miscarriage. My husband rushed home and called the ambulance when he saw all the blood all over the restroom. Luckily, his brother(an EMT) was near by and wound up picking me up. When we got to the hospital, I was immediately sent to the ER. There they did an ultrasound and discovered my placenta had erupted. I had an emergency c-section. I was told both me and my baby had to stay in an ICU because I had lost almost half a liter of blood and there was a possibility we would not be, let’s say, living for long? Yes. I had several blood transfusions and was in an ICU for about a week. My baby got to come home a month later. We are both very healthy now, and I do not plan in getting any kind of IUD anytime soon. If you do decide to get an IUD have a talk with your OB about all the risks, factors, disadvantages, and possibilities in getting pregnant. I was that .2% who wound up pregnant and it was a very difficult time in my life. Now 8 months after I gave birth I’m being told it will be nearly impossible to get pregnant again. I was hoping for our first baby girl in 5 years. Well see where this takes me.— I am only 20 so age was a big part in my pregnancy. Sorry if I scared anyone with my story, it is not my intention. I only hope no one will have to go through what I did. My blessings to all who decide to get an IUD. Good luck(:

  4. Ok, I have a paraguard, and i had it put in in November of 09, after the birth of my 2nd daughter in sept 09! It is now, may 2010, and i am seriously considering having my IUD taken out! I have had the most erratic periods ever! I use to only have a period once every 2mo or so,No i have periods that last 2-4weeks and are 2-3weeks in between! Not very comfortable.! I am not preg which is really the only good thing that has came from this! I havent really had any other symptoms, i have some wierd cramps once in a while, and went to hospital and was told everything looked great after a pelvic exam, and a ultra sound! so I dont know exactly what im doing yet! but i will say that yes, IUDs arent for everyone! DO YOUR RESEARCH!!!

  5. Yep, not once but twice. I loved them when they worked though. And I thought “what are the odds that two will fail” when I decided to have the second one placed. Well my odds are 100% failure.

    I don’t know if I’m extremely fertile or my lady parts just don’t work with the paraguard or what exactly happened. When the doc at PP pulled the IUD she said it was “really low” and not effective where it was at.

    I don’t want to scare people away from the paraguard because I don’t think my experience is any where near typical. I grew up with a girl who’s mother got pregnant w/ all three of her children while on three different kinds of birth control; IUD, pill, and cervical cap. There isn’t a perfect solution.

  6. On the contrary…I got pregnant TWICE on two different Paraguards. This Fertile Myrtle did not have infertility problems.

  7. I’m going in to get Paragard from Planned Parenthood in 2 weeks and I can’t possibly be more excited! I have done hours and hours of internet research, I have spoken with both my gynecologist and the RN at my general practitioner’s office, and I’ve made sure to look into both Mirena and Paragard.
    I feel that I’m extremely well informed about the risks and benefits of IUD’s. I ended up choosing Paragard because of the price (mostly) and because I’m hoping that by getting off of hormonal birth control (I’ve been on the pill for 3 years now) that I’ll get my libido to get back up to normal.
    I know that there are significant risks associated with IUD’s, but they’re really no worse than the risks associated with hormonal methods. After speaking with professionals at P.P., with my gyno., and with an R.N., I truly feel that I’m making a well-informed and very beneficial decision for myself and for my partner!

  8. I had my IUD (paraguard) put in almost 4 years ago. I love that I’m protected from pregnancy and I don’t really have to think about it. My libido came back and my headaches stopped, but the cramps I get are awful. I didn’t really ever have cramps before but these will wake me out of a deep sleep. I kind of hate to do it, but I’m having mine taken out as soon as I get insurance because I can’t take the pain anymore. Not sure what I will use instead… I have some friends who have the Mirena and really like it – minimal cramping, lighter period.

  9. I think you’re being really alarmist. No, the IUD isn’t right for everyone, but neither is the pill. Women have even died from taking the pill!!111!!!ELEVENTY1!

    Just like the birth control pills available today are safer and better than the pills that were available when the technology was first introduced, the IUDs today are safer than the ones of the 1970s and 1980s (three decades ago, now).

    Just because the IUD is not the right method for everyone doesn’t mean it’s terrible and dangerous and ineffective. My sister-in-law had four unplanned pregnancies on the pill. With an IUD, she hasn’t had any more kids and she’s back in school, fulfilling plans that spent years on hold. I had a great experience with my IUD and no problems getting pregnant after I had it taken out.

    Every woman needs to talk to her doctor, learn about the pros and cons, and make her own decision.

  10. Of course, sadly, the research to find a good, reliable, sustainable, non-dangerous BC method is not being funded.

    The drug companies can put billions of dollars of money into a medication to GROW YOUR EYELASHES (WTF?) But we still don’t have good male birth control, or a method for women to be in control of that won’t perhaps either kill us or cause us great discomfort in the process of MAYBE preventing a pregnancy. We SHOULD and COULD have done better by now.

    My point was although I love Planned Parenthood a lot, they are really running with the new review of the literature on IUDs (and the results are VERY specific and that isn’t being said when the “benefits and fallacies” about the IUD are being talked about) and NOT addressing the fact that the IUD is far from a fool proof or safe form of birth control.

    Every woman needs to talk to her own doctor, making sure she reports her ENTIRE health history, as the IUD has more issues than are being addressed by the most recent (the only thing I can call it) Media Blitz.

  11. Hmm, let’s just remember that there have been a number of deaths caused by various hormonal methods as well.
    The way I see it, effective contraception disables one of the most elementar body processes. One simply can’t expect this to have no side effects.

  12. Also, the “new” review of the literature which shows that “IUDs do not present a significant risk of tubal inferility” were VERY specific in their participant bias.

    ALL the women were nullipara, none of the women had ever had an STD, most were also using condoms (a lot of young women would think, “I’m protected, what’s the point?”) and most important the AVERAGE number of partners the women in this review had…..: ONE!

    The “review” and new study are seriously flawed and it could lead to an other generation of women (who have more than one partner, who pick up a STD, or have ever had one, for whatever reason, who DO NOT use condoms in addition to their IUDs) with serious side effect from this very flawed method of birth control.

    Just my opinion…..based on science.

  13. It depends on the woman. I have had endometriosis and heavy cramping and I would NEVER get an IUD. Some women have bled to death!

    Also, I know a number of women (both personally and professionally) who had NON Dalkon Shield IUDs in the 70s and 80s who DID have issues with fertility. AFAIK, none of them had any STDs that weren’t treated. People don’t always tell you, but still. The UID CAN damage the lining of the uterus, ask any woman who has had a uterine perforation or after years of intertility has scar tissue which cannot be blamed on STDs. And scarring is NOT just from the Dalkon Shield. Regular IUDs can cause uterine scars. THERE IS A WIRE IN YOUR UTERUS! Think about that.

    There is also the risk of the IUD embedding itself into the uterine wall. (the wire works it’s way INTO the endometrium or even the muscle wall, which then grows around it.) In most cases the treatment is hysterectomy. No thanks.

    My OBGYN said he delivered more than one baby “with the IUD in his hand.” I am sure that is an exaggeration, but many women who DO get pregnant with the IUD have to decide between riding out the pregnancy with the IUD in place (which increases miscarriage rate) and removing the IUD AND the pregnancy. Having an IUD increases abortion risks, so either is not a good choice, either way.

    I know too many women who also had PID (Pelvic Inflammatory Disease) while using the IUD and again NONE Of them had the Dalkon Shield, just a Copper T, or the plastic one. I have NOT known a woman to have a PID SINCE IUDs became less common about 15 years ago. As nurse, I saw too many problems with the UID, I’d NEVER use one.

    Women who have not been pregnant have a higher risk of passing (expelling) the IUD, (so it isn’t for them) some without realizing it, which not only can damage the uterine lining on the way out, but can cause pregnancy as the method is gone.

    It is NOT a danger proof method and I think only suits a small number of women.

    I have to honest, as much as I LOVE Planned Parenthood, there has been a LOT of push for IUD use lately from them, and I am not crazy about this push along with a downplaying of VERY serious symptoms and side effects. In terms of mortality and morbidity the IUD is probably the MOST dangerous form of birth control. Who wants to even RISK ending up either infertile or dead due to their birth control method?

    I think medical science can do BETTER than to be putting wires and foreign objects into women”s uteri for birth control.

  14. I have had my IUD (Paragard) for 6 months now, and I LOVE it. I’m good for at least decade, I don’t have to deal with icky hormones the mess with my head and body, and I don’t have to remember to take a pill/change a patch/get a shot all the time. The insertion was uncomfortable, but not painful, and after a couple of days with some cramping, I didn’t notice a thing at all. My period’s not any heavier (a side effect for some), and my cramps seem to be the same as when I was on The Pill (stronger cramps can be another side effect).

    I have been recommending an IUD to all my friends that are looking for long-term birth control, and I must say that I feel pretty safe with it. Plus, I use condoms, so I’m doubly protected against pregnancy. I like that I don’t have to freak out if the condom breaks or deal with running to the pharmacy to get Plan B.

    I think the fact that I’m pretty paranoid about getting knocked up (all the women in my family seem to get pregnant just by looking at a dude) makes an IUD a good choice for me. I like that I don’t have to worry about user error (forgetting a pill, etc.) and, when I’m eventually in a place with my boyfriend where we feel comfortable no longer using condoms, I don’t have to go back on a BC with hormones. I feel like I’m doing a commercial for IUDs or something, but I really don’t have any negatives from mine, and think that more women should be getting them.

    Unfortunately, a couple of doctors talked me out of it over the years (I’m young and have no children) until I finally sat down and did my own research and saw a doctor that was happy to put one in. I hope that public opinion changes; it’s far behind the times on this one.

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