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We know you’ve heard all about the IUD. You probably know that the little intrauterine device, which is inserted inside the uterus, is 99 percent effective at preventing pregnancy. You may also know that there are a variety of options out there, from the hormone-free Paraguard, which lasts for 10 years, to Mirena and Skyla, which secrete a synthetic version of progesterone and last for five and three years, respectively.

“The IUD is all the rage, particularly in younger women who haven’t had children yet,” says Alyssa Dweck, M.D., an ob-gyn in Westchester, New York, and the co-author of V Is for Vagina.

Even more, the American Congress of Obstetricians and Gynecologists is now recommending that ob-gyns suggest IUDs as the first line of contraception, says Dweck.

That being said, while IUDs are becoming an increasingly popular method of birth control, there are still a few things you may be wondering about‹and are maybe even a little too shy to ask your doc. Here, Dweck answers questions she commonly gets from patients about IUDs on a daily basis.

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“There’s this persistent myth that IUDs are only for women who have had children, but that’s not the case. In older times, some practitioners thought it was easier to insert IUDs in a parous uterus, or one that¹s had children,” says Dweck. “They thought the cervix and uterus would be more extended, but they didn¹t have the benefit of these very easy-to-insert IUDs.”

Being child-free doesn’t disqualify you from getting an IUD, but if your uterus is misshapen, has fibroids, or you¹ve had pelvic inflammatory disease recently, you should consider other birth control options. Same goes for if you¹re breastfeeding after delivering a baby. “In that case, you’d still be a candidate, but the risk of perforation is a little higher,” says Dweck. “My guess is lower estrogen due breastfeeding means the uterine surface may be a little more delicate.”

Good news: Your fertility returns to normal immediately after your IUD is removed. The only major exception is if your fertility was impaired before you got an IUD, that won¹t change for the better just because you get one. Another thing to keep in mind is age. “Most women¹s fertility drops naturally by age 35 and definitely by age 40, says Dweck. “If you get an IUD at 33 and have it removed five years later, your fertility will have naturally declined.”

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“I get this question almost every day [from patients],” says Dweck. “You can absolutely use a tampon with an IUD. The IUD is inside your uterus, and there are the little threads that come out of the cervix slightly. A tampon is in your vagina.” A tampon and an IUD occupy two totally different spaces within your anatomy, so feel free to go for it. And no need to worry that when you¹re changing a tampon, you might yank the IUD out instead. “We typically trim the strings, so while they¹re palpable, they¹re not hanging down in an elongated way,” says Dweck. “It would be difficult to grab onto them and dislodge your IUD.”

There are a few different potential complications, although they’re all highly unlikely. “It’s very unusual for an IUD to become embedded into the wall of the uterus or to perforate the uterine wall,” says Dweck. If it does happen, your doctor may perform an ultrasound to see where the IUD is and figure out next steps. “I’ve only experienced extremely rare occasions when I had to take someone to the operating room to look for an IUD,” says Dweck.

One potential issue that¹s more common is the IUD strings curling up into the cervical canal so they¹re not visible to an ob-gyn. “That can make removal a little more challenging,” says Dweck. “Most of the time, we can still get it out without difficulty by searching for it with a small instrument, even though we can’t see it.”  There’s also a small chance your uterus will expel the IUD soon after it¹s placed, in which case you can just get it again and see if it sticks the second time around, says Dweck.

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Removal is along the same procedural lines as insertion. The doctor puts in a speculum, then uses an instrument that can grab onto those fine threads, clamp down on them, and pull out the IUD, says Dweck. There may be a little cramping, but if you¹d like another IUD to replace that one, you can get it right away and walk out of the office knowing you’re protected for years to come.

Source:  Health Medicine Network – July 9, 2015