8 Surprising Things That Can Happen When You Get An IUD

Hello, breakthrough bleeding.

by JR Thorpe
A copper IUD against a red background. IUDs can have many side effects, including bleeding and cramp...
DEA / M. FERMARIELLO/De Agostini/Getty Images

So you've decided to take the plunge and get an intra-uterine device (IUD) put in to protect you from pregnancy. If you're concerned about bleeding, cramps, or any other side effects from your IUD, be reassured that they're considered pretty mild and uncommon.

"Side effects of IUDs are few," Dr. Jonathan Schaffir M.D., an OB-GYN at The Ohio State University Wexner Medical Center, tells Bustle. But it's always best to know all of the possible outcomes when you're making a decision about your reproductive health.

Side effects vary depending on the type of IUD you have, Dr. Felice Gersh, M.D., an OB-GYN, founder of Integrative Medical Group, and author of PCOS SOS Fertility Fast Track, tells Bustle. There are two kinds of IUDs: hormonal, which release small doses of hormones into your reproductive system, and copper, which makes your uterus inhospitable to sperm. Some side effects are common regardless of what you have, Dr. Gersh says. Abnormal bleeding and pain happen to a lot of people after they've had an IUD inserted for the first time. Other side effects are linked to particular types of IUD.

Just because a side effect can happen doesn't mean it's going to happen to you. If you notice any of these after getting an IUD fitted, let your OB-GYN know. Here are some of the side effects of IUDs.

Heavier Periods

"With the copper IUD, periods may be somewhat heavier and crampier than usual," Dr. Schaffir says. Because copper IUDs don't involve hormones, they don't stop you from having a period, and people who've had one fitted often report a heavier period, particularly in the first few months. It's not known exactly why this is — it could have to do with blood flow in your reproductive system, or irritation to your uterus — but stock up on heavy-duty pads or be prepared to empty your menstrual cup a lot.

Lighter Periods — Or No Period At All

"With the hormonal IUD, periods are lighter, sometimes to the point where a period does not come at all," Dr. Schaffir says. This is relatively common; in 20% of people who have the Mirena hormonal IUD, according to the Food and Drug Association (FDA), periods disappear entirely. This is why hormonal IUDs are sometimes recommended to help people deal with heavy periods.

Discomfort During Sex

"Rarely, IUDs may be related to some discomfort during intercourse," Dr. Schaffir says. In a small study published in Obstetrics & Gynecology in 2016, 17% of people with IUDs reported sexual dysfunction in the first three months after their IUD was inserted, citing increased bleeding in particular. (It's worth noting that 40% of people reported positive changes in their sex lives, too!) Your sexual partner might also feel uncomfortable if they can feel the strings of the IUD, Dr. Gersh adds, but it's basically impossible for sex, no matter how rough, to dislodge an IUD.

A Higher Risk Of Pelvic Inflammation From STIs

If a person with an IUD gets an STI, the infection is more likely to affect their reproductive system and result in a painful pelvic infection, or Pelvic Inflammatory Disease (PID), Dr. Schaffir says. Studies show that this remains pretty rare — and an IUD won't cause PID on its own — but it's a good idea to use condoms and dental dams with new partners, even with birth control.

Breakthrough Bleeding

Hormonal IUDs, Dr. Schaffir says, are more likely than copper IUDs to cause breakthrough bleeding. "This is light bleeding that occurs unrelated to a period," he says. It's not just hormonal IUDs, though. A study published in Open Access Journal of Contraception in 2016 found that up to 70% of people with copper IUDs experienced breakthrough spotting in the first three to six months.

IUD Expulsion

Sometimes, Dr. Gersh says, the IUD doesn't stay in the uterus, and begins to fall out. This happens in around 10% of people who get an IUD within the first three years, according to a study published in Obstetrics & Gynecology in 2014. Scientists don't agree on why it happens, but your OB-GYN might have placed the IUD badly, your uterus might be an odd shape, or there could be other factors involved. One study published in Contraception in 2017 found that younger IUD users are more likely to experience expulsion than older ones. If you think your IUD is falling out — maybe you can feel it poking into the bottom of your cervix, or the strings are much lower than they used to be — schedule a trip to the OB-GYN immediately.

Perforated Uterus

In unusual cases, Dr. Gersh says, the IUD can decide it wants to embed itself in your uterus. This is really rare; a study published in Open Access Journal of Contraception in 2016 found that it only happens in about one in 1,000 IUD insertions. You'll know that something's off if your IUD is perforating your uterus, because the muscle walls will start cramping and you'll experience pain. It will likely have to be removed surgically.

Intercranial Hypertension

This might be a really, really uncommon side effect of hormonal IUDs, Dr. Gersh says. It's a condition where the pressure of the fluid surrounding the brain gets too high, causing serious headaches and, in some people, loss of sight. "This is rare," Dr. Gersh says. One 2015 study published in Therapeutic Advances In Drug Safety found that a hormonal IUD appeared to be linked to a higher risk of intercranial hypertension. But a lot more studies need to happen before scientists understand how or why.


Dr. Felice Gersh M.D.

Dr. Jonathan Schaffir M.D.

Studies cited:

Etminan, M., Luo, H., & Gustafson, P. (2015). Risk of intracranial hypertension with intrauterine levonorgestrel. Therapeutic advances in drug safety, 6(3), 110–113.

Diedrich, J. T., Klein, D. A., & Peipert, J. F. (2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis. American journal of obstetrics and gynecology, 216(4), 364.e1–364.e12.

Higgins, J. A., Sanders, J. N., Palta, M., & Turok, D. K. (2016). Women's Sexual Function, Satisfaction, and Perceptions After Starting Long-Acting Reversible Contraceptives. Obstetrics and gynecology, 128(5), 1143–1151.

Jatlaoui, T. C., Riley, H., & Curtis, K. M. (2017). The safety of intrauterine devices among young women: a systematic review. Contraception, 95(1), 17–39.

Madden, T., McNicholas, C., Zhao, Q., Secura, G. M., Eisenberg, D. L., & Peipert, J. F. (2014). Association of age and parity with intrauterine device expulsion. Obstetrics and gynecology, 124(4), 718–726.

Villavicencio, J., & Allen, R. H. (2016). Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates. Open access journal of contraception, 7, 43–52.