The IUD
Long-acting, set-it-and-forget-it protection
The IUD is one of the most effective forms of birth control available — over 99%. Once it's in, you don't have to think about it for years. It's safe for teens, safe for people who've never been pregnant, and available at low or no cost at many clinics.
Effectiveness
Over 99%
How often
Nothing to do — lasts 3–12 years
STD protection
No
Prescription needed
Yes — provider inserts it
Hormones
Hormonal or hormone-free (copper)
Fertility return
Quickly after removal
How it works
An IUD (intrauterine device) is a small, T-shaped device inserted into the uterus by a healthcare provider. There are two main types: hormonal IUDs and the copper IUD. Both are highly effective, but they work differently — so the right choice depends on your body and preferences.
Hormonal IUD
Releases a small amount of progestin locally. Prevents ovulation and thickens cervical mucus. Brands include Mirena (8 yrs), Kyleena (5 yrs), Liletta (8 yrs), and Skyla (3 yrs — smallest, often recommended for teens). Often makes periods lighter or stops them entirely.
Copper IUD (Paragard)
Completely hormone-free. Copper is toxic to sperm, preventing fertilization. Lasts up to 12 years. Can also be used as emergency contraception if inserted within 5 days of unprotected sex. May make periods heavier, especially at first.
What insertion is actually like
- 1A provider inserts the IUD during an office visit — the procedure itself takes about 5 minutes.
- 2You'll feel cramping during insertion — it's real, but brief. Most people describe it as intense period cramps.
- 3Cramping and spotting for a day or two after is normal. Ibuprofen beforehand can help.
- 4Once it's in, check the strings monthly (they sit just inside the vaginal opening) to confirm it's in place.
- 5Removal is also done by a provider and is usually quicker and less uncomfortable than insertion.
Is it safe if I've never been pregnant?
Yes — completely. The idea that IUDs are only for people who've already had children is an outdated myth. Major medical organizations including the American Academy of Pediatrics recommend IUDs as a top-tier option for teens. The Skyla IUD is specifically designed with a smaller size for people who haven't given birth.
Pros & cons
Pros
- Over 99% effective — nothing to remember after insertion
- Lasts 3–12 years but can be removed anytime — fertility returns quickly
- Hormonal IUDs often make periods lighter or stop them entirely
- Copper IUD is completely hormone-free
- Copper IUD can double as emergency contraception if inserted within 5 days
- Often the most cost-effective option over time — free at many Title X clinics
Cons
- Insertion can be painful — cramping during and after is common
- Requires a provider visit for both insertion and removal
- Copper IUD can make periods heavier and more painful, especially in the first few months
- Does not protect against STDs — use condoms alongside it
- Rare risk of expulsion (the IUD shifting out of place) — more common in the first year
- Upfront cost without insurance can be high ($500–$1,000+), though clinics often cover it
How to get an IUD — including confidentially
Getting an IUD requires a provider visit, but many clinics see teens confidentially and cover the cost on a sliding scale. The upfront cost can look intimidating, but over the years it's actually one of the cheapest options available.
- Planned Parenthood inserts IUDs and offers them on a sliding-scale fee — many teens pay little or nothing.
- Title X family planning clinics are federally funded to serve people of all income levels, including teens.
- If you have Medicaid, IUDs are typically covered at no cost to you.
- If you're on a parent's insurance, ask the clinic about confidential billing to avoid an Explanation of Benefits (EOB) being sent home.
Common questions
Ready to talk to someone?
A provider can answer your questions about IUDs, walk you through the types, and insert one — often confidentially and at low or no cost.
Find a clinic near you