One of the more popular long-term birth control methods right now is the intrauterine device, or IUD, with its use climbing from 1.5 percent of American women in 2002 to 7.8 percent of women in 2018. Many women appreciate its hands-off nature and high efficacy rate. However, because it is inserted into the uterus, some women wonder if it could cause pain or discomfort, especially during sex.
Does having an IUD make sex feel different? Here’s everything you need to know about IUDs and painful sex.
What Is an IUD?
An IUD is a very small, T-shaped device that is inserted into a woman’s uterus with the goal of avoiding pregnancy. It may also be used in some cases to control issues such as endometriosis and abnormal uterine bleeding.
There are two types of IUDs: hormonal and nonhormonal. A hormonal IUD contains a hormone known as progestin that may suppres the ovulation process and thickens cervical mucus while thinning the uterine lining. All of these conditions make it very difficult for sperm to penetrate.
Nonhormonal IUDs are typically made of copper, which creates an inflammatory reaction in the body that prevents pregnancy.
Both methods of contraception are highly effective, with hormonal IUDs failing in just 0.4 percent of cases and nonhormonal IUDs failing in only 0.8 percent of cases.
Sexual Intercourse With an IUD
IUDs are not always effective immediately after they have been placed. If you have a hormonal IUD, you cannot depend on it for pregnancy prevention right away. Instead, the timing will depend on where you are in your cycle when it is inserted and the birth control method you are switching from. Your doctor will advise you on when to begin having sex without using a backup method after placing a hormonal IUD.
With a copper IUD, however, you can expect protection from pregnancy right away in theory, but doctors recommend using a backup birth control method during the first week to be on the safe side.
Here are the answers to some frequently asked questions about what to expect once you start having sex with an IUD in place.
Is Sex More Painful With an IUD?
Having sex with an IUD should not feel any different to you physically. However, your partner might notice a slight difference, with some men reporting that they can feel the strings of IUD during sex. This is not usually the case, and if it does happen, you may ask your gynecologist to adjust or trim the strings. However, they typically soften and curl up around the cervix over time.
If you are experiencing pain during sex with an IUD, it is unlikely to be related to the IUD itself. In any case, it is important to mention it to your healthcare provider, particularly if it is accompanied with light bleeding after sex as it could indicate an infection or irritation.
What Complications Can Arise From Having Sex With an IUD?
IUDs are generally considered safe, but there are some complications that may arise due to having sex while an IUD is in place. The first is the potential for an infection to occur if proper hygiene is not maintained or safe sex precautions are not followed. This is a concern for women without IUDs as well. Use of condoms with new sexual partners is recommended for patient’s with an IUD.
Another concern relates to a displaced IUD. If an IUD is not positioned properly, it could cause discomfort during sex. It may also lead to irregular bleeding or bleeding after intercourse. If you are having problems with pain or bleeding with intercourse you should contact your gynecologist to check the position of your IUD.
Can an IUD Fall Out During Sex?
Experts report that the chances of an IUD falling out during sex are very low, so there is no need to refrain from more exuberant sexual activity because of an IUD. This device is placed within the uterus, which means it is inaccessible to sex toys, fingers, and penises.
Although someone could theoretically pull the IUD strings hanging through the cervix in a manner that could cause it to dislodge, it is difficult to grab and pull the strings without the right instruments. Gynecologists use a special device known as ring forceps to clamp IUDs in the right way to remove them from the vagina. This is something that is highly unlikely to occur accidentally during sex.
Other Causes of Painful Sex
Pain during sex is not normal when you have an IUD and is always something you should mention to your healthcare provider. Although it may be due to your IUD being placed incorrectly, particularly if the pain only began once you got the IUD, it is more likely that your painful sex can be attributed to a different cause.
For example, painful sex may be related to some type of infection, such as yeast or a sexually transmitted infection. A lack of arousal and poor lubrication can also lead to painful sex, and this can typically be alleviated with more foreplay and the use of lubricants. Genital irritation or allergies from personal hygiene products, condoms, and spermicides may also lead to painful sex.
For some women, it could be due to a condition known as vaginismus, which causes the muscles around the vagina to shut tightly. The change in hormone levels associated with menopause may also make sex painful. If your pain is inside the pelvis, it could be due to an ovarian cyst, pelvic inflammatory disease, fibroids, irritable bowel syndrome, endometriosis, or constipation.