Can IUDs be used as emergency contraception?

Reproductive Health

Yes! Intra-uterine devices (IUDs) are in fact the most effective form of emergency contraception there is.

They do require a clinical visit and can be expensive without insurance, which can make them a challenge when time is of the essence. But IUDs are nearly 100% (99.9%) effective at pregnancy prevention when inserted within 5 days of unprotected sex.

Once inserted, the copper IUD (Paragard) can offer continued pregnancy prevention for up to 12 years and the hormonal levonorgestrel 52-mg IUDs (Mirena and Liletta) offer pregnancy prevention for up to 8 years. They can be taken out any time by a clinician, and you can try to get pregnant right away if you choose.

IUDs are more effective than emergency contraception pills. The emergency contraception pills Plan B One-Step, Take Action, My Way, AfterPill, Aftera, and EContra are about 75-89% effective if taken within three days, and they are more effective the sooner you take them. These are a good choice for people who weigh under 165 pounds, who want an over-the-counter option, and have access within three days of unprotected sex. The emergency contraception pill ella® is 85% effective when taken within five days, and it’s a good option for people who weigh less than 195 pounds. It is available by prescription only.

❓Who should consider an IUD as a form of EC?

Any sexually active person who wants to avoid pregnancy and has had an issue with their regular method (for example, the condom broke) or had unprotected sex involving sperm within the last 5 days.

They are safe for adolescents and do not affect the chance of getting pregnant in the future. The American Academy of Pediatrics recommends them as a first line of contraception for sexually active teens.

People for whom pill emergency contraceptives may be less effective. This includes people who weigh more than 165 pounds or who are taking medications that may interfere with the effectiveness of oral contraceptives. Ask your clinician about your particular medications.

❓How do they work?

IUD’s are small, t-shaped devices made of copper and plastic which are inserted into the uterus by a clinician. IUD’s affect sperm, slowing them down and weakening them so they have a hard time fertilizing an egg. They also thicken cervical mucous which makes it harder for sperm to reach the uterus. In the unlikely event that an egg does get fertilized, the IUD prevents it from implanting in the uterus.

IUD’s will not remove a fertilized egg that is already attached to the uterus. In other words, they DO NOT terminate an existing pregnancy.

❓Where can I get an IUD for emergency contraception?

Gynecologists, family planning clinics, and many family medicine and pediatric clinics are able to place IUDs. Time is of the essence when it comes to emergency contraception, so you’ll need to get an appointment very quickly.

Since you need an appointment and may need prior authorization from insurance for an IUD, some family planning experts encourage people to think about emergency contraception in advance. This might mean either having emergency contraception pills on hand or getting an IUD now to avoid an emergency.

Remember, if you decide to use an IUD as continued contraception, condoms (internal or external) are still needed to protect against sexually transmitted infection.

Using an IUD as a form of emergency contraception might seem inconvenient because it requires a trip to a provider and a somewhat uncomfortable procedure. But IUDs do present the most effective option.

Don’t wait for an emergency to happen! Discuss your emergency contraception options with your provider now to determine which route would be best for you in the event of an emergency situation.

Additional Resources and References:

Find a Planned Parenthood Health Center

Planned Parenthood: How IUDs Work As Emergency Contraception

New England Journal of Medicine Article Comparing Different Types of IUDs

International Journal of Women’s Health Article Describing the Efficacy of IUDs as Emergency Contraception

American Academy of Pediatrics Article on Long-Acting Reversible Contraception in Adolescents

University of California San Francisco – Beyond the Pill

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