Almost anyone with a uterus can get an IUD, regardless of age or whether they’ve given birth. IUDs are approved for use in adolescents, adults, and people approaching menopause, and fewer than 1 in 100 users become pregnant in the first year. The list of people who truly cannot use one is short, though a few medical conditions may rule out one type or the other.
Age and Pregnancy History Don’t Disqualify You
One of the most persistent misconceptions about IUDs is that they’re only for people who’ve already had children. That’s outdated. The CDC classifies IUD use for people who have never given birth (nulliparous) as a category 2, meaning the benefits generally outweigh any theoretical risks. For people who have given birth, it’s category 1, meaning no restrictions at all.
The same applies to age. Teens who have started their periods can get an IUD, and so can people over 45. Both age groups fall into category 2 on the CDC’s eligibility scale. In practical terms, the main difference is that placement in someone who hasn’t given birth can be slightly more uncomfortable because the cervix is tighter. Pain management options like a local anesthetic at the cervix can help with that.
People With Heavy Periods or Endometriosis
Hormonal IUDs aren’t only used for birth control. They’re also a first-line treatment for heavy menstrual bleeding. Devices like Mirena and Liletta release a small amount of hormone directly into the uterus, which thins the uterine lining over time. Most users stop having periods entirely after the first year. For people dealing with painful, heavy cycles or conditions like endometriosis, a hormonal IUD can serve double duty as both contraception and symptom relief.
Choosing Between Hormonal and Copper IUDs
There are two categories of IUD, and your health profile may make one a better fit than the other.
Hormonal IUDs come in several sizes and durations. Mirena and Liletta last six years. Kyleena, which is physically smaller, lasts five years. Skyla, the same size as Kyleena, lasts three years. All of them tend to make periods lighter or stop them altogether.
The copper IUD (Paragard) contains no hormones and lasts up to 10 years. It works by creating an environment in the uterus that’s inhospitable to sperm. It’s a strong option for people who want to avoid hormones entirely, though it can make periods heavier and crampier, especially in the first few months.
Who Should Not Get an IUD
The absolute disqualifiers are few but important. You cannot have either type of IUD placed during pregnancy. An active, untreated pelvic infection also rules out a copper IUD, and a healthcare provider who finds signs of cervical infection during the exam will typically delay placement until it clears.
For hormonal IUDs specifically, a current or past diagnosis of breast cancer is a contraindication, as are uterine or cervical cancer and active liver disease. Certain uterine conditions, like large fibroids that distort the shape of the uterine cavity, can prevent an IUD from sitting in the right position. A uterus that’s formed atypically, such as a bicornuate (heart-shaped) uterus, increases the risk of the IUD failing or being placed incorrectly, and providers generally recommend an alternative method in those cases.
For the copper IUD, Wilson’s disease (a rare genetic condition that causes copper to build up in the body) is a specific contraindication. A copper allergy would also rule it out.
STI History Doesn’t Disqualify You
A past sexually transmitted infection does not prevent you from getting an IUD. The CDC does not even require STI screening before placement, though people at higher risk should be screened and treated promptly if anything is found. Research has shown that same-day IUD placement is rarely complicated by pelvic infection.
Despite this, surveys have found that roughly 20% of family planning clinic directors incorrectly believed a recent STI history made someone ineligible, and only about a third of physicians surveyed said they would place an IUD for someone with an STI in the prior two years. If a provider tells you that a past infection disqualifies you, it’s worth seeking a second opinion.
Getting an IUD After Giving Birth
You can have an IUD placed very soon after delivery. Some hospitals now offer immediate postpartum insertion, within minutes of the placenta being delivered or within the first three days. This approach is considered safe, effective, and convenient because it eliminates the need for a separate appointment during a hectic time.
The tradeoff is a higher chance of expulsion. When placed within 10 minutes of delivery, the expulsion rate is about 10.2%. Placement between 10 minutes and 72 hours after delivery carries a rate of about 13.2%. If you wait until the traditional postpartum visit at four to six weeks, the expulsion rate drops to roughly 1.8%. Your provider can help you weigh the convenience of immediate placement against the small risk of the device coming out of position.
After an abortion or miscarriage, an IUD can typically be placed during the same visit, as long as there’s no sign of infection.
What to Expect With Follow-Up
No routine follow-up visit is technically required after IUD placement, though some providers schedule a check at four to six weeks to confirm the device is still in position. Adolescents and people with certain medical conditions may benefit from more frequent check-ins. After that initial period, most people don’t need to think about their IUD again until it’s time for removal or replacement, which depends on the device: three years for Skyla, five for Kyleena, six for Mirena or Liletta, and up to 10 for Paragard.