Talking to your kids about sex can be daunting, no matter how close you are. But discussing issues like abstinence, sexually transmitted diseases (STDs), and birth control can help lower teens' risk of an unintended pregnancy or contracting an STD.

The American Academy of Pediatrics (AAP) supports sex education that includes information about both abstinence and birth control. Research has shown that this information doesn't increase kids' level of sexual activity, but actually promotes and increases the proper use of birth control methods among sexually active teens.

How and when you discuss sex and birth control is up to you. Providing the facts is vital, but it's also wise to tell your kids where you stand. Remember, by approaching these issues like any other health topics, not as something dirty or embarrassing, you increase the odds that your kids will feel comfortable coming to you with any questions and problems. As awkward as it might feel, answer questions honestly. And if you don't know the answers, it's OK to say so, then find out and report back.

If you have questions about how to talk with your son or daughter about sex, consider consulting your child's doctor. Lots of parents find this tough to tackle, and a doctor may offer some helpful perspective.

What Is an Intrauterine Device (IUD)?

The intrauterine device (IUD) is a piece of T-shaped plastic, about the size of a quarter, that is placed inside the uterus to prevent pregnancy. Two types of IUDs are available: one is covered with copper, the other releases the hormone progesterone.

How Does an IUD Work?

The copper-coated IUD primarily prevents pregnancy by not allowing the sperm to fertilize the egg. It may also make it harder for a fertilized egg to implant in the uterus. When an IUD is coated with progesterone, it works in a similar way, but also thickens the cervical mucus and thins the uterine lining. In some cases, it stops ovulation (the release of an egg during the monthly cycle). This prevents sperm from fertilizing the egg and implanting.

One type of progesterone IUD also can be used to help reduce blood flow for girls who have heavy, painful periods (dysmenorrhea).

How Effective Is It?

Both types of IUDs are very effective at preventing pregnancy. Over the course of a year, fewer than 1 out of 100 typical couples using an IUD will have an accidental pregnancy.

The IUD is effective from the time it is put in and it lasts a long time. A copper IUD can stay in place for up to 10 years. Progesterone IUDs can stay in place for 3 to 5 years, depending on the brand. This makes the IUD a good option for women who are not ready to start a family. Even though an IUD can stay in place for a long time, a gynecologist or specialized nurse practitioner can remove it at any time.

Protection Against STDs

The IUD does not protect against sexually transmitted diseases (STDs). Couples who are having sex must always use condoms along with the IUD to protect against STDs.

A doctor or nurse practitioner will check to be sure a girl doesn't have any STDs before putting in an IUD. If a girl gets an IUD put in at the same time she has an infection, it could lead to pelvic inflammatory disease (PID).

Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.

Possible Side Effects

The most common side effects of the IUD include:

• irregular bleeding for the first few months
• with the copper IUD, heavier periods with more cramps
• lighter and shorter periods (or no periods) with some kinds of progesterone IUDs
• PMS-like symptoms such as moodiness, headaches, acne, nausea, and breast tenderness with the hormonal IUD

Rare problems include:

• Expulsion. An IUD can come out of a girl's uterus by accident (called "expulsion"). Sometimes a girl doesn't know this has happened. The overall risk of expulsion is low, but it is slightly more common in women who have never had a baby. A woman can check that an IUD is still in place by feeling for the string (a doctor or nurse practitioner can explain how to do this). A doctor should also be told about any odd vaginal discharge, cramping or pain, fever, or if the length of the IUD string changes. After a girl has an IUD inserted, she'll need to go back for a follow-up visit with the doctor within the first 3 months. The doctor or nurse practitioner will check that the IUD is properly in place.
• Perforation of the uterus. There's an extremely small (1 in 1,000) risk that an IUD might push through the wall of the uterus while it is being put in.
• Pelvic inflammatory disease (PID). There's a very low risk of infection from bacteria getting into the uterus during IUD insertion. Most infections occur in the first 20 days after placement of the IUD.

Who Uses an IUD?

IUDs are a good birth control option for almost every female. However, IUDs aren't recommended if:

• a girl has PID or an active STD infection
• a girl is already pregnant or may be pregnant
• a girl has problems with her uterus, like a disease or malformation, or if she has abnormal bleeding

Experts now recommend IUDs as a good birth control option for younger women and teens because they last for many years, require no daily maintenance, and are very effective at preventing pregnancy. A newer type of IUD is smaller and uses a lower dose of progesterone, which may make it a better option for females who have never had a baby.

Where Are IUDs Available?

An IUD must be inserted by a doctor or nurse practitioner. It is often easiest to put an IUD in during a girl's period, but it can be inserted anytime during a girl's cycle as long as she is not pregnant.

Copper IUDs need to be replaced every 10 years, and progesterone IUDs should be replaced every 3-5 years, depending on the brand.

How Much Does It Cost?

An IUD costs about $500 to $1,000. That doesn't include the cost of having a doctor or nurse practitioner insert and remove it, as well as follow-up visits — these things cost extra. Many health insurance plans cover the costs, and family planning clinics (such as Planned Parenthood) may charge less.

Because an IUD lasts for many years, the cost works out to about the same as monthly birth control methods, such as the Pill or ring.

Reviewed by: Julia Lancaster, RN, and Larissa Hirsch, MD
Date reviewed: April 2013