- What happens if I get pregnant with an IUD?
- What to do if you have an IUD and suspect pregnancy
- What if I become pregnant while using Paragard?
- Liletta Side Effects
- For the Consumer
- For Healthcare Professionals
- Further information
- More about Liletta (levonorgestrel)
- WHAT CAN I EXPECT BEFORE, DURING, AND AFTER THE INSERTION?
What happens if I get pregnant with an IUD?
Next, we look for the IUD strings in the cervix to potentially remove the device. Studies have shown that the risk of miscarriage, preterm birth, and infection of the amniotic sac and fluid before delivery (chorioamnionitis) is significantly higher when IUDs are left in place during pregnancy compared to pregnancies in which the IUD is removed. However, while taking out the IUD improves the pregnancy outcome, there is still a higher risk of pregnancy complications compared to patients who never had an IUD in place. For most women whose IUD strings are visible through the cervix, we recommend removal of the IUD at the first visit.
In some women, the IUD strings curl up into the cervix. When that happens, we sometimes can use a small tool to grasp the strings, or use ultrasound guidance to retrieve the IUD. However, because the uterus has grown with the enlarging fetus, the IUD sometimes cannot be reached. In these cases, we have to leave the IUD in place because searching for it could inadvertently injure the mother or pregnancy. After delivery, we will make sure to locate the IUD within the placenta, membranes, or uterus.
For women with ectopic pregnancies, we recommend treatment, which can be a medication or can involve surgery. Ectopic pregnancies are dangerous because of the high risk of rupture and hemorrhage. If ectopic pregnancy occurs, the risks for the patient include severe pain, infection, and even death.
What to do if you have an IUD and suspect pregnancy
First, take a home pregnancy test. Today’s tests are very good at diagnosing pregnancy early. If the test is negative and you’re still worried, call your health care provider, who can answer your questions, perform an exam, or do additional testing if you need it.
If your test is positive, call your Ob/Gyn and explain your situation. The doctor can order an ultrasound and perform an exam. If you develop right- or left-sided pelvic pain with vaginal bleeding and can’t be seen by your doctor right away, it’s reasonable to visit the emergency department because the cause might be an ectopic pregnancy.
IUDs are an incredibly good form of birth control for many women, but no contraceptive is 100 percent effective. If you’re considering an IUD, talk to your doctor or other healthcare provider about whether this form of highly effective contraception is right for you.
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Photo: Suphat Bhandharangsri/Getty Images
A while back, I took my two young sons to the park. It was a beautiful late summer day, the clouds tatty and thin, like an unraveling of cotton candy. They ran and tackled each other in the grass. It was the kind of day where I let myself relax into feeling lucky.
Later, at home, I took a pregnancy test, the kind with two dark lines for positive. I remember taking those tests over and over, trying for our first. Squinting, willing a second line into existence. I am glad those days are over. I was taking the test because my breasts were hot and sore and my period was late. I was taking the test so I could stop that little worm of worry that kept getting into my throat. I have an IUD — there was only a slim chance. Such a wafer of a chance. And besides, my husband and I were done. We were past done. I was just starting to get myself back: I’d lost the baby weight and then some; I was writing again; my days weren’t filled with the carrying of children. Often, my arms were empty, and that felt like freedom.
Days with my children are both routine and freewheeling, bursting with creativity and mired in drudgery. Every moment feels untidy, unkempt, pre-defined, both beyond my control and demanding of it. My child complained that I was taking too long. I was rushing around my head, planning lunch and naps and maybe a brief, quiet window of writing. Then they bloomed before me, life emphatic, a yes to the question I never even wanted to ask.
Two dark lines.
No, was my immediate response.
My IUD was placed eight weeks after my second child was born. My oldest had hand, foot, and mouth; he was feverish and pleading in the waiting room, Let’s go, Mom. Let’s go home. But I did not want to risk getting pregnant again — the thought made me feel weak, ill. Power through, I told myself. Just power through. A cheerful midwife came in. I remember nothing she said. I do remember how terribly she hurt me when placing the IUD, because the IUD I had between the births of my sons hadn’t hurt nearly as much. I also remember how long it took for her to complete the procedure, and how desperately sad I felt looking at my oldest, red-faced and staring, powering through.
I’d made the requisite follow-up appointment to have the IUD placement checked. But I never went to that appointment, likely fearing the return of the sadness I felt in that white room, how out of my reach any semblance of control in my life felt.
At six weeks pregnant I was scheduled for an ultrasound so they could locate the IUD. It had migrated, and was now lodged in the rear right of my uterus, like Pooh stuck in Rabbit’s door. Two doctors, an ultrasound tech, and an ultrasound-tech-in-training stared at the screen, squinting and pointing and quibbling, while one of them held a probe inside my cervix, jabbing it here and there. “Oh, there’s the baby,” someone said, as the wand passed what looked like a blinking kidney bean. I barely made it to the car before the tears came, sloppily tumbling down my face and onto my coat. I called my husband and told him I wanted an abortion.
I didn’t have an abortion.
It’s hard to explain why I never went through with it. I realized I’d never truly faced what I would do if I were ever put in the position of an unwanted pregnancy. Each time I had been pregnant before, it was because I had wanted to be; the yearning for a child was so real that it was painful. Now, unwillingly pregnant at age 37, I had no idea if I was capable of either option: another baby, or ridding myself of a pregnancy. Each option felt equally terrifying.
I went to the internet, craving a sign at the very least, a definitive answer at most. What I found was surprising: of the information on abortion, most was targeted to or written by single, childless women who wanted to remain that way. I could not find any useful information about married mothers who are done having babies. It felt, and it feels, like an anomaly. Like the universe is saying, What’s one more child?
Or, What are you, a monster?
Because I could not decide, I didn’t decide. I wept and I raged. I allowed myself the rare moments of excitement. I went to my second doctor’s appointment. At some point, as I listened to my doctor describe the minutiae of blood tests and ultrasounds, she stopped herself. Maybe she saw something in my face.
“I’m sorry. I’m assuming you want to continue with this pregnancy. Is that a safe assumption?”
And I began sobbing.
She let me cry, and she explained my options. My in-network hospital would not perform abortions, so I’d need to be referred to another one. (Writing this from a more stable place, I would like to say fuck that hospital.) I could take a series of pills that would stop the production of progesterone and cause a miscarriage up until nine or ten weeks; if I chose to end the pregnancy after that it would be a surgical procedure. I was still crying, worrying the tissue she’d handed me into wilted confetti. The doctor asked me, quietly, had I experienced depression after my last two births?
Had I ever had suicidal thoughts?
There it was, the truth: I hadn’t healed from the birth of my second son, nearly two years prior, and I hadn’t healed from the birth of my first, almost five years ago. My trauma was right there; I was coated in it, a ghosty afterbirth that I could ignore but never wash off. She handed me a card for a therapist, hugged me, and told me everything would be okay. No matter what I chose.
I wish I could say my decision hit me like a lightning bolt, or a glowy miracle, or a loud, twinkly epiphany. I wish I could say my feelings about it are more clear, now that I’ve veered onto the keep-it fork in the road. I wish I could explain how I even got here. I can’t. I believe all women should have the right to choose, and that they should be supported before, during, and after. I believe abortion should be safe and legal, and I cheer for all the women who exercise their right to choose, and I ache for them. Life is hard either way.
If I could distill my decision down, it would be this: I need help. I need a lot of help. I will stop pretending that I don’t. I let that doctor hug me, and I hugged her back. I find myself in deep conversations with other women, strangers sometimes, about motherhood and abortion and how nothing is simple. I search their words for light, and the light always comes.
About a month ago, I found out I was having a girl. I had long ago made my peace with not having a daughter, though I used to long for one. “You said ‘a girl,’ right?” I asked the woman on the phone. And then I cried. They are leaving the IUD in because it is too risky to remove it. They hope it comes out with the birth but if not, there will need to be a surgical procedure. The presence of the IUD can cause preterm labor; it has perforated my uterus and that might cause an infection. This is my second “geriatric pregnancy,” so there will be a lot of extra monitoring. Still, she perseveres. Her heartbeat is strong; she kicks her legs in defiance of the ultrasounds. I feel the fury of her flutters.
In my first pregnancy, when I found out I was having a boy, my mother told me she was glad. That boys are special, chosen. I think of that, and I think of this girl, this “determined little nugget,” as a friend called her, and how she ignited upon landing, how she lit everything up, how she seems to have chosen me. Maybe I can’t explain how I got here because it wasn’t ever my decision. Life emphatic, a girl I welcome and fear. Not that she’s asking.
What if I become pregnant while using Paragard?
If you think you are pregnant, contact your healthcare professional right away. If you are pregnant and Paragard is in your uterus, you may get a severe infection or shock, have a miscarriage or premature labor and delivery, or even die. Because of these risks, your healthcare provider will recommend that you have Paragard removed, even though removal may cause miscarriage.
If you continue a pregnancy with Paragard in place, see your healthcare provider regularly. Contact your healthcare provider right away if you get fever, chills, cramping, pain, bleeding, flu-like symptoms, or an unusual, bad-smelling vaginal discharge. A pregnancy with Paragard in place has a greater-than-usual chance of being ectopic (outside your uterus). Ectopic pregnancy is an emergency that may require surgery. An ectopic pregnancy can cause internal bleeding, infertility, and death. Unusual vaginal bleeding or abdominal pain may be signs of an ectopic pregnancy. The copper in Paragard does not seem to cause birth defects.
Liletta Side Effects
Generic Name: levonorgestrel
Medically reviewed by Drugs.com. Last updated on Feb 17, 2019.
- Side Effects
Note: This document contains side effect information about levonorgestrel. Some of the dosage forms listed on this page may not apply to the brand name Liletta.
For the Consumer
Applies to levonorgestrel: oral tablet
Other dosage forms:
- intrauterine insert extended release
Along with its needed effects, levonorgestrel (the active ingredient contained in Liletta) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking levonorgestrel:
- Heavy or light menstrual bleeding
Incidence not known
- Absent missed or irregular menstrual periods
- irregular menstruation
- pain in the pelvis
- stopping of menstrual bleeding
Some side effects of levonorgestrel may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Abdominal or stomach pain
- tenderness of the breasts
- unusual tiredness or weakness
For Healthcare Professionals
Applies to levonorgestrel: intrauterine device, oral tablet, subcutaneous implant
The most commonly reported adverse effects are alterations of menstrual bleeding patterns, nausea, abdominal/pelvic pain, headache/migraine, dizziness, fatigue, amenorrhea, ovarian cysts, genital discharge, acne/seborrhea, breast tenderness, and vulvovaginitis.
Common (1% to 10%): Dysmenorrhea, breast pain/discomfort, upper genital tract infection, genital tract bleeding, pelvic inflammatory disease, endometritis, dyspareunia, pelvic discomfort/pain, delay of menses more than 7 days, vaginal discharge, bleeding not related to menses
Uncommon (0.1% to 1%): Uterine spasm, cervicitis/Papanicolaou smear normal class II, change in vaginal secretion
Rare (less than 0.1%): Uterine perforation
Frequency not reported: Breast enlargement, vaginal candidiasis, changes in cervical erosion, changes in cervical secretion, ectopic pregnancy
Postmarketing reports: Oligomenorrhea, irregular menstruation
Very common (10% or more): Nausea (up to 23.1%), abdominal/pelvic pain (up to 22.6%)
Common (1% to 10%): Diarrhea, vomiting
Uncommon (0.1% to 1%): Abdominal distension
Frequency not reported: Bloating, abdominal cramps
Very common (10% or more): Fatigue (16.9%)
Common (1% to 10%): Partial/complete IUS expulsion, weight increased
Uncommon (0.1% to 1%): Edema, change in body weight
Very rare (less than 0.01%): Face edema
Frequency not reported: Decreased weight, sepsis, group A streptococcal sepsis
Postmarketing reports: IUS breakage, procedural bleeding
Very common (10% or more): Headache (up to 16.8%), dizziness (11.2%)
Common (1% to 10%): Migraine
Postmarketing reports: Stroke, syncope, IUS insertion related vasovagal reaction or seizure
Common (1% to 10%): Depression/depressed mood, mood changes, mood swings, decreased libido, nervousness
Frequency not reported: Changes in libido
Very common (10% or more): Acne/seborrhea (15%)
Common (1% to 10%): Alopecia, hirsutism
Uncommon (0.1% to 1%): Pruritus, eczema, pigmentation changes/hyperpigmentation
Rare (less than 0.1%): Rash, urticaria
Frequency not reported: Chloasma, melasma
Postmarketing reports: Angioedema
Postmarketing reports: Increased blood pressure, arterial/venous thrombotic events, pulmonary emboli, deep vein thrombosis, stroke
Common (1% to 10%): Back pain
Frequency not reported: Benign/malignant liver tumors
Postmarketing reports: Breast cancer
Frequency not reported: Contact lens intolerance
Frequency not reported: Diabetes mellitus
Frequency not reported: Allergic reaction
Postmarketing reports: Hypersensitivity reactions
1. “Product Information. Kyleena (levonorgestrel).” Bayer Pharmaceutical Inc, West Haven, CT.
2. “Product Information. Mirena (levonorgestrel).” Berlex Laboratories, Richmond, CA.
3. “Product Information. Plan B (levonorgestrel).” Women’s Capital Corporation, Bellevue, WA.
4. Cerner Multum, Inc. “Australian Product Information.” O 0
5. “Product Information. Skyla (levonorgestrel).” Bayer Pharmaceutical Inc, West Haven, CT.
6. “Product Information. Liletta (levonorgestrel).” Actavis Pharma, Inc., Parsippany, NJ.
7. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.
- What is the difference between Kyleena, Liletta, Skyla and Mirena?
- What are the side effects of IUDs?
More about Liletta (levonorgestrel)
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- Drug class: contraceptives
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Other brands: Mirena, Plan B, Plan B One-Step, Kyleena, … +13 more
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- Birth Control
WHAT CAN I EXPECT BEFORE, DURING, AND AFTER THE INSERTION?
LILETTA® (levonorgestrel-releasing intrauterine system) 52 mg is a hormone-releasing system placed in your uterus to prevent pregnancy for as long as you want for up to 6 years.
- Do not use LILETTA if you:
- Are or might be pregnant; LILETTA cannot be used as an emergency contraceptive
- Have a serious pelvic infection called pelvic inflammatory disease (PID) or endometritis unless you have had a normal pregnancy after the infection went away (PID occurs in less than 1% of users)
- Have an untreated lower genital infection now
- Have had an infection from an abortion within the last 3 months
- Can get infections easily; for example, if you:
- Have problems with your immune system
- Have multiple sexual partners or your partner has multiple sexual partners
- Use or abuse intravenous drugs
- Have or suspect you might have cancer of the uterus or cervix
- Have bleeding from the vagina that has not been explained
- Have short-term (acute) liver disease or liver tumor
- Have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past
- Have an intrauterine system (IUS) in your uterus already
- Have a condition of the uterus that changes the shape of the uterine cavity, such as large fibroid tumors
- Are allergic to levonorgestrel, silicone, polyethylene, or barium sulfate
- Call your healthcare provider right away if you think you are pregnant. If you get pregnant while using LILETTA, you may have an ectopic pregnancy, which means the pregnancy is not in the uterus. Unusual vaginal bleeding or abdominal pain especially with missed periods may be a sign of ectopic pregnancy. Ectopic pregnancy can cause internal bleeding. There are also risks if you get pregnant while using LILETTA and the pregnancy is in the uterus. Severe infection and premature labor or delivery can occur with pregnancies that continue with an IUS
- Although uncommon, pregnancy while using LILETTA can be life threatening and may result in loss of pregnancy or fertility
- Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter or may stop
- Life-threatening infection can occur within the first few days after LILETTA is placed. Call your healthcare provider immediately if you develop severe pain or fever shortly after LILETTA is placed
- Some IUS users get a serious pelvic infection called pelvic inflammatory disease (PID) or endometritis. These are usually sexually transmitted. You have a higher chance of getting PID or endometritis if you or your partner has sex with other partners. PID or endometritis can cause serious problems such as infertility, ectopic pregnancy or pelvic pain that does not go away. More serious cases of PID or endometritis may require surgery. Removal of the uterus (hysterectomy) is sometimes needed. In rare cases, infections that start as PID or endometritis can even cause death. Tell your healthcare provider right away if you have any of these signs of PID or endometritis: long-lasting or heavy bleeding, unusual vaginal discharge, low abdominal pain, painful sex, chills, or fever
- LILETTA may partially go into (become embedded) or go completely through (perforate) the wall of the uterus. If perforation occurs, LILETTA may move outside the uterus and can cause internal scarring, infection, or damage to other organs. You may need surgery to have LILETTA removed if it is embedded or perforation occurs. Risk of perforation is increased in breastfeeding women
- LILETTA may come out of your uterus (expulsion). Expulsion occurs in about 4 out of 100 women, most often in the first year of use. You may become pregnant if LILETTA comes out. If you think that LILETTA has come out, use another birth control method like condoms and spermicide or do not have sex (vaginal intercourse) until you are seen by a healthcare provider
- Ovarian cysts may occur but usually disappear
LILETTA does not protect against HIV or STDs.
Available by prescription only.
Please also see full Prescribing Information.
Levonorgestrel is a female hormone that can cause changes in your cervix, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus. Levonorgestrel intrauterine system is a plastic device that is placed in the uterus where it slowly releases the hormone to prevent pregnancy for 3 to 5 years.
Levonorgestrel intrauterine system is used to prevent pregnancy for up to 5 years. You may use this device whether you have children or not. Mirena is also used to treat heavy menstrual bleeding in women who choose to use an intrauterine form of birth control.
Levonorgestrel is a progestin hormone and does not contain estrogen. The intrauterine device (IUD) releases levonorgestrel in the uterus, but only small amounts of the hormone reach the bloodstream. Levonorgestrel intrauterine system should not be used as emergency birth control.
Levonorgestrel intrauterine system may also be used for purposes not listed in this medication guide.
You should not use this intrauterine device if you have abnormal vaginal bleeding, a pelvic infection, certain other problems with your uterus or cervix, or if you have breast or uterine cancer, liver disease or liver tumor, or a weak immune system.
Do not use during pregnancy. Call your doctor if you miss a period or think you might be pregnant.
An intrauterine device can increase your risk of developing a serious pelvic infection, which may threaten your life or your future ability to have children. Ask your doctor about your personal risk.
Do not use this IUD during pregnancy. This device can cause severe infection, miscarriage, premature birth, or death of the mother if left in place during pregnancy. Tell your doctor right away if you become pregnant. If you choose to continue a pregnancy that occurs while using a levonorgestrel intrauterine system, watch for signs of infection such as fever, chills, flu symptoms, cramps, vaginal bleeding or discharge.
You should not use this device if you are allergic to levonorgestrel, silicone, silica, silver, barium, iron oxide, or polyethylene, or if you have:
- abnormal vaginal bleeding that has not been checked by a doctor;
- an untreated or uncontrolled pelvic infection (vaginal, cervical uterine, or bladder);
- endometriosis or a serious pelvic infection following a pregnancy or abortion within the past 3 months;
- a history of pelvic inflammatory disease (PID), unless you have had a normal pregnancy after the infection was treated and cleared;
- uterine fibroid tumors or other conditions that affect the shape of the uterus;
- past or present breast cancer, known or suspected cervical or uterine cancer;
- liver disease or liver tumor (benign or malignant);
- a recent abnormal Pap smear that has not yet been diagnosed or treated;
- a disease or condition that weakens your immune system, such as AIDS, leukemia, or IV drug abuse; or
- if you have another intrauterine device (IUD) in place.
To make sure levonorgestrel is safe for you, tell your doctor if you have ever had:
- high blood pressure, heart disease or a heart valve disorder;
- a heart attack or stroke;
- a bleeding or blood-clotting disorder;
- migraine headaches; or
- a vaginal infection, pelvic infection, or sexually transmitted disease.
You should not use this IUD if you are breast-feeding a baby younger than 6 weeks old. This IUD may be more likely to form a hole or get embedded in the wall of your uterus if you have the device inserted while you are breast-feeding.