Seeing pregnancy signs with an IUD and no period?

Intrauterine devices — or IUDs — are one of the most popular forms of contraception, and it’s easy to see why. They’re low-cost, effective, and reversible. If you don’t want to become pregnant, you can have one fitted by a health care professional, they last for a number of years, and are more than 99% effective at preventing pregnancy. 

However, as with any form of contraceptives, IUDs are not perfect. While it’s very unlikely, it is still possible to get pregnant with an IUD. 

If you’ve started to notice some of the telltale signs of early pregnancy but don’t have a period, it can be hard to know when the best time to take a test would be. Here’s the lowdown on what to do if you have an IUD and think you could be pregnant. 

Key takeaways

• There are two types of IUDs: copper and hormonal. Both are more than 99% effective in preventing pregnancy.
• If you have a hormonal IUD, then the bleeding you experience each cycle may have decreased over time, or it may have even stopped. 
• If you use a copper IUD, then you’ll likely still have a period each cycle. 
• While extremely rare, it’s still possible to get pregnant if you have an IUD. If your IUD is nonhormonal, then a missed period could be the earliest signifier of this. If you don’t have a period, as you have a hormonal IUD, this can be a little tougher. 

The best thing to do if you think you could be pregnant is to take a pregnancy test. You can learn more about this using Flo’s pregnancy test calculator. And if you’re not sure when to take one, speak to your doctor. 

Understanding IUDs and the potential effects on your cycle

In a nutshell, IUDs are widely considered to be a safe, low-cost, and effective form of long-term birth control. What’s more, IUDs are over 99% effective in preventing pregnancy, and each device can work for years. 

As Dr. Jenna Flanagan, an assistant professor in obstetrics and gynecology at the University of Utah, US, and member of Flo’s expert board, explains: “IUDs are some of the most effective forms of contraceptives. The overall risk of pregnancy with an IUD as compared to noncontraceptive users or users of different methods is lower comparatively.”

There are two types of IUDs: copper and hormonal. Both IUDs come in the form of a T-shaped device, which is inserted into the uterus and has strings so that it can be removed at a later date. IUDs work to prevent pregnancy in different ways: 

Hormonal IUDs: 

This type of IUD releases a synthetic form of progesterone called progestin into your body. Progestin thickens your cervical mucus, which can make it more difficult for sperm to reach your egg after ovulation. It also thins the uterine lining and can sometimes stop ovulation altogether.

Copper IUDs: 

Copper IUDs release a very small amount of copper into your body. This creates a toxic environment in your uterus for sperm and can make it more difficult for them to reach your egg after ovulation. Similarly, like a hormonal IUD, copper IUDs can thin the lining of the uterus, making it more difficult for implantation to take place.

Can IUDs cause irregular or missed periods? 

Whether an IUD impacts your menstrual cycle or not depends on the type used and also your own body. Everyone is different, after all. Hormonal IUDs generally make periods lighter — and can even stop them altogether. That’s because the progestin released by hormonal IUDs (known as levonorgestrel) can impact ovulation. Ovulation is when one of your ovaries releases an egg. 

Hormonal IUDs can stop or interfere with ovulation, meaning you experience lighter or fewer periods. One study found that one brand of hormonal IUDs decreased menstrual bleeding by 80% after four months — and by 100% after two years of use. 

Since a missed period is one of the earliest signs of pregnancy, this change in your cycles may make you worry that you’re pregnant. While it’s unlikely, it’s always best to take a pregnancy test to be sure. 

Conversely, copper IUDs do not affect ovulation and may have the opposite effect on your periods. They can make yours heavier or longer. The copper from your IUD works to prevent sperm from meeting your egg, but it can also cause an inflammatory response. In some cases, it can cause your periods to be heavier or for you to have more cramping. This isn’t something you have to manage alone. Speak to your doctor if your periods have become heavier or more painful. 

Since copper IUDs are unlikely to impact your period, a missed period if you’re using this form of contraception is caused by something else. Pregnancy isn’t the only reason why you might miss a period. Stress, hormonal fluctuation, and some health conditions can impact your cycle.

What are the potential side effects of IUDs? 

Before you start any new type of contraception, it can be good to explore the pros and any possible side effects. A health care professional should walk you through these so you can make the best choice for you. 

Everyone is different, so these side effects aren’t a given. You may experience some of them, all of them, or none at all. We all react differently. However, some side effects of IUDs may include:

• You may experience bleeding between your periods.
• If you have a copper IUD, you may have heavier, more painful, and longer periods. This usually improves after a few months.
• Your partner can feel the threads of your IUD during sex. Again, speak to a health care professional if this happens.

As ever, speak to your doctor if you have any concerns about side effects before or after getting an IUD — especially if they don’t go away. Your contraception should work for you, and side effects aren’t something you just have to live with. Your doctor will be able to advise you on your best next step. 

Is it possible to get pregnant with an IUD? 

In short, yes, but it’s extremely rare. As we’ve said, an IUD that has been properly inserted is more than 99% effective in preventing pregnancy.

However, pregnancy is still a possibility. There are two main ways this can happen. Firstly, IUDs have a lifespan. Copper IUDs usually last for up to 10 years, while hormonal IUDs typically last a little less (up to eight years). So, if your IUD is past its expiry date and hasn’t been replaced, then it is more likely to fail, and you can become pregnant. 

An IUD can also fail if it moves out of place. Dr. Flanagan explains: “Occasionally, the IUD will slip lower in the uterus or into the cervix or become partially expelled, and it will be less effective at this point.” Dr. Flanagan adds that “a very small percentage of pregnancies” happen even with good IUD placement. 

If you have an IUD and suspect you might be pregnant, then it’s crucial that you speak to a health care professional. While it’s rare, being pregnant with an IUD can cause a complication called ectopic pregnancy. This describes when your fertilized egg implants itself outside of the uterus, often (but not always) in one of your fallopian tubes. 

Ectopic pregnancy can be emotionally distressing and an incredibly difficult thing to navigate. However, it isn’t possible to safely progress with your pregnancy in this way, so it’s important that you get the medical help you need. 

Potential signs of pregnancy with an IUD

The early signs of pregnancy are the same whether you have an IUD or not. Everyone will feel slightly different, but you may notice:

• Sore breasts
• A heightened sense of smell
• Feeling bloated
• Food cravings
• Feeling nauseous or being sick 
• Feeling more tired
• A metallic taste in your mouth
• Cramps that feel a bit like period pains
• Headaches
• Suddenly liking or disliking specific foods
• Light bleeding or spotting 
• Peeing more frequently
• Changes in your cervical mucus 

Can you get pregnant without a period? 

Yes, it’s possible to get pregnant even if you aren’t having a period. That’s because, in rare cases, you can ovulate without having a period. Medications and certain conditions are just a couple of reasons why you might not have a period but continue to ovulate. And it’s ovulation that’s crucial when you’re trying to conceive. 

“Pregnancy can occur at any point that ovulation occurs. Typically, a menstrual cycle occurs two weeks after ovulation if a pregnancy does not occur. Therefore, at any point, if there is an ovulatory event, then fertilization would occur before any menstrual cycle,” says Dr. Flanagan. “People who have infrequent cycles or periods of amenorrhea [which is when you don’t have periods at all] can still become pregnant; it is just harder.” 

You can learn more about getting pregnant with irregular periods with Flo. 

What to do if you think you may be pregnant with an IUD

If you think you may be pregnant with an IUD, there are a few things you can do to confirm your pregnancy and get the support you need.

Think about recent sexual activity 

IUDs are very effective at preventing pregnancy. However, if you’ve had sex recently, there is always a possibility that you could be pregnant. One main sign of pregnancy is if you’ve missed your period this month. 

If you have a copper IUD and you’re not sure when your period is due, try using Flo’s period-tracking app to better understand your menstrual cycle. Similarly, if you have a hormonal IUD and haven’t had a period for a while, it’s best to take a pregnancy test to be sure. 

Take a pregnancy test 

Being uncertain if you’re pregnant or not can be really unsettling. Taking a test will give you some clarity. You can use Flo’s pregnancy test calculator to understand when the best time might be to take a test to get an accurate result. Generally speaking, it’s best to wait until the first day of a late or missed period. When taken correctly, pregnancy tests are 99% accurate.

Speak to your doctor 

If your pregnancy test comes back positive, then it’s important to contact your doctor or health care professional. They will then be able to confirm your pregnancy and how far along you are. They will also be able to advise you on the best next step. 

Connect with your community

Early pregnancy can be filled with mixed emotions. It’s very typical if you aren’t sure how you feel at this point. Remember that you’re not alone, and you know what’s best for you. Similarly, connecting with the Flo community through Secret Chats may allow you to speak to millions of other members in a safe and friendly space, completely anonymously.