I keep seeing TikToks saying IUDs can mess up your fertility long-term—what’s real vs fear-mongering, and are there any legit risks (like scarring or PID) that could make it harder to conceive later?

Q: I keep seeing TikToks saying IUDs can mess up your fertility long-term—what’s real vs fear-mongering, and are there any legit risks (like scarring or PID) that could make it harder to conceive later?A: Here’s the blunt version: IUDs themselves do *not* cause infertility in healthy users. Most TikTok horror stories leave out key details—like untreated STIs, rare complications, or pre-existing conditions.Large studies show that people who’ve used IUDs get pregnant later at the *same* rates as people who never used them. The main real risk to fertility is pelvic inflammatory disease (PID) from infections like chlamydia or gonorrhea that go untreated and scar the fallopian tubes. Getting an IUD doesn’t cause PID, but inserting one when you *already* have an STI can slightly increase the chance the infection spreads.Other rare risks (like uterine perforation) almost never affect long-term fertility when caught.So yes, there are risks—but the “IUDs make you sterile” narrative is wildly overblown.If TikTok has you spiraling and you want to sort actual science from scare content, you can always chat with Gush and unpack what fits *your* body and history.

Do IUDs cause infertility or long-term fertility problems?

What the research actually says about IUDs and future fertility

Studies across thousands of users have looked at pregnancy rates after IUD removal. The pattern is boring in the best way:- Most people conceive within **12 months** of removal if they’re actively trying.- IUD users have **similar fertility** to people who used condoms, pills, or no birth control.- No increase in long-term infertility is seen with either copper or hormonal IUDs.Why? Because an IUD mostly works **inside the uterus**:- Copper IUD: toxic environment for sperm, doesn’t stop ovulation.- Hormonal IUD: thick cervical mucus, thin uterine lining, may dampen ovulation in some—but it’s reversible.Your ovaries, brain, and long-term fertility system aren’t being “shut down.” They’re just being temporarily redirected.The loudest online horror stories are real experiences—but they’re *not* the norm, and they’re often missing context like untreated infection, misplacement, or an underlying condition.

Real risks: PID, scarring, and when it could impact fertility

Let’s talk about the scary stuff without sugarcoating it.**Pelvic Inflammatory Disease (PID)**PID is an infection of the uterus, fallopian tubes, and/or ovaries. Long-term, it can cause scarring in the tubes, which can:- Make it harder for the egg and sperm to meet.- Increase risk of ectopic pregnancy.Key point:**PID comes from bacteria (usually an STI), not from the IUD itself.**Here’s where things get twisted on TikTok:- If you have an untreated STI when an IUD is inserted, the bacteria can be pushed upward, slightly raising the risk of PID.- That risk is highest in the **first 20 days** after insertion.- After that, your risk of PID is the same as someone without an IUD—it depends on exposure to STIs, not the device.With proper STI screening and condom use with new partners, the fertility damage from PID is *highly* preventable.**Scarring from the IUD itself?**Very rare. It’s possible after a complicated perforation or repeated infections, but that’s not the standard IUD experience.If your IUD story doesn’t match the nightmare fuel you see online, that’s good—you’re the majority.If your experience doesn’t fit cleanly into “textbook risk” or “TikTok myth,” that’s normal—and exactly where a personal convo helps. You can walk through what *actually* happened to your body anytime on Gush.

Other rare IUD complications and what they mean for fertility

**1. Uterine perforation (IUD pokes through the wall)**- Happens in roughly 1 in 1,000 insertions.- Usually found via pain, missing strings, or ultrasound.- IUD is removed surgically if needed.- Most people’s fertility is not affected long-term once the device is out and the uterus heals.**2. IUD expulsion (it falls out)**- Happens in up to ~5–10% of users, especially younger patients, heavy bleeders, or postpartum.- If it slips partially or fully out, it just stops working as birth control.- This doesn’t damage your fertility—it just leaves you unprotected.**3. Chronic endometritis (low-grade uterine inflammation)**- Rare and more likely with repeated infections.- Can impact implantation.- Usually treated with antibiotics; most people go on to conceive.We hear way more about these in dramatic storytime format than they actually occur. Still real, just *rare*.

How your menstrual cycle and hormones behave with an IUD

Understanding the hormone side helps cut through the “IUD ruins your hormones forever” panic.**Copper IUD**- No hormones.- Your natural cycle continues:- Follicular: estrogen rises.- Ovulation: LH surge, egg release.- Luteal: progesterone holds lining.- Early months often mean heavier, crampier periods because the copper irritates the uterus a bit.- Fertility is not suppressed at all.**Hormonal IUD (levonorgestrel)**- Constant small release of progestin.- Main actions:- Thickens cervical mucus.- Thins uterine lining.- Sometimes blunts ovulation, especially in the first year or with higher-dose IUDs.- Many users’ cycles become:- Lighter or nonexistent periods.- Less cramping.- Very stable hormone levels (fewer estrogen highs).When it’s removed:- Progestin drops quickly.- Your cycle reverts back to its natural pattern, that same estrogen–ovulation–progesterone loop.No evidence shows long-term disruption of this HPO (hypothalamic–pituitary–ovarian) axis after removal.

Red-flag symptoms to watch for while you have an IUD

Stuff that deserves attention *fast*:- **Severe, worsening pelvic pain**, especially with fever or feeling really sick- **Bad-smelling discharge** with pain or bleeding after sex- **Unusually heavy bleeding** that soaks pads/tampons every hour for several hours- **Strings suddenly feel much longer or shorter**, or you can’t feel them at all and something feels off- **Positive pregnancy test** with an IUD still in (higher risk of ectopic pregnancy)These don’t automatically mean infertility, but they *do* mean: don’t push through it, don’t minimize it, and don’t let a provider brush you off.Partners, doctors, and society all love to tell women “it’s probably nothing” while our organs yell for help. Listening to your body is not being dramatic; it’s maintenance.

Protecting your future fertility while using an IUD

If you care about kids later, here’s what actually matters more than the device:- **Regular STI screening**At least yearly, or every 3–6 months if you have new partners.- **Condoms with new or untested partners**IUDs prevent pregnancy, not infections. PID risk tracks with exposure, not birth control method.- **Advocating for yourself at insertions and check-ups**Ask directly:- “Are you screening me for STIs before insertion?”- “What’s the plan if I have severe pain after this?”- **Tracking your baseline**Know what’s normal for you: period length, cramp level, discharge. That way you can tell when something really changes.IUDs are not gentle little fairy devices, but they’re also not fertility death sentences. They’re powerful tools that require real consent, real information, and real follow-up.

Bottom line: separate fear from facts

Real talk:- IUDs do **not** cause infertility in the vast majority of users.- The real threat to fertility is **untreated infection** and rare complications—not the device existing in your uterus.- TikTok is useful for hearing lived experiences, but not for baseline medical reality.You deserve more than fear-based contraception decisions. You deserve the full picture—and the power to choose anyway.