With so many contraceptive methods on the market for women today, it can sometimes be challenging to navigate the options on offer. If you’ve been considering the IUD (or Intrauterine device), it’s vital to get the facts and decide which version best suits your needs. In this article, we break down some of the key differences between the types of IUD available for women and discuss their relative strengths and weaknesses.
What is an IUD?
An IUD is a small, T-shaped contraceptive device that’s inserted into the uterus by a doctor or nurse to prevent pregnancy. It’s also effective in treating women who suffer from:
- Painful periods
- Heavy bleeding
- Fibroids (Non-cancerous tumours that grow around the uterus
There are different types of IUD available; copper IUDs or progestin-releasing hormonal IUDs. Depending on which type you choose, they work in different ways and offer different benefits.
What are the different types of IUD?
Copper IUDs work by releasing copper ions which are toxic to sperm. The T-shaped device also obstructs the sperm’s path towards the egg. Copper IUDs start working immediately and can be left in place for up to ten years; they can also be used as emergency contraception.
Hormonal IUDs work by releasing progestin, a hormone that plays a role in the menstrual cycle and that can be found in birth control pills. Progestin makes the mucus around the cervix thicker, making it much more difficult for sperm to reach and fertilise the egg. It also thins the lining of the uterus, which makes it harder for fertilised eggs to attach to the uterus. Hormonal IUDs usually take around 7 days to start working.
There are four brands of hormonal IUD available, all of which use the drug levonorgestrel. The brands Liletta and Skyla last for up to three years, whereas Kyleena and Mirena both last for up to five years. Of the four, Kyleena releases the lowest dose of hormones over the course of its five-year lifespan. Mirena releases the highest dose of hormones and can help to reduce heavy menstrual bleeding by up to 90% after the first six months.
It’s important to note that neither type of IUD protects against STIs. After the IUD is removed, it is once again possible to get pregnant.
How is an IUD inserted?
Your IUD is usually inserted by a doctor or nurse during your period. The cervix is washed with an antiseptic solution before insertion, then a plastic tube containing the IUD is inserted through the vagina and into the uterus with the help of a plunger. The tube is then removed, leaving two small strings on the outside of the cervix to aid with the removal of the IUD. During insertion, you may experience some pain or discomfort, cramping and possible lightheadedness.
Are there any side effects with an IUD?
As with any medical procedure, there are some side-effects reported by women who use the IUD.
After insertion, some women report cramps and back pain for up to two days following insertion but these symptoms can be relieved with over the counter pain medication. For some, spotting (irregular bleeding between periods) may occur during the first six to twelve months, but for the majority of women, periods get lighter and happen less often once the IUD is inserted.
Pros and cons
It’s worth bearing in mind that the IUD is unsuitable for you if any of the following apply to you:
- You are at high risk for Sexually Transmitted Infections (STIs)
- You have a history of pelvic infection
- You are pregnant
- You have abnormal pap tests
- You have been diagnosed with cervical or uterine cancer
- You have a very large or very small uterus
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- 'Intrauterine Devices (IUD): Medlineplus Medical Encyclopedia' (Medlineplus.gov, 2019) <https://medlineplus.gov/ency/article/007635.htm>
- 'Which Type Of Long-Term Birth Control Is Best For You?' (WebMD, 2019) <https://www.webmd.com/sex/birth-control/features/long-term-birth-control-new-implants-patches#1>
- 'Birth Control' (U.S. Food and Drug Administration, 2019) <https://www.fda.gov/consumers/free-publications-women/birth-control>
- 'Intrauterine Device (IUD)' (nhs.uk, 2019) <https://www.nhs.uk/conditions/contraception/iud-coil/>
- 'Progestin-Only Hormonal Birth Control: Pill And Injection - ACOG' (Acog.org, 2019) <https://www.acog.org/Patients/FAQs/Progestin-Only-Hormonal-Birth-Control-Pill-and-Injection?IsMobileSet=false>