When it comes to women’s choices in contraception, the options are limited and not as advanced as you might expect in the 21st century.
Thankfully, the current options for intrauterine devices have come a long way since the early 1950s when an IUD looked more like a strange torture tool. Now IUDs are used by more than 180 million women worldwide, with great effectiveness. (2)
For those women considering having an IUD inserted in order to prevent pregnancy, here are six things you should know or discuss with your health care provider.
1) There are 2 types of IUD options.
One type is a copper-coil IUD which contains no hormones, called ParaGard.
The other is an IUD that contains a progestin known as levonorgestrel. Mirena and Skyla are both this hormonal type of IUD. Do not confuse progestin with bio-identical progesterone made naturally in the body.
2) The 2 IUDs each prevent pregnancy in slightly different ways.
Copper acts as a spermicide in a sense. It damages sperm and affects their swimming motility so they cannot meet and meld with an egg. The levonorgestrel in the hormonal IUD also prevents the sperm from meeting with the egg by thickening cervical mucus to prevent the sperm from reaching the egg.
However, it thins the lining of the uterus to prevent the chance of implantation, as well.
3) IUDs can be implanted for the long haul.
They are really only great options for someone not looking to become pregnant in the near future. The copper IUD can remain inserted for up to 10 years, while the hormonal IUD is approved to remain in the uterus for three to five years, depending on the brand.
Removal is generally straightforward, though, so if someone has a change of fertility plans or wants their device out, it usually justrequires a quick trip to the gynecologist’s office.
Because the IUD is T-shaped with flexible arms, your health care provider will take hold of the strings up inside the vagina with forceps and simply pull down and out. Within seconds, the procedure is over.
4) The side effects for each IUD are different.
The copper IUD does not have any hormone in it so this is the first choice for women who prefer a non-hormonal route. Unfortunately, the copper can increase menstrual bleeding and cramps during a woman's period.
It is generally advised that a woman take about six months to feel fairly balanced and adjusted to this IUD. Keep in mind, the copper IUD is left in for 10 years so once adjusted, she does not have to think about it for a long time!
The hormonal IUD will thin the lining of the uterus. Many women report their periods become significantly lighter, or diminish all together.
Having said this, though, the hormone can cause increased episodes of unscheduled bleeding, back pain, acne, weight gain, mood swings, hair growth, changes in libido, and increased vaginal infections.
Both IUDs can become expelled out of the uterus, perforate through the wall of the uterus, or cause pelvic inflammatory disease (PID). However such occurrences are quite infrequent.
5) Your partner might feel the strings ... but usually not.
The devices have microfilament strings that hang out of the uterus into the vagina by only a few centimeters. Over time, vaginal mucus soften the strings so that they lay flat against the cervix, and are commonly not felt by the partner during intercourse.
Your health care provider will check your strings at each Pap exam.
6) Neither IUD protects against STDs so you must still be alert and protect yourself.
If the IUD sounds like a good option for your contraception plans, talk with your health care provider about which device would work best. You'll also go over the details on in-office insertion.
For millions of women in America, the IUD is an easy long-term choice.
Reviewed February 29, 2016
by Michele Blacksberg RN
Edited by Jody Smith
1) Conrad Stoppler, M. (2015). Mirena Side Effects Center.
2) Darney, P, Speroff, L. (2010). A clinical guide for contraception (5th ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. pp. 242–243.
3) Teva Women’s Health, Inc. (2015). Paragard Frequently Asked Questions.