What are the risks/benefits of an IUD?

What are the risks/benefits of an IUD?

There are two IUDs on the market in the United States. One is called Paragard, and it contains copper but no hormones. Copper is an effective spermicide, and the presence of an object in the uterus makes it difficult for sperm to move through to fertilize eggs and makes the uterus an inhospitable environment for an egg. The other is called Mirena, and it releases an extremely low dose of synthetic progesterone, which thickens cervical mucous, making it hard for sperm to enter, and thins the lining of the uterus.

Both IUDs are extremely effective against pregnancy. Paragard is about 99.4% effective, and Mirena is about 99.8%. This is comparable to the effectiveness of surgical sterilization. Many monogamous people feel comfortable using just the IUD (without condoms) as birth control, which allows for more spontaneity. IUDs can be left in for a long period of time (Mirena for 5 years, Paragard for 10), so you don’t have to worry about remembering to change it or take it every day.

Unlike birth control pills, injections, patches, rings, and hormonal implants, Paragard has no hormonal side effects at all, and Mirena very rarely causes any hormonal side effects aside from its affects on menstruation. Both IUDs are acceptable for people who have had problems like nausea, weight gain, and sex drive reduction on hormonal birth control methods. Neither IUD significantly increases the chance of blood clots if you’re a smoker. Upon removal of an IUD, your fertility is immediately or nearly immediately back to normal.

Because Mirena thins the lining of the uterus, it significantly reduces menstruation in many people. For this reason, it is sometimes used as a treatment for painful periods and endometriosis (abnormal tissue growth associated with the menstrual cycle). About 20 percent of people with Mirena stop menstruating altogether, which some people like and some people don’t. During the first few months after getting a Mirena it is common to have spotting and cramping. This usually resolves within 3 months, but may last as long as 6.

Paragard tends to cause very long, heavy, painful periods for the first few months. Some women cannot tolerate this side effect and get it removed quickly. Periods usually return to about normal within 6 months of insertion.

IUD insertion ranges from uncomfortable to extremely painful, especially for women who have never had a baby. IUDs are also a little bit more likely to expel in women who have not given birth. Expulsion is when the IUD comes out partially or completely. It is only dangerous in that it makes the device less effective. For these reasons, some doctors are unwilling to use IUDs in women who haven’t had babies, so it is sometimes necessary to shop around. You can check to make sure the IUD is in place by feeling for the strings, which stick out of your cervix.

Like hormonal birth control methods, IUDs do not protect against STIs. If you have an STI when your IUD is inserted, it may increase your chance of developing pelvic inflammatory disease. Old IUDs made pelvic inflammatory disease more common if you got an STI while the device was in place. Studies seem to indicate that this is not the case with the new IUDs, but many doctors are still unwilling to use them in patients who are not monogamous.

Recommendations: A guide to the variety of contraceptive options.