Intrauterine devices (IUDs) have become increasingly more popular as a highly effective and long-term birth control method. The IUD reduces the risk of unwanted pregnancy while minimizing the chance of human error that comes with other forms of birth control.
When it comes to choosing the best IUD for you, it can be confusing. There are many things to consider when choosing between a hormonal or non-hormonal IUD, including your medical history, personal preferences, and the side effects that you may experience.
What is an IUD?
An intrauterine device or IUD is a small piece of flexible plastic that is shaped like a T. It is placed inside the uterus by a doctor to prevent unwanted pregnancy. These devices are a long-term and reversible birth control method that stops sperm from reaching and fertilizing eggs.
Attached to the end of the IUD are two plastic threads or strings that hang slightly outside of the cervix and into the vagina. The threads or strings are cut short, so they do not hang outside of the body and cannot be felt by you or your partner during sex.
What are the types of IUDs?
There are two types of IUDs available in Canada: hormonal and non-hormonal or copper IUDs.
Hormonal IUDs
Hormonal IUDs work by releasing levonorgestrel, a synthetic form of progesterone. This hormone works by thickening the mucous in the cervix making it difficult for sperm to pass through.
This hormone also thins out the uterine lining making it difficult for an egg to implant in the uterus and cause a pregnancy. Because the uterine lining is thinned out with the hormonal IUD, most women may experience a lighter period or no period at all.
The hormonal IUD can cause irregular menstrual bleeding for the first few months or other side effects similar to the birth control pill.
There are two different brands of hormonal IUDs: Mirena and Kyleena, which last up to 5 years.
If you are uncomfortable with the idea of not having a period or react badly to progestin, you may want to consider a non-hormonal or copper IUD.
Non-Hormonal IUD or Copper IUDs
Non-hormonal or copper IUDs do not contain any hormones. The copper coiled around the IUD interferes with sperm getting to the egg. The copper also prevents any fertilized eggs from attaching to the uterus.
Some women, who choose the non-hormonal or copper IUD may experience periods that become heavier, last longer, and more painful. This may not be a good option for people who have painful or heavier periods to begin with, endometriosis, and/or anemia.
At Brampton Women’s Clinic, we offer the non-hormonal IUD (MonaLisa 5 NT Cu380), which can be left in for 5 years.
The Pros and Cons of Hormonal vs. Non-Hormonal IUDs
Hormonal IUDs
The pros of hormonal IUDs:
- Highly effective. Hormonal IUDs are over 99% effective and are slightly more effective than the non-hormonal or copper IUD.
- Light to no periods. The hormones in the IUD may cause people to experience light to no period at all.
- Safer option. It is a safer option for people who are unable to use birth control containing estrogen, including those that experience migraines or at a higher risk for blood clots or stroke.
The cons of hormonal IUDs:
- The hormonal IUD is slightly more expensive than the non-hormonal IUD depending on your insurance coverage. Without insurance coverage the hormonal IUD can cost upwards to $450.
- Side effects. Some women may experience side effects, such as spotting, irregular periods, or cramping after getting a hormonal IUD. This usually goes away with 3-6 months, once your body has had time to get use to the IUD.
- Do not protect against sexually transmitted infections/diseases (STIs/STDs). IUDs are the most effective forms of birth control, but do not protect against STIs. So, it is important to still use condoms.
- Needs to be inserted by a doctor.
- In rare cases, the IUD may cause a pelvic infection to develop.
Non-Hormonal IUDs
The pros of non-hormonal IUDs:
- No hormones. Because copper IUDs do not contain hormones, they are a safe option for people who cannot use hormonal birth control methods.
- Highly effective. Although slightly less effective than the hormonal IUD, copper IUDs are still over 99% effective.
- The non-hormonal IUD is a less expensive option costing upwards to $150.
The cons of non-hormonal IUDs:
- Heavier and crampier periods. Some women may experience heavier, longer lasting, and crampier periods with the non-hormonal IUD.
- Do not protect against sexually transmitted infections/diseases (STIs/STDs). IUDs are the most effective forms of birth control, but do not protect against STIs. So, it is important to still use condoms.
- Needs to be inserted by a doctor.
- In rare cases, the IUD may cause a pelvic infection to develop.
But aren’t IUDs painful to have put in?
The IUD can be inserted at any time, including after an abortion, during your menstrual period, or after birth.
To have an IUD inserted the doctor will need to use a speculum to hold open the vagina, like having a pap smear. The doctor will then use a special insertion device to place the IUD inside the uterus through the cervix. This usually takes less than 5 minutes to complete.
Most women experience some cramping or pain while their IUD is being placed. To minimize cramping your doctor or nurse may offer you pain medications before your IUD is placed.
So overall, why should you consider an IUD?
- Highly effective. The hormonal and non-hormonal IUD are both over 99% effective making it the most effective forms of birth control compared to other non-permanent contraceptive methods.
- Long-term birth control method. The IUD is a long-acting contraceptive method that can last up to 5 years depending on your choice of IUD.
- In the long-run the IUD is an inexpensive birth control method compared to other non-permanent forms of birth control. It also avoids frequent visits to your doctor and/or pharmacy for more prescriptions.
- You don’t need to remember to take it. Once the IUD is placed, the only thing you need to remember to do is your ‘string check’ by reaching inside the vagina to make sure you feel the threads or strings at the end of your IUD after each period.
- Although the IUD is effective for up to 5 years, it can be taken out at anytime.
- Once the IUD is placed, no one will know it is in place besides you. You should not be able to feel it nor should your partner.
- Can be used as emergency contraception. If the IUD is inserted within 7 days of unprotected sex it can be used to prevent an unwanted pregnancy.