The two main types of intrauterine devices (IUDs) are hormonal and nonhormonal. Hormonal IUDs use progestin to prevent pregnancy, while nonhormonal IUDs use copper. There are several brands of hormonal IUDs, each with their own features to consider. Currently, there is only one brand of copper IUD.
These devices are intended to be used for long-term birth control, so it’s important to understand their potential benefits and drawbacks before making a decision about this contraceptive.
What Is an IUD?
An IUD is a small, T-shaped device inserted in the uterus to prevent pregnancy. The device must pass through the vagina and cervix before being carefully inserted into the uterus. Medical providers must insert IUDs to ensure they’re placed properly.
An IUD has strings that hang from the end and reach to the back of the vagina. At the time of insertion, a medical provider will also trim the strings to the appropriate length. If you have an IUD, you can check the strings periodically to make sure the device is still in place. Your healthcare provider will also use the strings to take the IUD out when it’s time to replace or remove it.
How IUDs Work
IUDs prevent pregnancy in different ways depending on the type of device used.
Hormonal IUDs release a progestin called levonorgestrel, a hormone often used in birth control pills. Levonorgestrel prevents the ovaries from releasing an egg, makes cervical mucus thicker so the sperm can’t get inside the uterus, and thins the lining of the uterus to make implantation more difficult. Hormonal IUDs start working within seven days after insertion and can remain in the uterus to prevent pregnancy for up to three to five years (depending on the brand). These IUDs are 99.8% effective.
With hormonal IUDs, your period might be lighter, less frequent, or stop completely. This is more likely to occur with hormonal IUD brands that have higher levels of levonorgestrel.
Hormone-free IUDs are wrapped in copper wire. This wire releases copper ions that are toxic to sperm. This type of IUD works immediately after being inserted, so it can also be used as an effective form of emergency contraception. Copper IUDs can stay in the uterus to prevent pregnancy for up to 10 years and are 99.2% effective.
You will still get a period if you use a copper IUD. In fact, your period might be heavier for the first few months of use. However, women who want a hormone-free form of birth control might prefer this device.
The four hormonal IUD brands on the market include:
- Mirena: Mirena is the most commonly used IUD. It has also been on the market longest and has been FDA-approved to treat heavy menstrual bleeding. It prevents pregnancy for up to five years.
- Skyla: Skyla is slightly smaller than Mirena, so it can be a better fit for women who haven’t previously given birth. It has the lowest dose of hormones compared to the other hormonal IUD brands. It prevents pregnancy for up to three years.
- Liletta: Liletta was specifically developed as a low-cost IUD option. It prevents pregnancy for up to five years.
- Kyleena: Kyleena is the newest of the four hormonal IUD brands. It delivers a lower dose of hormones than Mirena and Liletta. It protects against pregnancy for up to five years.
The only nonhormonal brand is the copper IUD Paragard. It prevents pregnancy for up to 10 years and can also be used for emergency contraception.
IUD Benefits and Drawbacks
When deciding whether to use an IUD, first weigh the pros and cons. The benefits of using an IUD include:
- Very effective: IUDs are more than 99% effective at preventing pregnancy, which is higher than the efficacy of most other contraceptives.
- Long-lasting: Once the IUD is inserted, it can last up to three to 10 years depending on the brand.
- Reversible: You can have an IUD removed at any time, and your fertility will go back to normal immediately.
- No reminders: You don’t have to do anything else to remain protected against pregnancy while using an IUD. This is advantageous for women who struggle to stay on schedule with pills, patches, rings, or shots.
- Cost-effective: Because one IUD lasts years, it can be cheaper than other forms of birth control.
- Privacy: No one can tell whether you’re using an IUD (not even a sexual partner), so it’s completely discreet.
Drawbacks of using IUDs include:
- Appointment required: Only a medical provider can insert or remove an IUD.
- No STI protection: You’ll still need to use a condom to protect against sexually transmitted infections.
- Side effects: Some women experience cramping, pain, dizziness, or irregular bleeding shortly after having an IUD placed.
- Possible complications: In rare cases, women might develop a pelvic infection after getting an IUD.
Popular Misconceptions About IUDs
Here’s the truth behind some of the most common IUD myths:
- Myth: IUDs aren’t for young women or women who haven’t given birth. Truth: All women of reproductive age can use IUDs safely.
- Myth: Getting an IUD inserted is very painful. Truth: Women experience different levels of discomfort when having an IUD placed; some get severe cramps while others feel very little pain. If you’re concerned about pain, you can talk to your medical provider about ways to minimize your discomfort.
- Myth: IUDs are expensive. Truth: The device can be fairly expensive, but insurance usually covers most or all of the cost. People without insurance can inquire about Liletta, which is a more affordable IUD option.
- Myth: The IUD can cause infertility. Truth: There is no increased risk of infertility when using an IUD.
Who Should Not Use an IUD
The IUD isn’t a good fit for everyone. Healthcare providers do not recommend it for women who are pregnant or who have:
- A higher risk for STIs
- A recent history of or current pelvic infection
- Abnormal Pap tests
- Cervical or uterine cancer
- A very large or very small uterus
If you’re interested in long-lasting birth control, consider using an IUD. With two types of IUDs and five brands from which to choose, you’ll have plenty of options.