Birth control has always been a very important point of consideration for women. It gives them the freedom and comfort to enjoy life without the stress and worry about accidental pregnancies. The women choose birth control methods to avoid the risk of getting pregnant without having their partners worry much.
The choice of birth control often depends on different factors such as your health, when do you and your partner want children, and how often do you engage in sexual activity. An IUD is a very common contraceptive used by women. An Intrauterine Device or IUD is a t-shaped device that can be inserted into the uterus to avoid pregnancy. It is one of the long-acting reversible birth control methods.
In simple words, this means that women can use this contraceptive for an extended period. They can easily remove it when they want to get pregnant and make the birth control reversible. IUDs are safe for use and once removed, the body becomes fertile for reproduction again.
There are 5 different types of IUDs that are FDA approved in the United States – Skyla, Liletta, ParaGard, Kyleena, and Mirena.
IUDs are inserted into the uterus by a doctor, and they can last from 3 to 10 years, depending on the brand. These devices usually do not have any side-effects. However, there can be a slight risk of ectopic pregnancy or pelvic infection. If the IUD falls out, then a woman can get pregnant if the device is not re-inserted back. Most IUDs except ParaGard releases a hormone – Levonorgestrel. ParaGard is hormone-free, and its functionality is because it is constructed from copper.
Types of IUDs
IUDs are 99% effective in avoiding the risk of pregnancy. This is higher than compared to other contraceptive options like condoms and birth control pills. The pills are 91% effective, while condoms are only 85% effective.
IUDs look the same as all of them are T-shaped. A hormonal IUD contains hormones inside. A copper one can have copper parts or copper balls inside the IUD. They are inserted into the uterus through the cervix and have a string that protrudes into the vagina.
The insertion of the device can be a different experience for every woman. For women who have had children, insertion can be like a minor annoyance. But for some, it can be difficult as dilators will be needed to open up the cervix. It is usually pain-free and a simple procedure to have one inserted.
As discussed above, there are two kinds of IUDs – hormonal and non-hormonal. Hormonal IUDs are Skyla, Kyleena, Mirena, and Liletta. They have different levels of the hormone levonorgestrel inside it and release different quantities.
Hormonal IUDs act as contraceptives by releasing progesterone. The brands that use hormones differ in size and the level of hormone released and the duration. Kyleena and Skyla measure 28×30 mm while Liletta and Mirena measure 32×32 mm.
The main motive is to ensure that the sperm is uninhabitable inside the uterus. It can also make the endometrial lining thin and may impair egg implantation. Because of the thin lining, the woman may experience very light or no menstrual bleeding.
As such, these devices can also treat heavy menses once pathological causes are ruled out. The hormone released acts locally and releases a certain level of progesterone.
- Active Ingredients – The active ingredients in Skyla, Kyleena, Mirena, and Liletta is levonorgestrel.
- Dose – Each IUD has different levels of the hormone. Mirena and Liletta have 52 mg, Skyla has 13.5 mg, and Skyla has 19.5 mg.
- Work – The synthetic progesterone is released into the system daily. The hormone thickens the vaginal mucus and makes the uterine lining thin. The ovaries are also prevented from releasing an egg. All these actions prevent sperm from attaching themselves to an egg.
Side Effects of Hormonal IUDs
Mirena and Liletta users experience very light or no periods at all due to the thinning of the uterine lining. Other side effects include mood swings, nausea, cysts, and breakthrough bleeding. The effects are lesser for IUDs with a lower dosage of levonorgestrel.
Each IUD has different periods of use. Mirena, Liletta, and Kyleena last for five years, while Skyla lasts for three years. After the time period expires, the IUDs need to be taken out and replaced.
- Who can use?
Mirena can be used by women who experience heavy bleeding. Liletta is best for those who have no health insurance, or the insurance does not cover any IUDs. Kyleena is best for women who want regular periods along with protection. Skylar allows women to have periods. It is also best for women with tight cervix and also those who have not had any children in the past.
- Who should avoid?
Women who do not react well to synthetic hormones or prone to ovarian cysts should avoid using Mirena. Also, all the hormone IUDs do not last long as a copper IUD.
Non-hormonal IUDs are made of copper, or they can be inert. An inert device does not have any bioactive component and is made of inert materials such as plastic or stainless steel.
The stainless steel ring is made of steel coils that can be inserted into the uterus. The plastic IUDs like Lippes Loop can also be inserted into the uterus where it takes a trapezoidal shape. The main objective or mechanism remains the same. Making an inhospitable environment for sperm or the implantation of an embryo.
Such IUDs have higher rates of pregnancy prevention after fertilization. Inert IUDs have not been approved to be used in the United States, but other countries have been using it.
Copper IUDs are T-shaped, and the arms hold the device at the right place. This device damages the sperm and affects the motility, ensuring that they do not get to the egg. Copper is a spermicide, and the increased copper ions in the uterus can negatively affect the viability and motility of the sperm.
ParaGard is wrapped in copper, causing an inflammatory response in the body. The inflammation stops sperms, and even if some swimmers do make it, they are destroyed by the copper element. It either does not allow the sperm to move through or destroys it in the process. Below are more details about the non-hormonal IUD – ParaGard.
- Active Ingredients – Copper
- Dose – There are no hormones and no doses.
- Work – The copper in the device acts as a spermicide. The sperm viability and motility are negatively impacted, ensuring no egg fertilization.
Side Effects of Non-hormonal IUDs
Copper leads to inflammation which blocks sperms. However, it can also increase the flow, duration, and bleeding during the menstrual cycle.
As per the FDA, ParaGard lasts for 10 years, but research says it can be useful for 12 years. Consult with your doctor to decide on the period of use.
- Who can use?
Women who want a long-lasting option in contraception but want to avoid synthetic hormones may choose this IUD. Women who have light to normal flow can use this.
- Who should avoid?
Woke who feel cramps and have a heavy flow may not like this as copper IUDs can lead to heavy bleeding and a longer duration of the menstrual cycle.
Important: One significant advantage is that it can be emergency contraception even after five days post unprotected sex. There are no hormones involved, so even breastfeeding women can use it.
IUDs in the market have different features and sizes. In order to determine the best option for a woman, a consultation with a medical practitioner (obstetrician-gynecologist) is important. They vary in terms of size and dosage. A woman and her medical history need to be considered before deciding on the best IUD for birth control.
Similarities in All IUDs
An IUD is a convenient method of birth control. There is no intake of pills required, which might be problematic if you forget to take them or are on antibiotics. There is also no need for a condom every time you want to get intimate with a partner.
As mentioned above, there are two types of IUDs. Hormonal and Non-Hormonal. They function differently, but there are quite a few similarities between all of them. Both IUD types are similar in shape. They are T-shaped devices that are inserted into the uterus through the cervix. The procedure to insert the device is also the same.
One appointment with the doctor and the device can be added. Sometimes a woman might need a dilator, but that applies to any type of IUD.
Both IUD types stop sperm movement and prevent pregnancies. The sperm is stopped from meeting the egg, which can then become an embryo. All of them are highly effective birth control methods on their own.
If you remove the IUD, then your fertility can be back to normal, and women can get pregnant. Most can be used and kept in the uterus for a good number of years. There are a few brands that have a life of three years, but most have it from 5-10 years.
For those years, the users can be free from the stress of an unwanted pregnancy. One can remove IUD anytime. Women who are not satisfied with the side effects or may want to have children again can go to the doctor for the removal, even before the expiry date.
IUDs have a lower risk of side effects, but there is always a risk of the device falling out, although this is not common. If an IUD falls out, then the woman can get pregnant again unless it replaced immediately, or, begin using an alternative birth control method. There is also an increased risk of ectopic pregnancy. An ectopic pregnancy is not viable and can be life-threatening if the fallopian tube gets ruptured.
Both IUDs work well and have been ranked high on the effective methods list for birth control. You can prevent pregnancy without tying tubes which may be a non-reversible procedure. IUDs are a good option if the woman does not want to completely forget the idea of having children biologically while using birth control that is very effective.
Anyone can use an IUD, even women who have not had any children yet. This method is not a final stop as women can remove IUD any time they want to plan pregnancy. All IUDs are safe for women who cannot take other forms of birth control due to some personal medical issues or medical history.
Most IUDs are affordable and are quite reasonable in the long run. Not to mention you do not have to constantly keep a tab like you need to do with pills. However, one must note that although IUDs are effective in controlling pregnancies. They do not protect you from sexually transmitted diseases.
Differences Between IUD Types
The main difference between the two broadly classified IUD types is that one is hormonal and the other non-hormonal. One uses hormones to prevent pregnancy while the other uses metal as a spermicide. Hormonal IUDs make the cervical mucus thick, prevent ovulation and thin out the uterine lining.
A hormonal IUD is coated with a substance or membrane that controls the hormone release. The hormones will thicken the mucus in the cervix, and the uterus environment is not conducive for the sperm. It also thins the endometrial lining, but this is not the usual function of the IUD.
A non-hormonal or copper IUD increases the prostaglandins, white blood cells, and copper ion levels in tubal and uterine fluids. Copper IUDs draw responses from the human body, as a foreign object. The inflammatory response stops the sperm from reaching the egg, preventing the creation of an embryo.
Copper ions, along with the cervical mucus, make spermicide that kills sperm. It also stops sperm from moving fast to get to the egg, thus preventing fertilization. Some research also suggests that copper is harmful to eggs and sperm, meaning that it can avoid fertilization and pregnancy.
How are the Hormonal IUDs different?
Hormonal IUDs work with synthetic hormones being released into the woman’s body. Because of the hormone changes, women often get very light periods or none at all. Some common side effects could be nausea and mood swings. Various brands offer hormonal IUDs. They are different from each other, even though they all use levonorgestrel.
Mirena has been in use for the longest period of time. Originally approved for only those women who had children, now it can be used by all. It releases around 20 micrograms of the hormone every day for five years and then 14 mcg every day after that. Medical practitioners very commonly recommend it for painful and heavy periods. It also helps in reducing the pain and bleeding caused by endometriosis or fibroids. Periods become very light or do not come at all for many women who use Mirena. Some research suggests that it can be used for up to 6 years.
Liletta IUD is very much like Mirena, having almost the same daily dosage that of a synthetic hormone. It releases 19.5 mcg daily and is approved for use up to 3 years, but some researchers suggest that it can be used up to five years. It is explicitly approved to be used by women who have not had children yet. Liletta is an affordable brand in the market, especially for those where insurance does not cover IUDs.
Skyla is slightly smaller in size than Mirena and has a lower dose of hormones. This IUD releases 14 mcg daily, lasting up to 3 years. Most Skyla users found that although it makes periods lighter, they do not go away for good. Because of its small size, Skyla can be inserted without much discomfort to the woman.
The same size as Skyla, Kyleena IUD releases a higher dose of the hormone – 17.5 mcg daily. It lasts up to 5 years, and a few women will experience no periods after one year of use.
How are the Non-Hormonal IUDs different?
Non-hormonal IUDs include ParaGard that has copper in it. A copper filament is wrapped around the device, which helps in the production of copper ions. It is a good emergency contraceptive, and you can consider it within five days of unprotected sex.
ParaGard users have heavier and longer periods, specifically during the first six months of use. After that, they tend to regulate. Women who are anaemic or have heavy and unregulated periods are advised against this. They can go for hormonal IUDs after discussing it with a doctor.
An IUD is quite an effective birth control method. It is easy to use and requires only a one-time inserting procedure. After that, you do not have to take any supplementing actions. You can have some peace of mind that you have an effective birth control device that will prevent any unwanted pregnancy.
IUDs are as effective as permanent methods such as vasectomy or tubectomy. But the issue with this is it cannot be reversed. IUDs, on the other hand, can be removed and let a woman get pregnant.