Table of ContentsView AllTable of ContentsIUDs and PregnancyIUD EffectivenessManaging Certain ConditionsWhat Causes a Failure?How They WorkHow Long Your IUD LastsComplicationsWho Should Avoid ThemAlternative Options
Table of ContentsView All
View All
Table of Contents
IUDs and Pregnancy
IUD Effectiveness
Managing Certain Conditions
What Causes a Failure?
How They Work
How Long Your IUD Lasts
Complications
Who Should Avoid Them
Alternative Options
For some users, the benefits of IUDs may go beyond birth control. Hormonal IUDs can help reduce common menstrual problems like heavy menstrual bleeding and cramps. They may also offer relief for other conditions, like endometriosis and polycystic ovary syndrome (PCOS).
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IUDs are over 99%effectiveat preventing pregnancy. The low failure rates make IUDs a popular choice among those seeking long-acting reversible contraception (LARC). In the United States, 14% of all contraceptive users between 15 and 44 years old have an IUD.
Once a healthcare provider inserts the T-shaped device into the uterus, it works continuously for three to 10 years, depending on the type.This low-maintenance reliability makes IUDs a top choice for those looking for a reliable, long-term option that doesn’t require daily upkeep like birth control pills. IUDs also eliminate the risk of user error with barrier methods like condoms or diaphragms.
In addition to preventing pregnancy,copper IUDs(Paragard) and two hormonal IUDs (Mirena, Liletta) can double as emergency contraception. If inserted within five days after having unprotected sex, these IUDs can prevent pregnancy with an effectiveness of over 99%, making them one of the most reliable postcoital options available.
IUD Effectiveness Comparison
While both hormonal and copper IUDs are highly effective, there are some slight differences in their function, effectiveness, and how long they last.
There are five intrauterine devices (IUDs) available in the United States. All five IUDs are over 99% effective at preventing pregnancy. The slight variations in failure rates are minimal, and choosing the most suitable IUD depends on how long you want the device to last, whether you hope to gain other benefits from IUD use (e.g., lighter periods), and personal preferences.
Can IUDs Help Manage Certain Conditions?
Beyond contraception, IUDs—particularly hormonal types—offer therapeutic benefits for various reproductive health conditions. By releasing small amounts of progestin, hormonal IUDs may relieve symptoms of several conditions.
Endometriosis
The study found the hormonal IUD significantly decreased menstrual cramps (dysmenorrhea) and pain during intercourse (dyspareunia). Additionally, the size of endometriomas (blood-filled ovarian cysts associated with endometriosis) decreased in some women, and CA 125 levels (inflammation marker in the blood) also dropped.
Heavy Menstrual Bleeding (HMB)
By releasing a steady dose of progestin, hormonal IUDs thin the uterine lining, leading to lighter periods. For some, periods may become so light that they stop altogether, making hormonal IUDs a popular choice for people withheavy menstrual bleeding(HMB).
A study of 105 participants examined the effectiveness of a levonorgestrel-releasing 52-mg IUD in reducing heavy menstrual bleeding.
Polycystic Ovary Syndrome (PCOS)
While IUDs don’t directlytreat polycystic ovary syndrome(PCOS), hormonal IUDs can help manage symptoms like irregular bleeding. PCOS often causes irregular menstrual cycles and spotting (breakthrough bleeding) between periods due to hormonal imbalances.
When the uterine lining isn’t shed regularly during a period, it can thicken over time, increasing the risk of endometrial hyperplasia, a condition in which the lining grows excessively. If left unchecked, hyperplasia can lead to more severe complications, including an elevated risk of endometrial cancer.
Premenstrual Syndrome (PMS)
The effects of hormonal IUDs on people with PMS or PMDD remain unclear due to limited research. Studies have not explicitly focused on people with PMS or PMDD, making it difficult to determine whether hormonal IUDs can help or worsen PMS and PMDD symptoms.
Some women report mood changes with hormonal IUDs, including depressed mood or nervousness, especially during the first six months of use. Still, these side effects appear to be rare, with depression rates as low as 0.2–0.5% in more extensive studies. More research is needed to determine what effects they may have.
While IUDs have a failure rate of less than 1% per year, certain factors can reduce their reliability and cause them to fail. Possible causes of IUD failure include:
Signs and Symptoms of IUD Failure
Signs and symptoms to watch for that can indicate anIUD has fallen outof place and is no longer effective include:
Potential IUD Side Effects
Even when functioning correctly, IUDs can causeside effects, especially in the first few months following IUD placement as the body adjusts to the device. Possible hormonal side effects include:
Possible side effects of copper IUDs include:
Some IUD symptoms can be a sign of an infection or IUD misplacement. See a healthcare provider promptly if you experience any of the following:
How Do IUDs Work?
Hormonal and copper (nonhormonal)IUDs workin different ways to prevent pregnancy, as follows:
Hormonal IUDs
Hormonal IUDs (e.g., Mirena, Kyleena, Liletta, and Skyla) release a synthetic progestin (levonorgestrel) similar to the hormone progesterone the body produces. By releasing a small amount of progestin daily, hormonal IUDs thicken cervical mucus, forming a barrier that blocks sperm from reaching the egg. It also thins the uterine lining, making implantation less likely. In some cases, hormonal IUDs suppress ovulation.
Nonhormonal Copper IUDs
Nonhormonal copper IUDs, such as Paraguard, are wrapped in copper, which has spermicidal properties that make it harder for sperm to move and survive. By making the uterine environment inhospitable to sperm, the copper IUD effectively prevents sperm from fertilizing an egg.
How long an IUD lasts depends on the type (hormonal vs. non-hormonal) and the brand. Here’s how long you can expect an IUD to last:
Regardless of the type, a healthcare provider canremove your IUDat any time before its expiration date if you decide to change your contraception plan or are ready to become pregnant.
Complications Are Rare
IUDs are generally safe and well-tolerated. Most users experience only mild side effects, such as cramping or spotting, especially in the first few months after insertion. Although rare,complicationscan occur, such as:
Who Shouldn’t Use an IUD?
While IUDs are safe and effective for most people, they may not be suitable for everyone. Certain medical conditions or circumstances can increase the risk of complications or IUD failure. You may need to consider alternative contraceptive options if you:
Alternative Contraceptives
If an IUD isn’t the right choice for you, there are many othercontraceptive optionsavailable to fit your lifestyle and preferences. These include:
Summary
IUDs are a highly effective, long-lasting form of contraception with failure rates below 1%. They come in two types: hormonal, which releases progestin to prevent pregnancy, and copper, which is hormone-free and prevents sperm from fertilizing an egg and also works as emergency contraception. Beyond birth control, hormonal IUDs often provide therapeutic benefits for managing symptoms of endometriosis, PCOS, and heavy menstrual bleeding.
Complications, such as expulsion or infection, are rare, making IUDs a safe choice for most. However, they may not be suitable for people with certain medical conditions. Talk to a healthcare provider if you are considering an IUD. They can discuss the options and pros and cons and help decide if this is the right contraceptive method for you.
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