Given that the world is still dealing with the novel coronavirus, one less thing to worry about would be getting pregnant at this time, especially if you are not planning to start a family. A great option would be to consider a long-term contraceptive option, and one of the most popular options would be intrauterine devices.
- What are intrauterine contraceptive devices?
Intrauterine Devices, or IUDs, are made of an inert material and is in a “T” formation in the United States. It is designed to be inserted into the uterus, and is one of the most effective contraceptive methods available for prevention of pregnancy, with over 99% efficacy. These devices have increasingly become more popular over the past two decades, with 23% of all women in the world using them.(1,2) There are multiple other IUD types and shapes in other countries, not described here.
- What are my choices with these devices and how long do they last?
Please note, the following information is applicable only in the United States. There are two major types of IUDs, the Copper IUD or Paragard (lasts up to 10 years), and the hormonal IUD, of which there are four types. The primary hormone in the IUDs is a progesterone called levonorgestrel, and the four types are Skyla (lasts up to 3 years), Kyleena (up to 5 years), Liletta (up to 6 years), and Mirena (up to 5 years). All of these devices are inserted through the cervix into the uterus and are designed to stay from anywhere from 3 years to 10 years depending on the type of device. The Paragard contains no hormones, but has a copper coil, and can last for up to 10 years. These options are also reversible, which means that they can be removed any time before the maximum time limit, and is known to preserve fertility. Once removed, a woman can conceive right away.
- What are some common disadvantages and advantages of the IUDs?
The advantages include convenience, effectiveness, and ease of use. The IUDs are inserted and removed by a physician, which means that there is no action needed to be taken by a person for it to work. There also is no need to remember when to activate it because it works all the time. This feature makes it worry-free and especially suited for people that have erratic schedules, travel often, and are busy and prone to forgetting to take the pills, patch, or ring. It is also great for family planning especially if someone has goals to finish off an educational degree or want to devote to work or another pursuit for a season. With the best effectiveness out of all the contraceptive options (excluding sterilization), it is rare that the IUDs will fail. The disadvantages are that these devices are semi-permanent, and can cause irregular bleeding patterns, can cause more cramps, and can on occasion, migrate and possibly fall out. Most individuals have lighter periods and may not even have any bleeding with the hormonal IUDs. The Copper IUD often can lead to continued menstruation and slightly heavier bleeding at times. Both devices are not useful for secondary benefits, such as for acne or mood regulation. Although uncommon, vaginal and uterine infections can sometimes happen more often with the IUDs in place.
- I’ve never had children – am I still eligible to have one of these devices?
Yes! For those that have never been pregnant, there are smaller devices that are better choices. Particularly, the Skyla and Kyleena are the smallest IUDs out there, and they last 3 and 5 years respectively. There is no evidence to suggest that having an IUD will decrease your chances of becoming pregnant in the future. If someone has had a child already, the Mirena and Paragard are better options for them, as they last for a longer period of time.
- I’m interested! How can I get one?
Unlike the birth control pill, patch, or ring, the IUD is something that can only be ordered by your physician, and it can only be placed by a health care professional. So, for those that are interested, talk to your OBGYN doctor to see which model is right for you. DO NOT attempt to try to insert or remove the device by yourself.
(1) Worldwide use of intrauterine contraception: A review. Buhling KJ, Zite NB, Lotke P, Black K, for the INTRA Writing Group. Contraception. 2014;89(3):162.
(2) ACOG Practice Bulletin Number 187, November 2017. Long-Acting Reversible Contraception: Implants and Intrauterine Devices.
Jennifer E. Cho, MD, FACOG