By Christina Justice
IUDs (intrauterine devices) are becoming more and more popular for women in the United States according to Planned Parenthood. There are hormonal IUDs (Mirena, Liletta, Skyla, and Kyleena) and also a non-hormonal or copper IUD (ParaGuard). IUDs are ranked among the best forms of birth control with an effectiveness of 99% along with hormonal arm implants and permanent sterilization. An IUD is considered a long-acting reversible contraceptive, or LARC, because these methods can last anywhere from 3-12 years and can be removed anytime to regain fertility ("Long-Acting Reversible Contraception (LARC): IUD and Implant," 2016; "Planned Parenthood Federation of America Inc.," 2016).
One of the most popular traits of the IUD is the one time office procedure for insertion. This means the IUD is not something that women have to remember to take everyday, every month, or even every year. This takes away the possibility of user error and increases effectiveness ("Long-Acting Reversible Contraception (LARC): IUD and Implant," 2016). The convenience of the IUD is one reason this method is becoming so popular. Other benefits include cost effectiveness, discretion, and hormonal IUDs can decrease the symptoms of the menstrual cycle or eliminate the cycle entirely. In populations where LARC methods are promoted and used there is a significant decrease in negative health outcomes such as unintended pregnancy, teenage pregnancy, sexually transmitted infections (STIs), and abortion rates (Ricketts, Klingler, & Schwalberg, 2014).
Just like any other form of medication, there can be negative side effects associated with IUDs. Some people may experience pain during insertion, bleeding and spotting for an extended period of time after insertion, irregular bleeding and spotting, weight gain, acne, mood changes, or PID (pelvic inflammatory disease). To clarify this, the IUD itself does not cause PID, but bacteria can be introduced during insertion that can cause the infection. Even though non-hormonal IUDs can offer individuals an effective form of birth control without hormones, this option can cause an increase in negative side effects of menstrual cycles. If pregnancy does occur, the chances of an ectopic pregnancy (pregnancy outside of the uterus) increase. Individuals need to discuss all options with a knowledgeable health care provider to find a birth control method that is the best fit for them. Many of these side effects are rare, but can be very serious if experienced ("IUD," 2017; "Mirena," 2017).
For people with a blood clotting disorder such as Leiden factor V, estrogen-based birth control is not an option. Estrogen-based birth control methods can increase the chances of developing blood clots throughout the body. Hormonal IUDs do not use estrogen, but instead they use small amounts of progestin. The amount of progestin that is used in contraception has not been proven to increase the risk of DVT (deep vein thrombosis) or pulmonary embolism (blood clot in the lungs) ("HIGHLIGHTS OF PRESCRIBING INFORMATION," 2017). The hormonal and non-hormonal IUDs offer a safe and very effective form of birth control for women who are at a predisposed risk for developing blood clots. Even if someone has a condition that prohibits them from using any form of hormones or just chooses to use hormone free methods, the non-hormonal IUD is always an option. The copper IUD offers effective and convenient birth control alongside the hormonal methods.
If you are interested in any of these options or wish to discuss them further, please see your health care provider to find the option that fits you best. You can also visit https://www.plannedparenthood.org/learn/birth-control or https://www.bedsider.org/methods for more information.
HIGHLIGHTS OF PRESCRIBING INFORMATION. (2017). from https://labeling.bayerhealthcare.com/html/products/pi/Mirena_PI.pdf IUD. (2017). Birth Control. from https://http://www.plannedparenthood.org/learn/birth-control/iud Long-Acting Reversible Contraception (LARC): IUD and Implant. (2016). http://www.acog.org/Patients/FAQs/Long-Acting-Reversible-Contraception-LARC-IUD-and-Implant Mirena. (2017). from https://http://www.mirena-us.com/?ecid=mirena:re:de:tl:othd:0:7800&WHGRedir=1 - globalFooter Planned Parenthood Federation of America Inc. (2016). from https://http://www.plannedparenthood.org/ Ricketts, S., Klingler, G., & Schwalberg, R. (2014). Game change in Colorado: Widespread use of long‐acting reversible contraceptives and rapid decline in births among young, low‐income women. Perspectives on Sexual and Reproductive Health, 46(3), 125-132. doi: 10.1363/46e1714