The Different Types of IUD's
Here’s a secret you may not know about doctors: female doctors use IUDs 2-5 times more often than women who aren’t doctors. Maybe it’s because doctors know the intrauterine device (IUD) is safe, low-maintenance, and super-effective.
There are two* different types of intrauterine devices (IUDs): Mirena and ParaGard. You may have heard about these two options in the media, but, fancy TV commercials aside, what’s the difference between them and is one of them right for you?
They’re different in some important ways:
A Mirena prevents pregnancy by releasing a very small amount of a hormone called progesterone each day. This progesterone acts locally in the uterus to prevent pregnancy, instead of going throughout your whole body, the way the pill or some other hormonal methods do. The Mirena also contains no estrogen, so it has fewer hormonal side effects than a typical Pill.
Many women who start using the Mirena IUD have irregular bleeding for 3-6 months. This bleeding is usually more like spotting—light and not painful. But you may not be able to predict your periods for the first several months, so wear black underwear!
The good news about the Mirena? Once you get through the first 6 months, your periods usually stop altogether or are regular, light, short and not painful. If not having a period every month would make you sick to your stomach worrying that you’re pregnant, you might prefer a ParaGard.
Most women who use ParaGard have heavier, longer, or crampier periods, especially for the first few months. After 6 months, many women’s periods return to normal. If you already have really heavy or uncomfortable periods, or you are anemic (too little iron in your blood), you might prefer a Mirena.
A ParaGard prevents pregnancy thanks to a tiny copper filament wrapped around the T. ParaGard contains no hormones of any kind—it’s the only super-effective non-hormonal birth control method around.
Still, the two IUDs have a lot in common:
They work. Really, really well. Both IUDs are ranked among the most effective birth control methods you could use, up there with having your tubes tied.
They’re safe. Pretty much anyone who wants to prevent pregnancy for a year or more could use an IUD. Editor's note: We should say more explicitly that "pretty much anyone" DOES include women who have never had a baby. Our article IUDs are A-OK will tell you more about how IUDs are safe for most women—whether they've had a baby or not.
They’re small. They’re both shaped like a T, and the T itself is about as thick as a tampon string. The whole thing is smaller than an iPod Shuffle.
They are affordable. IUDs are covered by many insurers, and you may be able to get a free IUD if you go to a family planning clinic. If you have to pay for an IUD up-front, it can seem expensive. But if you use it for at least a year, it is actually cheaper than most other forms of birth control, and definitely cheaper than having a baby! A clinic may be able to help you pay for an IUD in installments.
They are easy to start using. You can usually have the IUD inserted at your first visit to your doctor. Having an IUD inserted feels similar to having a Pap smear, and takes about 60 seconds total.
An IUD works for a long time, but you can stop using it any time you like. The Mirena (with progesterone) lasts for up to 5 years. The ParaGard (with copper) lasts for up to 12 years.* Whenever you decide to have the IUD removed, you can get pregnant the next month.
They DON’T prevent sexually transmitted infections (just like the pill, patch, ring, and Depo). Condoms are still the only game in town if you want to prevent STIs.
The bottom line? Both methods are safe, effective, and easy to reverse. In a boxing match between ParaGard and Mirena, both would win.
This plastic IUD releases a small amount of the synthetic hormone progestin to help your body keep sperm from reaching your cervix. It lasts up to 5 years and may give you lighter periods.
This IUD is 100% hormone-free and doesn’t alter your periods. It's made of plastic and a small amount of natural, safe copper. It can stay inside you up to 12 years.
This plastic IUD is the smallest one available and has been FDA-approved for women who have not had a child. It releases a small amount of the synthetic hormone progestin to help keep sperm from reaching your cervix. It works for up to 3 years.
THE DIFFERENT TYPES OF IUDS
There are three types of IUDs available. The hormonal IUDs are called Mirena and Skyla; the non-hormonal IUD is called ParaGard. All three types of IUDs are similar in many ways, but there are some key differences between them all.
Skyla was introduced as the third type of IUD in 2013. Marketed for women who have not yet had children, Skyla has a shorter usage time (3 years) than Mirena (5 years) or ParaGard (10 years).
Intrauterine devices (IUDs) come in two different types: 1) copper-releasing, or 2) progesterone-releasing.
- The TCu380A (Paragard) is a copper-containing IUD. It releases copper from a copper wire that is wrapped around the base. The released copper contributes to an inflammatory reaction in the uterus that helps prevent fertilization of the egg. It is approved to remain in place for up to 10 years.
- Levonorgestrel-releasing IUD (Mirena): This form of IUD releases a progestin hormone from the vertical part of the T. Progestin acts to thicken cervical mucus, creating a barrier to sperm, as well as renders the lining of the uterus inhospitable to implantation of a pregnancy. This form of IUD is approved for up to five years of use.
How does an intrauterine device (IUD) work?
It is not fully understood how IUDs work. They are thought to prevent conception by causing a brief localized inflammation that begins about 24 hours after insertion. This causes an inflammatory reaction inside the uterus that attracts white blood cells. The white blood cells produce substances that are toxic or poisonous to sperm. The progesterone-releasing IUDs also cause a subtle change in the endometrial environment that impairs the implantation of the egg in the uterine wall. This type of IUD also alters the cervical mucus, which, in turn, inhibits sperm from passing through the cervix.
IUDs are only available by prescription and must be properly inserted by a healthcare professional. A pelvic exam is required to insert an IUD. The IUD is inserted into the uterus long as she is not pregnant.
The woman must check her IUD every month to be sure that it is still in place. Sometimes, the uterus expels (pushes out) the IUD. Expulsions may not cause any specific symptoms and can be overlooked. In addition to the woman checking the IUD, the device must also be checked periodically by a healthcare professional.
Types of IUDs
- Hormonal IUD. The hormonal IUD, such as Mirena or Skyla, releases levonorgestrel, which is a form of the hormone progestin. The hormonal IUD appears to be slightly more effective at preventing pregnancy than the copper IUD. There are two hormonal IUDs—one works for 5 years, and the other works for 3 years.
- Copper IUD. The most commonly used IUD is the copper IUD (such as Paragard). Copper wire is wound around the stem of the T-shaped IUD. The copper IUD can stay in place for up to 10 years and is a highly effective form of contraception.
How it works
Both types of IUD prevent fertilization of the egg by damaging or killing sperm. The IUD also affects the uterine lining (where a fertilized egg would implant and grow).
- Hormonal IUD. This IUD prevents fertilization by damaging or killing sperm and making the mucus in the cervix thick and sticky, so sperm can't get through to the uterus. It also keeps the lining of the uterus (endometrium) from growing very thick.1 This makes the lining a poor place for a fertilized egg to implant and grow. The hormones in this IUD also reduce menstrual bleeding and cramping.