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IUD Types: How to Choose the Best IUD for You

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If you’re considering an intrauterine device or IUD, you’re in good company. IUDs, which are classified as long-acting reversible contraceptives (LARCs), are one of the most commonly used and effective forms of birth control, according to the Centers for Disease Control and Prevention (CDC). Since you have several IUDs to choose from, you might be wondering: “Which IUD is right for me?”

Currently, two IUD types are available: hormonal and non-hormonal. Both are known for their set-it-and-forget-it practicality, but they work differently to prevent pregnancy. Hormonal IUDs, including Kyleena, Skyla, Mirena, and Liletta, work by releasing the hormone levonorgestrel, a form of progestin. The only non-hormonal IUD option is the copper IUD, or Paragard, which prevents pregnancy by changing the environment in your uterus to make it toxic to sperm (more on this later).

Although more options are always a good thing, especially when it comes to birth control, it can also be overwhelming. And you’ll probably want to do some extra research before making a decision. Thankfully, we’re here to help! Here’s what the experts say you should know and consider when choosing the best IUD for you.

How do IUDs work?

An IUD is a tiny, T-shaped piece of flexible plastic that is inserted into your uterus by a medical provider. We mentioned earlier that the hormonal IUDs—Mirena, Skyla, Kyleena, and Liletta—all work by releasing the hormone levonorgestrel, a form of progestin. Levonorgestrel works by thickening the cervical mucus, which blocks the sperm from meeting up with an egg.1 If a highly motivated sperm (we’re talking Tom Brady-level athleticism and ambition) does make it through, progestin also thins the lining of the uterus making implantation unlikely to occur. 

Paragard, the only non-hormonal IUD, has copper wire coiled around it. That copper produces an inflammatory response in the uterus that’s toxic to sperm, and interferes with its movement, making it nearly impossible to have a meet-and-greet with an egg, according to the American College of Obstetricians and Gynecologists (ACOG).

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What’s the difference between hormonal vs. non-hormonal IUD?

Hormonal and non-hormonal IUDs have a lot in common. For example, they both do an excellent job of preventing pregnancy. They’re both small, T-shaped devices inserted into your uterus, which, by the way, requires a procedure for placement and removal. And neither one protects against sexually transmitted infections (STIs).

The differences, then, come from how each type prevents pregnancy (as we explained above), as well as their various side effects (which we’ll dig into below). The other key difference is how long you can leave the IUD in place. If you want long-lasting contraception, the copper IUD is approved for up to 10 years of use, with some doctors suggesting up to 12 years. In contrast, hormonal IUDs last for three to six years, depending on which one you choose.

There are also a few non-contraceptive benefits to consider for each type. For the copper IUD, that includes a reduced risk of cervical cancer and the ability to use it as emergency contraception. For hormonal IUDs, the list is a bit longer. They can reduce heavy bleeding and anemia, eliminate painful periods, decrease endometriosis-related pain, and also reduce the risk for cervical cancer, uterine cancer, and pelvic inflammatory disease.

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Which type of IUD is more effective in preventing pregnancy?

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IUDs, in general, are very effective in preventing pregnancy. That said, the levonorgestrel-based IUDs (Mirena, Skyla, Kyleena, and Liletta) are the most effective type on the market, Jen Lincoln, MD, an ob-gyn at the Providence St. Vincent Medical Center Family Maternity Center and medical board member at The Body Agency, tells SELF.

“The hormonal IUD is 99.8% effective at preventing pregnancy, which is amazing; however, the copper IUD (Paragard) is a very close runner-up, coming in at 99.2% efficacy,” she says. While there is a slight drop in effectiveness, Dr. Lincoln says they are both fantastic forms of birth control,2 and she wouldn’t let that tiny statistical difference be the thing that makes or breaks your choice between the two.

Source: Self

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