Some women are afraid of using an IUD because of pelvic infections that developed in the 1970s . Those problems have been resolved. Pharmaceutical companies have discovered they can put a progestin hormone into an IUD, so there are now more IUD products available.
Some women worry about the possibility of a perforated uterus with an IUD. The UK released this Drug Safety Update in 2015 about the risks: The most important risk factors for uterine perforation are insertion during lactation and insertion in the 36 weeks after giving birth. The IUDs studies included both copper and hormonal. Here are the results from the Drug Safety Update study on women as to perforation risk:
The American Congress of Obstetricians and Gynecologists reports this study on Uterine Perforation Rates for Levonorgestrel and Copper IUDs
The study involved more than 61,000 women from 6 countries—Germany, Austria, United Kingdom, Finland, Poland, and Sweden—who were new users of an IUD and was inclusive of repeat users of an IUD. Approximately 70% of the women used an LNG IUD and 30% used a copper IUD.
At 12 months, 92.9% of women with a LNG IUD and 87.5% of women with a copper IUD still had the device. Also at 12 months, 61 cases of uterine perforation occurred in the LNG IUD group and 20 cases occurred in the copper IUD group. First-time users had higher expulsion rates than repeat users.
Of the 81 women with uterine perforation, 64 women had risk factors for perforation, including breastfeeding (n=35), prostaglandin use before insertion (n=7), and previous use of general anesthesia (n=15). Based on these data, there is no clinically relevant difference in risk of uterine perforation between users of the LNG IUD and users of the copper IUD, with both groups having a relative risk hovering around 1/1,000 insertions.
However, there were notable differences in failure rates and ectopic pregnancy rates, said Heinemann. Unintended pregnancy occurred in 26 women with the LNG IUD and 92 women with the copper IUD, and ectopic pregnancy occurred in 7 women with the LNG IUD and 14 women with the copper IUD. He pointed out that although there were fewer users of the copper IUD (30% vs 70%), this group had more than 3 times the number of unintended pregnancies and double the number of ectopic pregnancies than the LNG IUD group.
Copper T intrauterine device (IUD) —This IUD is a small device that is shaped in the form of a “T.” Your doctor places it inside the uterus to prevent pregnancy. It can stay in your uterus for up to 10 years. Typical use failure rate: 0.8%.
What are the benefits of using the Copper T IUD? (Info below from Association of Reproductive Health Professionals.)
- This is a highly effective type of birth control.
- The Copper T IUD does not contain hormones or interact with medicines.
- You don’t have to think about birth control every day or every time you have sex.
- If you decide you want to get pregnant, you can have the IUD easily removed at any time. The IUD is quickly reversible, which means that its effects on your body go away as soon as it is removed and your fertility returns back to normal.
- Because one IUD can be used for so long, it is actually one of the least expensive methods of birth control.
Levonorgestrel intrauterine system (LNG IUD)—The LNG IUD is a small T-shaped device like the Copper T IUD. It is placed inside the uterus by a doctor. It releases a small amount of progestin each day to keep you from getting pregnant. The LNG IUD stays in your uterus for up to 5 years. Typical use failure rate: 0.2%.
Three brands of hormonal IUDs are available in the United States: Mirena® , Skyla™, and Liletta®. They all contain a hormone called progestin. They use the same hormone as in many 2nd generation birth control pills (Levonorgestrel)
How does a hormonal IUD work? (Info below is from Association of Reproductive Health Professionals.)
- It blocks sperm from joining with an egg to prevent pregnancy. It does that in several ways:
- The hormone in the IUD keeps ovaries from releasing eggs.
- An IUD thickens mucus in the cervix. That keeps sperm from reaching the uterus and traveling to an ovary to meet an egg.
- An IUD also affects the ability of the sperm to move toward the egg.
- After a hormonal IUD is inserted, it takes about 7 days for it to start working. Be sure to use backup birth control (like a condom) for the first 7 days.
What are the benefits of a hormonal IUD?
- It’s safe, convenient, and very effective.
- It makes your periods lighter. Some women stop getting periods while they’re using a hormonal IUD.
- You won’t have to think about birth control every day or every time you have sex.
- Because one IUD can be used for so long, it’s one of the least expensive methods of birth control.
- If you decide you want to get pregnant, you can have the IUD taken out. It’s a quick and painless process. For most women, fertility is back to normal a few weeks after the IUD is removed.