Types of IUDs: which One is Right for You?

Intrauterine devices (IUDs) are a low-maintenance birth control option. They’re generally better at stopping pregnancy than other forms of birth control, like condoms or pills.

A gynecologist puts the tiny, T-shaped device in your uterus. That’s a doctor who specializes in female reproductive health. There are two types: copper and hormonal. Here’s what you need to know.

Copper IUDs

Coppers IUDs are made of copper and plastic. They don’t have any hormones, but they start warding off pregnancy right away. Copper is a spermicide, something that kills sperm. Sperm meet the IUD before they’re able to reach an egg and fertilize it. Pregnancy can’t happen if there’s no sperm to fertilize your eggs. Copper also makes it hard for fertilized eggs to implant in your uterus.

ParaGard is the only copper IUD available in the United States. Possible side effects of copper IUDs include:

• Bleeding between periods
• Cramps
• Severe menstrual pain and heavy bleeding

Hormonal IUDs

Hormonal IUDs have a hormone called progestin levonorgestrel. They can take up to a week before they prevent pregnancy. Progestin thickens your cervical mucus and thins the lining around your uterus. This stops sperm from reaching and fertilizing eggs. The hormone can also stop ovulation. That’s when one of your ovaries release an egg.

Kyleena, Liletta, Mirena, and Skyla are the four leading brands of hormonal IUDs.

If you decide to get a hormonal IUD, you might have these side effects as your body gets used to the hormone:

• Headaches
Acne
• Weight gain
• Breast tenderness
• Irregular bleeding, which can improve after 6 months
• Changes in your mood
• Cramping and pelvic pain

What’s the Same

Even though copper and hormonal IUDs are made of different things, they’re alike in some ways. These include:

Effectiveness. Both copper and hormonal are more than 99% effective. Copper IUDs are 99.2% effective, while hormonal IUDs are successful 99.8% of the time. The chance of you getting pregnant is less than 1%.

Safety. IUDs are safe to use. Only an estimated 1 in 1,000 women have complications.

They don’t protect you from sexually transmitted diseases (STDs). You’ll need to wear a condom even if you have an IUD.

You can get it taken out at any time. You can have copper and hormonal IUDs removed whenever you’re ready.

What’s Different

There are two main differences between copper and hormonal IUDs. These are:

How long they last. Copper IUDs can stop pregnancy for up to 10 years. Hormonal IUDs only work 3-5 years, depending on the type and brand.

How they affect your period. You may have heavier bleeding, severe menstrual pain, and cramps if you get a copper IUD. You might even notice some bleeding in between periods. Hormonal IUDs typically ease menstrual pain and heavy bleeding. They may even stop ovulation and your period altogether.

How to Choose

Your doctor can help you decide which IUD is better for you. Here are a few things to think about:

Your goals. Avoiding pregnancy is usually the main one. You may want to try a hormonal IUD if you’re looking to ease period pain. Copper might be the way to go if you want to keep the IUD in as long as possible.

Cost. A copper IUD costs a little more than $1,200 without insurance. Hormonal IUDs are a little more than $1,500. If you have health insurance, most companies will pay for some or all of the costs.

Comfort. You may feel better about more hormones in your body than you do metal, or the other way around. You may prefer a specific brand. Talk to your doctor about what you’re OK with before you choose an IUD.

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