Cons Of The Hormonal Iud:
Hormonal IUDs can damage the vaginal microbiome and increase the risk of yeast infections and bacterial vaginosis.
Hormonal IUDs suppresses ovulation some of the time.
Hormonal IUDs can cause irregular bleeding and spotting during the first three to six months of use. After that, they may suppress bleeding entirely or permit a light natural menstrual period.
Insertion might be painful. But just to clarify: IUD is an in-office procedure that takes just a few minutesits not surgery. Youll probably be instructed to take a painkiller like ibuprofen to ease the cramping, or your doctor may decide to use a local anesthetic .
Hormonal IUDs can come out. The chance of expulsion is 5 percent but more likely immediately following childbirth and during breastfeeding.
Hormonal IUDs carry a small risk of uterine perforation, which could lead to surgery. The chance of perforation is 0.1 percent but more likely if during breastfeeding.
Hormonal IUDs can cause pelvic inflammatory disease but only during the first three weeks after insertion, and only if you have a pre-existing infection with gonorrhea or chlamydia.
Hormonal IUDs must be removed by a doctor. See my copper IUD post for more information about IUD removal.
Hormonal IUDs cannot protect against sexually transmitted infections.
Can I Get Pregnant After The Iud Is Taken Out
Yes, you will be able to get pregnant as soon as the IUD is taken out.
Pregnancy is very rare with an IUD in place. If you do get pregnant with an IUD in, there is no extra risk for your baby, but there is a risk of complication in the pregnancy. If you think you might be pregnant, talk with your doctor as soon as possible. It is best to remove the IUD.
Even With All Their Benefits Iuds Arent For Everyone Here Are A Few Reasons Why A Different Birth Control May Be Better For You
Maybe you like the sense of control that comes with taking a pill every day or youd prefer a method that you can start or stop at any time . IUDs have been established as safe and effective for most birth control users, but you also need to feel completely comfortable with your birth control method.
Its true that IUDs come with a small risk of expulsion, which is basically when your body starts to push out your IUD. According to the limited research on IUD expulsion, the average incidence rate is between 3 and 5 percent of all IUD users and 5 to 22 percent of adolescent IUD users, says the American Congress of Obstetricians and Gynecologists. But its important to note that this research was done in 2009 and 2010 and only looked at Mirena and ParaGard, not any of the newer options that have been developed over the last several years.
IUDs also come with the risk of perforation, which happens when an IUD pushes through your uterus, although this is even less likely than the chance of expulsion. One study published in the journal Conception in 2015 found that out of 61,448 women who had an IUD, only 81 reported having a perforation.
Technically, you could use an IUD until youre ready to start trying and be just fine, but thats not exactly cost-effective, Dr. Streicher says. IUDs can be expensive if your insurance doesnt cover them.
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Possible Drawbacks Of Iuds
Although you have read positive feedback, using an IUD can have important drawbacks as well. Some women who use the IUD for endometriosis reported quite a few downsides. For example, there were reports of greater pain than expected on insertion and removal, difficulty with the device remaining in place, and increased bleeding or spotting during the first few months of use. Weight gain, depression, nausea, and bloating are all IUD side effects. Serious, although rare, complications include severe infection and perforation of the uterus requiring surgery. In the unlikely event that you do get pregnant with an IUD in place, the likelihood of miscarriage, complications during pregnancy, and an ectopic pregnancy â which can be a life-threatening emergency â is much higher. The mechanism of action of todayâs IUDs is well known and their long-term implications have been observed to be safe over the past 40 years.
Unfortunately, not all women with endometriosis find relief from a hormonal IUD. Some users of MyEndometriosisTeam reported increased pain, heavier bleeding, ejection of the device, and other difficulties.
âI always describe my experience with Mirena as a âmassive life ruiner.â Worst year ever and then had it removed,â said one user.
âI had the worst experience with mine,â explained another user. âI was having pelvic pain so much I was in and out the emergency room just for them to tell me nothing was wrong. I ended up having to get it taken out.â
Other Advantages Of The Hormonal Iud
Also, the hormonal IUD:
- Reduces heavy menstrual bleeding by an average of 90% after the first few months of use.footnote 4
- Reduces menstrual bleeding and cramps and, in many women, eventually causes menstrual periods to stop altogether. In this case, not menstruating is not harmful.
- May effectively relieve endometriosis and is less likely to cause side effects than high-dose progestin.footnote 5
- Reduces the risk of ectopic pregnancy.
- Does not cause weight gain.
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Iud / Iud Side Effects: What They Are And How To Manage Them / The Hormonal Iud Releases A Tiny Amount Of The Hormone Progestin Into Your Body Over Several Years
Pid can cause serious problems such as infertility, ectopic pregnancy or pelvic pain that does not go away. According to the centers for disease control and prevention , copper iuds have a The copper iud doesn’t have hormones. Mirena also treats heavy periods for up to 5 years in women who choose intrauterine contraception. Advise the woman that the iud should be removed as soon as possible.
Who Can Use A Hormonal Iud
- Most women who want a reliable, long-term contraceptive
- Women who haven’t had a pregnancy
- Women who have decided to not have any more children
- Women who would like to space out their pregnancies
- Women who are breastfeeding
You should not use the hormonal IUD if:
- you might be pregnant
- you have a recent infection called pelvic inflammatory disease
- you have unusual bleeding from your vagina
- you have a history of breast cancer or some serious liver conditions
Talk to your doctor before deciding to use a hormonal IUD if you have:
- a recent sexually transmitted infection
- fibroids or other conditions that change the shape of your uterus
- previous problems with an IUD
- you are unable to have a follow-up check-up after the IUD is put in
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How Does The Iud Affect Your Menstrual Cycle
Removing the IUD can affect the return of menstruation and the time it takes to return to your normal menstrual cycle. Your period occurs when the uterine lining dissolves and leaves your body through the vagina. When a hormonal IUD is used, the hormone progestin in the IUD thins the lining of the uterus.
What Are The Disadvantages
- Some people feel pain, cramps or dizziness when the IUD is put in or taken out.
There are some risks from having an IUD put in:
- There is a small risk of infection when an IUD is put in
- There is a very small risk of damage to the uterus
- A copper IUD might give you more bleeding and cramping during your period, but this usually gets better over time
- The copper IUD can cause an allergic reaction, but this is very rare
- The hormonal IUD might give you irregular or light bleeding
- The IUD can sometimes come out by itself . You can check the threads are still in the right place at any time.
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How Do I Use The Hormonal Iud
The hormonal IUD is inserted inside the uterus by a trained doctor or nurse. You can choose to have a local anaesthetic or sedation while it is inserted. The IUD insertion takes around 15 minutes but you will be in the clinic for an hour or more. See below for a video about IUDs and how to help prepare for and manage pain from an IUD insertion.
The IUD has a fine nylon string attached to it which comes out through the cervix . The string cannot be seen and it does not hang out of the vagina. If you feel high up inside your vagina, you can check that the string is there and know the IUD is still in place. It is good to do this every month. If the string feels like it is shorter or longer than normal or you cannot feel the string at all, the IUD may have shifted and you should see a doctor or nurse.
Can The Iud Cause Any Serious Health Problems
In about 1 in 500 users, a small hole in the wall of the uterus may be created while the IUD is being inserted. The IUD can move through the hole and sit in the wrong place. If this happens, keyhole surgery is required to have the IUD removed.
Around 1 in 300 users get an infection when the IUD is first inserted. This can be successfully treated with antibiotics.
It is very unlikely to get pregnant when using an IUD. If you do get pregnant with an IUD in place, there is a higher chance of ectopic pregnancy. This means that the pregnancy may settle in the fallopian tubes . This should be medically assessed urgently and treated as required.
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Is There Anything You Can Start At The Same Time To Minimize Your Risk Of Acne Flare
Prescription medication for acne, like spironolactone and Accutane, can be safely taken alongside an IUD.
You shouldnt dismiss the importance of a good skin care routine.
Start with the basics, says Green. A cleanser to clean the skin and remove all traces of makeup and bacteria.
Acne-prone types should opt for a gel-based cleanser.
After cleansing, apply a toner to open the pores and allow other products to fully absorb, she adds.
Formulas containing salicylic or glycolic acid are best for people prone to acne.
Follow this up with a lightweight moisturizer that replenishes the skin and hydrates your skin cells, says Green.
The final step is skin-protecting sunscreen.
Once youve got the basics down, you can begin to add in other products, like exfoliators and serums.
Pregnancy In Women With An Iud In Place
The risk of ectopic pregnancy is higher in women who become pregnant with an IUD in place, compared with women who do not have an IUD 71). However, because IUDs are highly effective at preventing pregnancy, ectopic pregnancies occur less often in IUD users than in women using other methods of contraception or no contraception 72).
Once pregnancy is confirmed in a woman with an IUD, ectopic pregnancy should be excluded and the IUD removed 73). If the strings are not visible, ultrasonography can be used to confirm whether the IUD is present in the uterus. Invasive procedures, such as hysteroscopy, are not recommended for IUD removal during pregnancy 74). Patients who become pregnant with an IUD in place should be informed that there is a substantial risk of pregnancy loss even when the IUD is removed. One study found that among 89 women who became pregnant with an IUD in place and desired pregnancy continuation, 40% had spontaneous abortion following IUD removal 75). IUD removal is recommended because pregnancy loss and complications are less likely if the IUD is removed than if it is left in place. Later pregnancy complications, including placental abruption, placenta previa, preterm delivery, low birth weight, chorioamnionitis, and need for cesarean delivery, are also more likely in women who become pregnant with an IUD in place 76).
Women At Risk Of Sexually Transmitted Infection
A history of sexually transmitted infection does not preclude IUD insertion 64). In a study of patients in an urban university clinic, IUDs were used safely in women with a history of STI, and the incidence of STI in these women decreased following IUD insertion 65). However, clinicians should screen patients following Centers for Disease Control and Prevention guidelines for all women 66). For women with a known STI, it is recommended that IUD insertion be delayed for at least three months after resolution of the infection. Women should also be rescreened for STI three to six months after treatment 67).
If a woman does not have a known STI or active signs or symptoms of a genital tract STI, it is safe to screen for STI on the same day as IUD placement, although the rate of pelvic inflammatory disease will be slightly increased if it turns out that an STI was present at the time of IUD insertion 68). The prescribing information for the hormonal IUDs states that it is usually appropriate to remove an IUD if an STI is diagnosed however, the USMEC guidelines state that in a patient who tests positive for an STI but has no symptoms, antibiotics may be prescribed and, if clinically appropriate, the IUD may be left in place 69), 70).
Using An Ius After Giving Birth
An IUS can usually be fitted from 4 weeks after giving birth . You’ll need to use alternative contraception after the birth until the IUS is put in.
In some cases, an IUS can be fitted within 48 hours of giving birth. It’s safe to use an IUS when you’re breastfeeding, and it will not affect your milk supply.
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At A Glance: Facts About The Ius
- When inserted correctly, it’s more than 99% effective.
- It can be taken out at any time by a specially trained doctor or nurse. It’s possible to get pregnant straight after it’s removed.
- It can make your periods lighter, shorter or stop altogether, so it may help people who have heavy or painful periods.
- It can be used by people who cannot use combined contraception for example, those who have migraines.
- Once the IUS is in place, you do not have to think about it.
- Some people may experience side effects, such as mood swings, skin problems or breast tenderness.
- There’s a small risk of getting an infection after it’s been fitted.
- It can be uncomfortable when the IUS is put in, but you can take painkillers after, if you need to.
- The IUS can be fitted at any time during your monthly menstrual cycle, as long as you’re not pregnant.
- The IUS does not protect against sexually transmitted infections , so you may need to use condoms as well.
Mirena And Cancer Risk
Many studies have looked at the link between combination birth control pills and the risk of breast cancer. Less research has been done on the breast cancer risks of progestin-only birth control, like the Mirena IUD.
Some research on progestin-only birth control suggests that it doesnt raise your chance of breast cancer. Heres what one large study found:
- Breast cancer risk was slightly higher in the average population than in women ages 40-54 who used IUDs with levonorgestrel. Thats the hormone in Mirena.
- Breast cancer risk was slightly lower in the average population than in women ages 30-39 who used these IUDs.
- Regardless of age, there was no major difference in breast cancer risk between women who used this type of IUD and those who didnt.
- How long women used the IUD did not seem to affect their breast cancer risk.
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Miriah Plawer Md Facog
Miriah Plawer, M.D., F.A.C.O.G. is a Board Certified OB-GYN since 2008 and a Fellow of the American College of Obstetricians and Gynecologists. She is affiliated with hospitals of the NorthShore University Health System . Dr. Plawer graduated from the University of Illinois College of Medicine with honors and completed her OB-GYN residency program at Northwestern University.
Dr. Plawer is certified in the insertion and removal of LARCs . She is also fluent in medical Spanish.
In her spare time, Dr. Plawer enjoys spending time with her family, cooking, reading, traveling, and watching little league baseball. She is currently accepting new patients by calling .
Can The Hormonal Iud Cause Any Serious Health Problems
- In about 1 in 500 users, the doctor or nurse makes a small hole in the wall of the uterus while inserting the IUD. The IUD can move through the hole and sit in the wrong place. You would then need keyhole surgery to have it removed.
- Around 1 in 300 users get an infection when the IUD is first inserted. This is usually successfully treated with antibiotics.
- It is very unlikely you will get pregnant when using the hormonal IUD. If you do get pregnant with a hormonal IUD, there is a higher chance of ectopic pregnancy. This means that the pregnancy may settle in the fallopian tubes .
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Which Iud Do You Have & For How Long
After a discussion with my doctor, I opted for the Mirena IUD. I had it placed in March of 2017 and removed in August 2019 which means I had it for a total of two and a half years. The lifespan of the Mirena is five years, so I had it removed early.
At the time, I was personally advised away from the non hormonal IUD, Paraguard, because my time of the month was already debilitating and this IUD can make them heavier and more frequent. Reflecting now, Id take that over being pumped with synthetic hormones on the reg.
I was also advised to opt for the Mirena over the smaller sister IUD, Skyla , because its more convenient to take out Mirena earlier than it is to to take out Skyla due to expiration and insert a new one.