IUD Intrauterine Device
IUD | Intrauterine devices are small devices placed inside the uterus to prevent pregnancy. They are a long-term and highly effective birth control method. The failure rate after one year of use varies between 0.1% and 2.2% depending on the type of IUD used. When compared to tubal ligation in terms of effectiveness, the failure rate after one year is 0.8% for copper, while this rate is 0.05% for tubal ligation, which is very similar in terms of one-year safe protection. There are two types of IUDs: copper and hormonal (Mirena, Kyleena, Liletta, and Skyla).
Copper Spiral
IUD | It is a small plastic device with copper rings wrapped around the copper IUD. It does not contain hormones. It provides birth control for the patient for a period of approximately 10-12 years. In addition to birth control, it is a successful method as an emergency contraceptive method if applied within the first five days of unprotected intercourse. It is more effective in emergency contraception than hormonal methods (morning after pills). It works by preventing the sperm from reaching the egg with a foreign body reaction. In addition, fertility quickly returns to its previous level after removal.
What are the Side Effects of Copper Spiral?
IUD | Although the copper IUD is an effective method of birth control, some women may experience various side effects while using this method. These side effects usually occur after the IUD is inserted, and some may decrease over time. However, for some women, the side effects can be permanent or lead to serious complications. Here are the common side effects that can be associated with copper use:
Expulsion: In some patients, copper can be expelled from the uterus on its own. This risk is lower with TCu380A copper. In case of abnormal discharge, abdominal pain-cramping, pain during intercourse, severe pain during menstruation, spotting in the middle period between two menstruations, spotting after intercourse, definitely see your doctor for a check-up. Magnetic resonance imaging (MRI) can cause copper displacement. It is useful to have your doctor check the location of your IUD after having an MRI.
Uterine perforation: Very rarely, perforation can occur in the uterus while it is inserted into the uterus. This risk is closely related to the experience of the person inserting it. If it is inserted by an experienced doctor, this risk is less than 1 in 1000.
Increased Menstrual Bleeding and Severe Pain: Many women who use copper experience an increase in the amount of bleeding during their menstrual cycle. An increase of 20-50% can be observed in the average amount of bleeding during menstruation. In addition, menstrual pains can also be more severe. This may be due to the irritation caused by copper on the inner surface of the uterus. In some women, this complaint may return to normal after 3-6 months. In some women, spotting may be observed in the first 3-6 months after insertion.
Changes in Vaginal Discharge: After copper use, an increase or changes in vaginal discharge may be observed. This may increase the risk of intrauterine inflammation or infection.
Infections: Infection may be observed within the first 21 days after copper insertion. Although this is rare, having an infection such as chlamydia or gonorrhea in the patient during insertion increases this risk. If it is inserted correctly and with attention to sterility, the device itself does not carry a risk of infection.
Other Possible Side Effects: Some women may also experience other side effects associated with copper use. These side effects may include back pain, headache, nausea, pain during intercourse, or intrauterine bleeding.
IUD | Most of these side effects are mild or moderate and can be reduced or treated over time. However, women should consult a healthcare professional if they experience any discomfort or serious side effects while using copper.
Does Copper IUD Stop Menstruation?
IUD | The effect of the copper IUD on the menstrual cycle may vary from woman to woman, and it should be noted that it does not clearly interrupt the menstrual cycle. Here are the effects of copper on the menstrual cycle:
Increase or Decrease in the Amount and Duration of Menstruation: Some women who use copper have reported that the amount and duration of menstrual bleeding has increased or decreased. This may be due to its effect on the inner surface of the uterus and may vary depending on the person’s body structure.
Changes in Menstrual Pain: With the use of copper, some women may observe that the severity of menstrual pain has increased or decreased. The irritation it causes in the uterus may increase menstrual pain, but for some women, the pain may ease when the menstrual cycle is regulated.
Irregular Menstrual Cycles: After the use of copper, some women may report that their menstrual cycles have become irregular or that they experience intermenstrual bleeding. This may be due to the fact that it affects the hormonal balance in the uterus.
Changes in Premenstrual Syndrome: With the use of copper, some women may experience changes in the symptoms of premenstrual syndrome (PMS). Symptoms such as headache, mood swings, bloating and tenderness may increase or decrease with use.
IUD | The effects of copper on the menstrual cycle vary from person to person and depend on many factors. Therefore, changes in the menstrual cycle are normal when used. However, if symptoms such as excessive bleeding, severe pain or irregularities in menstruation are experienced, a healthcare professional should be consulted.
Who cannot have a copper IUD?
IUD | It cannot be used in patients who are pregnant or considering pregnancy, have a sexually transmitted disease, have a history of pelvic infection in the past 3 months, have malignant gestational trophoplastic disease, have abnormal uterine bleeding – cervical cancer – uterine cancer or have a history of septic pregnancy – miscarriage. Not having given birth is not an obstacle. The IUD can also be used safely in young and nulliparous women.
Hormonal IUD
IUD | Hormonal, like the copper IUD, is a device used for birth control, but it has a different working mechanism and mode of action. In addition to being used for hormonal birth control, it can also be preferred in the treatment of endometriosis, chronic pelvic pain, adenomyosis, and endometrial hyperplasia in order to reduce heavy menstrual bleeding. Thanks to its ability to reduce bleeding, it is also useful in correcting anemia in the patient. Different features of hormonal copper:
Hormone Content: Hormonal IUD contains a progesterone-derived hormone, often levonorgestrel. This hormone thins the mucosa in the uterus, prevents the passage of sperm and stops ovulation. In this way, it prevents pregnancy. Copper, on the other hand, prevents the movement of sperm by containing copper in the uterus and prevents the fertilized egg from attaching to the uterus.
Effects on Menstrual Bleeding and Pain: Hormonal IUD offers additional advantages such as reducing menstrual bleeding and relieving menstrual pain. Some women report that their menstrual cycles are lighter and more regular when they use hormones. This may be related to the progesterone hormone it contains thinning the mucosa in the uterus and therefore decreasing menstrual bleeding.
Duration of Use: Hormonal IUD can be used for 3 to 8 years. The failure rate after one year of use is as low as 0.1-0.2%.
Extra Hormonal Side Effects: Hormonal use may trigger hormonal side effects in some women. These may include headaches, weight changes, acne and mood swings. These side effects may be caused by the progesterone hormone it contains.
Pre-Use Assessment: Before using hormonal, a healthcare professional usually evaluates the woman’s health history and current condition. Some health conditions may prevent hormonal use or increase risks.
IUD | Hormonal has different advantages and disadvantages compared to copper. Since every woman’s birth control needs are different, a healthcare professional should be consulted to determine which IUD is more suitable.
Who Cannot Get Hormonal IUDs?
IUD | Although hormonal IUDs are an effective birth control method, they are not recommended or appropriate in some cases. Here are the situations where hormonal IUDs should not be used:
History of Breast Cancer: Hormonal IUDs may increase the risk of breast cancer due to the progesterone hormone they contain. Therefore, hormonal IUDs are generally not recommended for women with a history of breast cancer.
History of Uterine Cancer: Hormonal IUDs may increase the risk of uterine cancer. Hormonal IUDs are generally not recommended for women with a history of uterine cancer.
Active Sexually Transmitted Infections (STIs): Active sexually transmitted infections can increase the risk of infection of an IUD placed inside the uterus. Therefore, hormonal IUDs are not recommended for women with a history of STIs.
Intrauterine Infections: Hormonal IUDs are not recommended for women with an active intrauterine infection. Intrauterine infections can increase the risk of infection and can lead to serious complications.
Previous Pelvic Inflammatory Disease (PID): Hormonal IUDs are not recommended for women with a history of pelvic inflammatory disease. PID can increase the risk of an infection that is placed inside the uterus and can lead to serious complications.
IUD | Situations where hormonal contraceptives should not be used generally include situations where the hormones contained in the IUD or the risk of infection are increased. Therefore, it is important to talk to a healthcare professional before using hormonal contraceptives. A healthcare professional will help determine the most appropriate birth control method by evaluating the person’s health history.
Assoc. Prof. Dr. Esra ÖZBAŞLI’s Views on Copper and Hormone IUD
IUD | Assoc. Prof. Dr. Esra ÖZBAŞLI is a gynecologist specializing in contraception and has extensive experience in birth control methods. Here are Dr. Özbaşlı’s views on the copper and hormonal IUD:
Advantages and Disadvantages of the Copper IUD: Dr. Özbaşlı has positive views on the effectiveness and long-term use of the copper IUD. She states that it is a natural method with copper and does not contain hormones. In addition, she emphasizes that copper is suitable as a long-term birth control method and does not require any daily medication or application by the user. However, Dr. Özbaşlı states that some women may experience side effects such as increased menstrual bleeding and pain associated with the use of copper, and therefore recommends that you discuss the advantages and disadvantages in detail with your doctor before deciding on copper, whether it is a suitable method for you.
Advantages and Disadvantages of Hormonal IUD: Stating that hormonal IUD has advantages such as reducing menstrual bleeding, relieving menstrual pain and thus providing benefits in the treatment of anemia, Dr. Özbaşlı emphasizes that it is an effective hormonal birth control method that does not affect the person’s ability to conceive when removed. However, Dr. Özbaşlı states that hormonal side effects that may be associated with hormonal use may be disturbing for some women and therefore it is not suitable for every hormonal woman. He emphasizes that it is necessary to decide whether this IUD is suitable for you by discussing it in detail with your doctor.
Deciding Which IUD is More Suitable: Dr. Özbaşlı states that certain factors should be taken into consideration when deciding which IUD is more suitable for the individual. These factors include the woman’s health history, menstrual cycle, amount of menstrual bleeding, desire for pregnancy, hormonal sensitivities and personal preferences. Dr. Özbaşlı emphasizes that women should evaluate these factors by consulting a health professional and determine the right birth control method.
IUD | Dr. Özbaşlı’s views help women make informed decisions when choosing the right birth control method and help them find the option that best suits their personal needs.
