The intrauterine device (IUD) is a safe, effective and reversible long-term contraception option. Currently, there are two IUD products on the market – Mirena (a progestin-releasing IUD) and ParaGard (a plastic T-shaped device partially wrapped in copper wire). In addition to providing women with a viable option for family planning, these products offer a number of underreported benefits, including protection against disease.
The Truth About IUDs
During the 1960s to 1980s, a number of studies showed high risks associated with IUD use. However, many of these studies were found to carry numerous biases that led to inflated statistics. Unfortunately, many of the myths perpetuated by these studies are still in circulation.
IUDs are not only for women who have completed their childbearing
IUDs are completely reversible, and, therefore provide a viable contraception option for those women who believe they may want to have children at some point in the future as well as those who think they have completed their childbearing. There is, however, a greater risk of IUD expulsion in women who have not given birth.1
IUDs do not increase the risk for pelvic inflammatory disease (PID)
Current research suggests that after the first month of use, IUDs do not increase the risk of pelvic inflammatory disease (PID).2 The first month carries an increased risk of PID due to the possibility of introducing bacteria into the upper genital tract during insertion. However, Mirena acts to thicken cervical mucus and suppress or reduce endometrial bleeding and may offer some protection against an already low risk of PID.3
IUDs do not increase the risk of sexually transmitted infections (STIs)
Unfortunately, STIs are a risk of sexual activity, regardless of contraceptive choice. But, contrary to some information, IUD use does not increase the risk of contracting a STI. If, however, a woman has a cervical STI when an IUD is inserted, complications can result and lead to upper genital tract infections, including PID. Patients should talk to their healthcare providers to learn more about the ways they can reduce their risk of contracting STIs, including limiting sexual partners.
IUDs do not increase the risk of ectopic pregnancy
Like all contraceptive methods, including tubal ligation, the use of IUDs reduces the risk of ectopic pregnancy.4
Benefits of IUDs
In addition to providing women with a safe and effective means of family planning Mirena and ParaGard offer a number of other benefits.
Mirena Provides Relief for Women Suffering from Excessive Bleeding
Using Mirena can reduce excessive menstrual bleeding. In fact, women who use Mirena have reported that their bleeding diminished from seven to two days during the first year of usage.5 Women with heavy menstrual blood loss often resort to hysterectomy. Two separate studies found 80 percent and 64 percent of women with scheduled hysterectomies cancelled their procedures after trying Mirena.6 For post-menopausal women, Mirena has been shown to be more effective than oral progestins and with no systemic side effects.7
ParaGard May Protect Against Cancer and Other Illnesses
Numerous studies show that copper devices like ParaGard may offer protection against endometrial cancer.8
Mirena Reduces Blood Loss Caused by Uterine Fibroids
Mirena has been shown to reduce blood loss caused by uterine fibroids. This is encouraging news for women whose severe blood loss leads to anemia. In one study, only one out of 19 women diagnosed with anemia at the insertion of Mirena still had this condition after one year of use.9
Mirena and ParaGard Provide Viable Options for Women Whose Health Conditions Limit Other Forms of Hormonal Contraceptives.
Some health conditions, including venous thromboembolism, severe dyslipidemia, liver disease, estrogen-dependent tumors, or poorly controlled hypertension prevent women from being able to use other forms of contraceptives. IUDs provide a viable option for these women.10 Unlike oral contraceptives, injectables, and patches, ParaGard does not alter a woman’s natural hormonal pattern and thus does not produce hormonal side effects. While some women may experience increased menstrual blood loss and occasional pelvic pain with ParaGard, their hormonal activity remains unchanged. Mirena's low-level of hormones reduces hormonal side effects in women, making it a viable option for women who should not or cannot use hormonal contraceptives.
Mirena and ParaGard Are More Cost-Effective than Other Forms of Contraceptives
Some women find the cost of an IUD insertion (average cost is $345) daunting. But, since Mirena can be used for up to five years and ParaGard for up to 10 years, the initial investment is cost-wise after just two years of use. Research published in 2003, found Mirena and ParaGard to be the least expensive reversible contraceptives over a 5-year period.11
1 World Health Organization. Improving access to quality care in family planning: Medical Eligibility Criteria for Contraceptive Use 2 nd Edition. 1996.
2 Fortney, Judith A., PhD., et. al. "Intrauterine Devices: The Optimal Long-Term Contraception Method?" The Journal of Reproductive Medicine. Vol. 44 No.3. March 1999: 269-273.
3 Grimes, David A. "Intrauterine device and upper-genital-tract infection." The Lancet. Vol 356. September 16, 2000: 1013-1019.
4 Dardano, Kristin L., M.D. and Ronald T. Burkman, MD. "The intrauterine contraception device: An often-forgotten and maligned method of contraception." American Journal of Obstetrics and Gynecology. Volume 181 Number 1. July 1999: 1-5.
5 Hubacher, David, PhD and David A. Grimes, MD. "Noncontraceptive Health Benefits of Intrauterine Devices: A Systematic Review." Obstetrical and Gynecological Survey. Volume 57, Number 2. Feb. 2002: 120-128.
6 Fortney, Judith A., PhD., et. al. "Intrauterine Devices: The Optimal Long-Term Contraception Method?" The Journal of Reproductive Medicine. Vol. 44 No.3. March 1999: 269-273.
7 Hubacher, David, PhD and David A. Grimes, MD. "Noncontraceptive Health Benefits of Intrauterine Devices: A Systematic Review." Obstetrical and Gynecological Survey. Volume 57, Number 2. Feb. 2002: 120-128.
8 Rivera R, Best, K. "Current Opinion: Consensus Statement on intrauterine contraception." Contraception Volume 65. 2002: 385-388.
9 Dardano, Kristin L., M.D. and Ronald T. Burkman, MD. "The intrauterine contraception device: An often-forgotten and maligned method of contraception." American Journal of Obstetrics and Gynecology. Volume 181 Number 1. July 1999: 1-5
10 Grigorieva V, Chen-Mok M, Tarasova M, Mikhailov A. "Use of a levonorgestrel-releasing intrauterine system to treat bleeding related to uterine leiomyomas." Fertility and Sterility 2003; 79 (5): 1194-98.
11 Chiou CF, Trussell J, Reyes E, Knight K, Wallace J, Udani J, Oda K, Borenstein J. "Economic analysis of contraceptives for women." Contraception. Volume 68 Number 1. July 2003: 3-10.