Types of IUD & how they work

IUD types explained

IUDs are small T-shaped devices that are inserted inside the uterus in order to prevent pregnancy. Let’s dig a little deeper into the individual types of IUDs, including what they’re made of and how they work.

Hormonal IUDs: How they work

Made of plastic, the hormonal IUD contains a synthetic version of the hormone progesterone. This is released into the body and prevents pregnancy both by stopping ovulation and thickening cervical mucus. 

Benefits

• It’s long-acting: Depending on the brand of hormonal IUD, you can use it for up to eight years
• It’s more than 99% effective at preventing pregnancy
• IUDs are safe and easy to use (once inserted, you don’t need to do anything)
• It can make your periods much lighter or stop all together

Drawbacks

• It’s invasive: You need a healthcare professional to insert and remove an IUD
• You may find it uncomfortable or painful getting the IUD fitted, and there may be some cramping after
• Some people will experience side effects from the hormones in the IUD
• It does not protect against sexually transmitted infections (STIs)

Side effects of hormonal IUDs

Like all hormonal birth control methods, there are a number of side effects associated with the hormonal IUD. For most people, these will go away within the first few months of using the device, but others may find they continue. Side effects for this type of IUD include:

• Cramping and bleeding after fitting
• Irregular bleeding or spotting 
• Headaches
• Breast tenderness
• Acne 
• Mood changes

Copper IUDs: How they work

Like the hormonal IUD, the copper IUD is a T-shaped device that sits inside the uterus. It’s made of copper (a type of soft metal). The copper in the device prevents pregnancy in several ways: by thickening cervical mucus so sperm can’t reach the female egg cell and by stopping implantation of a fertilized egg cell.

Benefits

• It’s highly effective: More than 99% effective at preventing pregnancy
• It’s long-acting: Copper IUDs can prevent pregnancy for as long as twelve years
• It’s hormone-free, so it's a good option for those who want to avoid hormonal contraception
• Can be used as emergency birth control if inserted up to five days after unprotected sex

Drawbacks

• It’s invasive: You need a healthcare professional to insert and remove your copper IUD
• You may find it uncomfortable getting the IUD fitted, and there may be some cramping during and after this process
• It can make periods heavier and longer and may also cause worse period cramps
• Does not protect against STIs

Side effects of copper IUDs

Since the copper IUD doesn’t contain hormones, it doesn’t have the same negative side effects that are common with the hormonal IUD. However, there are still a few side effects, including:

• Cramping and bleeding after the device is fitted
• Irregular bleeding 
• Heavier periods
• Longer periods
• Increased menstrual cramps 

Copper IUD vs. hormonal IUD

Now we’ve unpacked these methods, let’s take a look at both IUD types side-by-side. 

What do they have in common?

• They are both invasive: Both types of IUD need to be inserted and removed by a healthcare professional – what it feels like to get an IUD fitted varies from person to person, but you may feel some pain or discomfort
• They are highly effective: Both types of IUD are more than 99% effective at preventing pregnancy 
• They are safe to use: There are very few risks associated with IUDs, and they are generally considered a safe birth control method
• They can’t protect you against STIs: Neither IUD type protects against sexually transmitted infections such as HIV, chlamydia, or gonorrhea 

How are they different?

• They last for different lengths of time: How long a hormonal IUD works for varies between brands, but copper IUDs last the longest and can be used for up to twelve years
• They work differently: The hormonal IUD uses synthetic hormones to prevent pregnancy, while the copper in the non-hormonal IUD prevents pregnancy
• They affect your period differently: You’re more likely to experience lighter or no bleeding with the hormonal IUD, whereas the copper IUD can cause heavier periods
• They have different side effects: Hormonal IUDs may cause side effects such as mood changes and breast tenderness, while with the copper IUD, you’re more likely to have more painful periods 

How to choose between types of IUD

Still undecided about which type of IUD to pick? Here’s a few things to consider:

What’s my goal? 

It’s worth thinking about your future as well as your current needs when you’re considering switching birth control methods. Do you want to prevent pregnancy for as long as possible? Then perhaps a copper IUD is a more suitable option for you. If you only want to prevent pregnancy for a couple of years, then a hormonal IUD might be a better fit.

The good news is that research shows that getting pregnant after IUD removal happens quickly for most people. However, if you want to get pregnant in the near future, then getting an IUD fitted may not be your best option, as you will need to get it removed before you can start trying for a baby. 

What’s my medical history?

If you’ve suffered before from hormonal birth control side effects from methods such as the hormonal implant, mini-pill, or birth control shot, it’s possible you may also have negative side effects on the hormonal IUD, and may prefer to try the non-hormonal option of a copper IUD. 

On the other hand, some people prefer to take hormonal birth control as it helps alleviate PMS symptoms such as mood swings, and in some cases, hormonal birth control can be prescribed for conditions such as PMDD (premenstrual dysphoric disorder), a severe form of PMS.

If you have or recently had breast cancer or cervical cancer, then the hormonal IUD may not be an option for you. The same goes if you have a history of arterial disease, heart disease, or stroke. Talk to your healthcare professional to learn more about what type of IUD will best suit you and your medical history.

What am I comfortable with? 

Personal preference is important when it comes to considering your birth control method. If the idea of having metal inside your uterus makes you uncomfortable, then a copper IUD may not be your best birth control option. On the other hand, some people may not like the idea of hormonal birth control and, therefore, opt for the hormone-free copper option.

Are you more comfortable with having heavier periods or no periods at all? Depending on the device you pick, your menstrual bleeding may be affected. Keep in mind that if you already struggle with heavy and painful periods, you may want to avoid the copper IUD. However, some people find getting their period regularly reassuring, and there’s a risk of irregular bleeding with the hormonal IUD, while others get no period on this method at all. 

The importance of birth control options

Both types of IUDs are valuable because they are two different birth control options that will suit different groups of people. At Natural Cycles, we’re passionate about contraceptive choice and want you to have all the facts when you consider what birth control will work best for you and your body. 

If you’ve read this article and still don’t think you’ve found the right birth control yet, why not find out if Natural Cycles could work for you? It’s the first FDA Cleared birth control app – non-hormonal and non-invasive – based on the science of your unique menstrual cycle.