IUDs: Copper vs. Hormonal

November 07, 2009

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IUDs: Copper vs. Hormonal

by Marjorie Greenfield, M.D.
reviewed and revised by Marjorie Greenfield, M.D.

Intrauterine devices are currently available in two forms in the United States: the Paraguard, which is a copper-containing IUD, and the Mirena, a hormone-releasing IUD that is advertised as a intrauterine progestin delivery system or IUS. The effectiveness rates listed below for both types are only possible with perfect use, meaning that the device is correctly in place, with its tail (or string) hanging just outside the opening of the cervix. Those IUD users who rarely or never check (and might have had an unrecognized expulsion of the IUD) may have a slightly higher pregnancy risk than those who follow all the instructions.

Remember that pregnancy rates in a year are determined by subtracting the effectiveness rate from 100; so, for instance, the risk of getting pregnant while using the Paraguard would be less than 1 percent over the course of a year.

Copper-containing IUD: 99.5 percent effective
This IUD is effective for a remarkable 10 years after insertion. It often leads to heavier periods than before and additional or more severe cramps, but the majority of users have normal cycles on the IUD and often are thrilled with the "no muss, no fuss" aspects of its use.

While the device itself and the insertion costs can be fairly high, medical insurance may help cover it. And if you average out the cost over 10 years, it turns out to be one of the least expensive methods of birth control available. The presence of copper has a toxic effect on the sperm and egg, thus making the Paraguard a bit more effective than older IUDs without this element. This copper has not been shown to have negative effects on the user.

Advantages:

very long-lasting contraception

highly effective

doesn't require a lot of attention on the user's part

inexpensive if used long-term.

Disadvantages:

short-term use is costly

may cause heavier or more painful menstrual periods

doesn't prevent sexually transmitted infections

The progestin IUS: 99+% percent effective
This IUD is impregnated (if you'll pardon the term) a type of female hormone used in many contraceptives. The system releases a small amount of the progestin into the uterus, rendering it inhospitable for sperm and egg alike. The Mirena lasts for five years, making it slightly more expensive overall than its copper-containing cousin. However, because of progestin's localized effects on the uterine lining, most women using the Progestasert have lighter, pain-free periods, and many lose their periods altogether.

Advantages:

lighter periods than with other IUDs

doesn't require a lot of attention on the user's part

provides some of the benefits of hormonal contraception, like lighter periods, with very low levels of the hormone in the bloodstream (since the effects are local

Disadvantages:

irregular bleeding is common during the first few months

short-term use is costly

doesn't prevent sexually transmitted infections


RELATED INFORMATION

			Home Pregnancy Tests
			The Events of Conception
			Birth Control

Created March 19, 2001
Reviewed and revised August 18, 2004

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