From the Guidelines
Intrauterine devices (IUDs) are a highly effective and recommended form of long-term contraception due to their high efficacy, ease of use, and minimal maintenance requirements. IUDs provide reliable birth control for 3-10 years depending on the type, with failure rates less than 1%, making them more effective than pills, patches, or rings 1. They require no daily attention or regular maintenance once inserted by a healthcare provider during a simple office procedure. Hormonal IUDs (like Mirena, Kyleena, Liletta, or Skyla) release small amounts of progestin locally in the uterus, which can reduce menstrual bleeding and cramps, and may eventually cause periods to stop altogether. The non-hormonal copper IUD (ParaGard) provides hormone-free contraception for people who prefer to avoid synthetic hormones or cannot use them due to medical conditions.
Some of the key benefits of IUDs include:
- High efficacy with failure rates less than 1% 1
- Ease of use with no daily attention or regular maintenance required
- Cost-effectiveness over time despite higher initial costs
- No interference with sexual spontaneity
- Immediate reversibility upon removal when pregnancy is desired
- Reduction of menstrual bleeding and cramps with hormonal IUDs
- Hormone-free contraception option with the copper IUD
IUDs are suitable for a wide range of individuals, including nulliparous adolescents and those with certain medical conditions, such as endometriosis, benign ovarian tumors, and severe dysmenorrhea 1. However, certain conditions, such as current purulent cervicitis, gonorrhea, or chlamydia, and distorted uterine cavity, may be contraindications to IUD placement 1. The most recent and highest quality study recommends IUDs as a safe and effective method of contraception for most individuals, with the advantages generally outweighing the risks 1.
From the Research
Reasons for Using IUD
- IUDs are an effective alternative to oral hormonal contraception, providing long-term contraception mainly by preventing fertilization 2
- They have similar contraceptive efficacy to combined oral contraceptives when used correctly, and are more effective than oral contraception used incorrectly 2
- The use of IUDs is associated with a low rate of pregnancies, with about 6 pregnancies per 1000 woman-years 2
- IUDs can be safely used by most women, including those who are breastfeeding, have diabetes or HIV infection, or are using nonsteroidal anti-inflammatory drugs 2, 3
- The levonorgestrel-releasing IUD is associated with a marked reduction in menstrual blood loss and irregular bleeding, and can be used for emergency contraception 4, 5
- IUDs are a highly effective form of contraception, with a low risk of ectopic pregnancy and other complications 4, 6
Benefits of IUDs
- High effectiveness in preventing pregnancy 2, 4
- Low risk of ectopic pregnancy 2, 4
- Reduced menstrual blood loss and irregular bleeding with the levonorgestrel-releasing IUD 2, 4
- Can be used for emergency contraception 5, 6
- Safe for use in breastfeeding women and those with certain medical conditions 2, 3
Comparison of IUD Types
- The levonorgestrel-releasing IUD is associated with a lower risk of pregnancy and ectopic pregnancy compared to copper IUDs 4
- The copper IUD is a first-line contraceptive method for women with a history of deep venous thrombosis, pulmonary embolism, or coronary events 2
- Both types of IUDs are highly effective, but the levonorgestrel-releasing IUD may have a lower risk of certain complications 4, 5