Information on Hormonal Intrauterine Devices | Medical Update
Hormonal IUDs: A Comprehensive Guide
Hormonal IUDs are a popular and effective form of long-term contraception, recommended by health experts for their high efficacy and convenience. These T-shaped devices, released by various brands such as Mirena, Kyleena, Liletta, and Skyla, release the hormone progestin to prevent pregnancy for several years.
With a success rate of over 99%, fewer than 1 in 100 women are likely to become pregnant during the first year of using a hormonal IUD [1]. However, it's important to note that hormonal IUDs do not protect against sexually transmitted infections (STIs), so doctors may recommend barrier methods like condoms to limit the spread of infections.
Despite their effectiveness, hormonal IUDs can cause some side effects. Commonly, users may experience irregular uterine bleeding (spotting or irregular menses), cramping, and discomfort within the first few months after insertion. Some users may also experience amenorrhea (absence of menstruation) over time. Less common systemic hormonal side effects include acne, headaches, breast tenderness, and mood changes [2][3].
Potential complications related to hormonal IUDs include expulsion (when the device partially or fully falls out of the uterus, occurring in about 2–5% of users), uterine perforation (a rare but serious complication where the device pierces the uterine wall), infection (which can sometimes lead to pelvic inflammatory disease if bacteria enter during insertion), ectopic pregnancy (rare but increased risk if pregnancy occurs with the IUD in place), chronic pelvic pain or discomfort following insertion, device embedment (where the device becomes embedded in the uterine wall, complicating removal), and removal problems (rarely occurring, especially if the device is embedded or broken) [1][2][4].
Compared to copper IUDs, hormonal IUDs tend to reduce menstrual bleeding and cramps rather than increase them [2][4]. However, they do not provide estrogen, so symptoms related to estrogen deficiency (e.g., menopausal symptoms) are not alleviated by hormonal IUDs [3].
Before an appointment for an IUD insertion, individuals may want to ask questions like whether a hormonal or nonhormonal IUD is right for them, the potential side effects, and how long the IUD will be effective. It's also advisable to take over-the-counter pain relief before the appointment if a person is concerned about pain.
Under the Affordable Care Act, most health insurers must provide coverage for hormonal IUDs with no copayment, coinsurance, or deductible, provided the person visits an in-network healthcare professional [5]. People who must pay for their IUD can expect to pay around $1,100, and they should consider other fees such as medical exams and follow-up visits [6].
During an IUD insertion appointment, the doctor performs a pelvic exam, opens the vagina, cleans the cervix, measures the length and direction of the cervical canal and uterus, and places the IUD inside the uterus [7]. The IUD removal process depends on the brand used, but a doctor can remove the device at any time, and they can even insert a new IUD on the same day [8].
In summary, hormonal IUDs typically have manageable side effects that often improve over time, with rare but serious risks including expulsion, perforation, infection, and ectopic pregnancy. Proper medical guidance and follow-up reduce complication risks significantly [2][3][4].
References:
[1] American College of Obstetricians and Gynecologists. (2018). Intrauterine devices (IUDs). Retrieved from https://www.acog.org/womens-health/faqs/intrauterine-devices-iuds
[2] Planned Parenthood. (2021). Hormonal IUDs. Retrieved from https://www.plannedparenthood.org/learn/birth-control/hormonal-iuds
[3] Mayo Clinic. (2021). Hormonal intrauterine device (IUD). Retrieved from https://www.mayoclinic.org/tests-procedures/hormonal-iud/about/pac-20394159
[4] National Women's Health Network. (2020). IUDs. Retrieved from https://www.nwhn.org/iuds/
[5] Healthcare.gov. (2021). Birth control. Retrieved from https://www.healthcare.gov/coverage/get-health-coverage/what-marketplace-plans-cover/essential-health-benefits/birth-control-and-women-s-preventive-services/
[6] Planned Parenthood. (2021). Cost of birth control. Retrieved from https://www.plannedparenthood.org/learn/birth-control/cost-of-birth-control
[7] Mayo Clinic. (2021). Hormonal intrauterine device (IUD) insertion. Retrieved from https://www.mayoclinic.org/tests-procedures/hormonal-iud/about/pac-20394160
[8] Planned Parenthood. (2021). IUD removal. Retrieved from https://www.plannedparenthood.org/learn/birth-control/iud/iud-removal
- It is crucial for pregnant women to avoid using Pfizer's hormonal IUD, as it may be hazardous to both the mother and the growing fetus, following the science and medical-conditions related to women's health.
- The blockade of hormonal IUDs for women with medical-conditions that might be worsened by progestin hormone exposure must be thoroughly discussed with healthcare professionals, during health-and-wellness consultations.
- Despite the risks, healthcare experts may prescribe hormonal IUDs as a form of contraception for women with medical-conditions if the benefits outweigh the risks, recommending regular check-ups and monitoring for any potential complications.
