wellness·4 min read

How Do Different Types of IUDs Work? We Asked an OB-GYN

A doctor holding a copper IUD in their palm
Design: theSkimm | Photo: iStock
Sep 20, 2022

This content is for informational and educational purposes only. It does not constitute a medical opinion, medical advice, or diagnosis or treatment of any particular condition. 

If you’re looking for a long-term form of birth control, an intrauterine device (IUD) is one of the safest, most effective options. But before you can “set it and forget it,” you’ll still have to decide whether to get a hormonal or non-hormonal IUD. Which is where things can start to get confusing. So we talked to board-certified OB-GYN Dr. Kristen Venuti to break down how IUDs work and the differences between the two types.

Expert Interviewed

Dr. Kristen Venuti

Dr. Kristen Venuti is a board-certified OB-GYN at Northwestern Medicine.

How does an IUD work?

An IUD is a T-shaped plastic or copper device that’s inserted into the uterus to prevent pregnancy. We won’t lie: IUD insertion can be uncomfortable or painful, but it’s typically a quick procedure. And you can ask your doctor for pain management options. 

Depending on the type, they’re FDA-approved to last from three to 10 years. And they’re more than 99% effective. 

There are two types of IUDs (hormonal and non-hormonal) and multiple brands that all have different shelf lives. Aka how long one can stay in your body before it loses effectiveness. 

Tell me about hormonal IUDS. 

A hormonal IUD, which can be left in for up to eight years — depending on the brand — releases levonorgestrel. It works by thickening cervical mucus to inhibit the sperms' mobility while also thinning the uterine lining. Sometimes, it can slow down the cilia in the fallopian tubes and suppress ovulation.  

Hormonal IUDs can also lighten periods (and occasionally stop them altogether). So if you have heavy, painful periods, a hormonal IUD “can really help with that discomfort,” said Dr. Venuti.

What about non-hormonal IUDs? 

The only non-hormonal IUD (also called the copper IUD) is ParaGard. It’s wrapped in copper, which is toxic to sperm

The copper IUD can be left in for up to 10 years. But note: People who get a copper IUD might experience heavier periods during the first three to six months, said Dr. Venuti, adding that they should eventually return to normal. 

Both the copper and hormonal IUDs can also be used as emergency contraception. But they need to be inserted within five days after unprotected sex. Meaning you’d need to have access to a nearby clinic so a medical provider can see you within that window.

QQ: Do IUDs impact fertility?

Nope, IUDs don’t cause infertility. “They just work locally,” according to Dr. Venuti. So if you want to get pregnant, you can start trying as soon as you get your IUD removed

theSkimm

There are two types of IUDs: Hormonal and non-hormonal. Both are long-acting birth control methods. And can prevent pregnancy for up to 10 years. If you decide to get one, make an appointment with your gyno to discuss which option is right for you. 

This content is for informational and educational purposes only. It does not constitute a medical opinion, medical advice, or diagnosis or treatment of any particular condition. 


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