Although many women use contraceptive pills as a birth control method, some look for alternatives, either because they don’t want to take a large amount of hormones, or because they find it difficult to remember to take the pill every day. That’s where IUDs come in as an option. But do you know what the difference is between the copper IUD and the hormonal IUD?
For many women, intrauterine devices (IUDs) are a very well-accepted alternative when it comes to birth control.
What is an IUD?
An IUD is a T-shaped device that is inserted into a woman’s uterus. The IUD can be coated with copper (copper IUD) or hormones (Mirena, hormonal IUD). This is already the first difference between the copper IUD and the hormonal IUD.
Both have the same function: to prevent the egg from being fertilized and the embryo from implanting in the uterus, thus preventing pregnancy. However, the IUD is not a barrier method (which prevents the sperm and egg from meeting), it works in a broader way, changing the conditions in the uterus.
Depending on the type, an IUD can prevent pregnancy for up to 10 years, but in some other countries there are devices with shorter duration, such as those lasting 3 years.
The price of hormonal devices ranges from R$ 700 to R$ 1,200, a relatively high cost compared to oral contraceptives. However, if you do the math for what is spent on birth control pills over five years, this amount is not very different.
Moreover, you won’t have to worry about the IUD while it’s in place. This is another difference between the copper IUD and the hormonal IUD: the cost to have it inserted.
How Does the Hormonal IUD Work?
Once placed in the uterus, this type of IUD slowly releases small amounts of the hormone Levonorgestrel to prevent sperm from reaching the egg.
Similar to hormonal birth control pills, the hormonal IUD can also prevent ovulation or the release of an egg from the ovary.
The hormones also thicken the cervical mucus to stop sperm from swimming to the egg, and thin the uterine lining to prevent a fertilized egg from implanting.
Besides preventing pregnancy, the hormonal IUD can also decrease menstrual flow and reduce cramps. The Mirena device can even cause menstruation to stop altogether. Menstruation.
Side Effects of the Hormonal IUD
During the first 3 to 6 months after IUD insertion, menstrual cycles are likely to be unpredictable. The hormonal IUD may also cause side effects similar to those from birth control pills, such as:
- Breast pain and tenderness (mastalgia)
- Headaches
- Nausea
- Fluid retention
- Spotting between cycles
- Mood changes
- Weight gain
- Acne
- Ovarian cysts
How Does the Copper IUD Work?
Copper IUDs are chosen by many women seeking a non-hormonal contraceptive solution. It offers an effectiveness rate over 98%—some data even point to a failure rate of just 0.6%.
It is a small plastic device wrapped in copper. Its price ranges from R$ 100 to R$ 300.00. Once in place, it works for up to 10 years.
Women may experience heavier bleeding and more cramping during the menstrual cycles following copper IUD insertion, but everything is expected to normalize a few months after IUD placement.
Side Effects of the Copper IUD
Other side effects of the copper IUD may include:
- Anemia
- Back pain
- Spotting between cycles
- Vaginal discharge
- Pain during sex
Similarities Between the Types of IUDs
Both copper and hormonal IUDs prevent pregnancy by affecting sperm movement. They prevent sperm from meeting the egg.
Both types of IUDs are equally effective. Fewer than one in every 100 women using either the copper or hormonal IUD correctly will get pregnant.
Although each IUD type offers protection for a different length of time, they can be removed at any moment. Removal is always an option if a woman decides she wants to get pregnant, or is unhappy with the side effects.
Main Difference Between Copper and Hormonal IUD
The main difference between the two types of IUD is that one type releases hormones and the other does not. In addition to blocking sperm from reaching the egg, the hormonal IUD thickens cervical mucus, thins the uterine lining, and prevents ovulation.
Another difference is duration of use. The copper IUD can last between 5 and 10 years; Mirena, 5 years. Mirena is considered more effective, as it resembles a tubal ligation. The copper IUD begins to work immediately after insertion, while the hormonal device (Mirena) may take a few weeks to become fully effective. Therefore, it is important to use a condom during intercourse until the doctor confirms everything is in place.
Does Not Prevent Sexually Transmitted Diseases
Additionally, the IUD only prevents pregnancy—it does not protect against sexually transmitted diseases. For this reason, barrier contraceptive methods such as condoms are recommended while using an IUD, to protect against diseases such as AIDS or gonorrhea, for example.
The hormonal IUD makes menstrual cycles lighter, with less cramping and even decreasing or completely stopping menstrual flow. The copper IUD can cause increased menstrual flow and more cramps than usual.
Risk Factors
The IUD is generally safe, but is not always recommended for all women. Some examples include:
- Pregnant or postpartum women
- Women taking medications (immunosuppressors, systemic corticosteroids, or anticoagulants)
- Women with chronic anemia (including Thalassemia and Sickle Cell Disease)
- Women with active or recurrent pelvic inflammatory disease (in the case of a single event, the situation should be evaluated)
- Women with Wilson’s Disease (a condition that causes copper to accumulate in the body)
- Women with unexplained bleeding or blood loss
- Women with sexually transmitted infections (STIs)
- Women who suffer from menorrhagia (heavy menstrual bleeding)
- Women with uterine fibroids that distort the shape of the uterine cavity and/or uterine malformations
- Women with cervical or endometrial cancer
- Women with cervicitis
- Women with breast cancer
- Women who have been menopausal for one year (the IUD should be removed after this period)
The copper IUD may increase the risk of pelvic inflammatory disease (PID). Because it contains copper, women allergic to copper should not use this type of device.
What to Expect During and After IUD Insertion
IUD insertion is typically straightforward. Although many women feel some discomfort, fewer than 5% experience moderate to severe pain.
Vasovagal reactions—such as sweating, vomiting, or brief fainting—and cervical lacerations occur in at most 1% of women. Generally, these problems are short-lived and rarely require immediate IUD removal.
They also do not affect the IUD’s ongoing performance. Women who have never given birth, or have done so infrequently, or whose last delivery was a long time ago, are most likely to experience these problems. A pain reliever can help reduce this discomfort.
The IUD has an attached string. This string helps the woman check that the device is in the correct position. It also helps the doctor remove it when necessary. After IUD insertion, women may have temporary side effects, such as:
- Cramps similar to menstrual cramps
- Back pain
- Heavier than usual bleeding
- Spotting between cycles
- Irregular cycles
More serious side effects are rare, but may include:
- Pelvic inflammatory disease (PID)
- IUD displacement
- IUD expulsion
- Perforation of the uterine wall
Before choosing any type of IUD or any other contraceptive method, it’s important to talk to a gynecologist to learn about the risks and benefits of each option. That’s why it’s so important to know more about the difference between the copper IUD and the hormonal IUD before making your decision.
It’s also important to consider the cost, convenience, and side effects when choosing. If a woman tries this method and decides it’s not a good fit, removal is possible at any time.
There are numerous birth control options available, and your doctor can help you determine which one is best for you.
See also: Injectable Birth Control – More Benefits or Disadvantages?
Photos: Sarahmirk
