This Is How Your Period Changes When You Get An IUD
Intrauterine devices, also known as IUDs, are revolutionizing the birth-control game. Doctors or other medical practitioners insert the tiny T-shaped instruments right into uteri of people seeking basically unparalleled protection against pregnancy, which they’ll get: IUDs have efficacy rates over 99 percent. IUD proponents often say that after an IUD is inserted, you can basically forget about it until it’s time for removal (depending on the type you get, that’s between three and ten years later). That’s almost true, but not in every case, because an IUD can actually affect your period in surprising ways. Here, ob/gyns explain what you can expect.
If you get a hormonal IUD
Hormonal IUDs secrete levonorgestrel, a synthetic hormone that thickens the cervical mucus, making it harder for sperm to wriggle their way towards an egg. Levonorgestrel also thins the uterine lining so that if an egg does manage to get fertilized, it has a hard time implanting in the uterus.
The most popular hormonal IUDs are Mirena, a five-year option, and Skyla, a three-year IUD, although a newer version, Liletta can also be used effectively for three years. “[Hormonal IUDs] differ in their sizes and in their indications,” Alyssa Dweck, M.D., assistant clinical professor of obstetrics at Mount Sinai School of Medicine and co-author of V Is For Vagina, tells us. (For transparency’s sake, Dweck is a consultant for Bayer, which manufactures Mirena and Skyla.) Skyla is slightly smaller than other IUDs on the market, so it can be an especially good option for women who haven’t had children and may find IUD insertion more uncomfortable than those who have been through childbirth.
The (very awesome) truth is that hormonal IUDs have a reputation of changing periods for the better, and Mirena is actually FDA-approved to help alleviate heavy periods. “Even in women with normal periods, hormonal IUDs may make them lighter,” board-certified ob/gyn Antonio Pizarro, M.D. says, adding that “with hormonal IUDs, it’s not unexpected for periods to stop altogether.” It’s perfectly safe to skip your period when on the Pill, and that also applies here.
But periods don’t always magically disappear after you get a hormonal IUD. “In some people, hormonal IUDs can cause irregular bleeding for the first three to six months,” says Dweck. And if you had pain-free, basically nonexistent periods on the Pill but are switching to hormonal IUDs, don’t expect your menstruation to stay exactly the same. “Some women do much better on the Pill from a period profile; others do better on an IUD,” says Dweck. Since IUDs and the Pill use different mechanisms to prevent pregnancy (the latter prevents ovulation and is usually a combination of the hormones progestin and estrogen), they may affect your period in different ways. It’s possible that hormonal IUDs can make periods worse over the long-term, but that’s very rare, says Pizarro.
If you get a copper IUD
The copper IUD, which goes by the brand name ParaGard, works by creating a toxic reaction that harms pesky I’m-trying-to-impregnate-you sperm, according to the Mayo Clinic. Like the hormonal versions, it’s a superstar when it comes to preventing pregnancy. But before getting it implanted, it’s good know the potentially annoying affects it can have during that time of the month. “The copper IUD usually causes periods to be heavier, crampier, and longer,” says Dweck. “I wouldn’t really pick this for somebody who already has issues with miserable periods. But for people who have manageable periods, want a 10-year IUD, and cannot or will not use anything hormonal, this can work,” she explains.
“The lining of the uterus is adjusting to the presence of this foreign body, so there can be some degree of inflammation or maybe mild tissue damage that’s being corrected over a period of months,” says Pizarro. That’s why doctors often recommend sticking it out until at least six months or so, although no judgment if you can’t take it for that long.
For some people, this effect goes away after some months, and for others, it persists. “If a patient said an IUD messed up their period for five or six months, then it straightened out, I’d say that’s an expected outcome that doesn’t worry me,” says Pizarro. But if you’ve always had really light, reasonable periods, the copper IUD’s effects on it may still be manageable for you, even if the changes stick around for years.
Overall, keep in mind that these changes don’t happen for every single person who gets an IUD.
Your best course of action is to talk to a medical professional who knows your history with menstruation. Together, you can come up with a plan that works for you.