What Are the Pros and Cons of the Copper IUD?

Deciding to get an IUD can feel like an empowering contraceptive commitment. But you also have a major choice to make: copper IUD or hormonal IUD? Whichever one you choose, these small, T-shaped devices are inserted into your uterus by a medical provider, and they can provide years upon years of extremely effective birth control. But they do work differently. You could opt for a hormonal IUD like Mirena, Skyla, Liletta, or Kyleena, which all use progestin to thin your uterine lining and thicken your cervical mucus, so it’s more difficult for sperm to reach an egg. And then there’s the non-hormonal outlier, the copper IUD.

What makes this one different? The copper IUD, also manufactured under the brand name Paragard, is in a class of contraceptives referred to as LARCs or long-acting reversible contraceptives, Nichole Butler, MD, FACOG, a board-certified ob-gyn for the Women’s Health Center at Weiss Memorial Hospital in Chicago, tells SELF. It’s made of soft, flexible plastic wrapped with a thin layer of copper. Every type of IUD is inserted into your uterus by a medical professional, but the copper IUD is unique in that it prevents pregnancy by changing the environment in your uterus to make it toxic to sperm. In contrast, hormonal IUDs (Mirena, Skyla, Liletta, and Kyleena) use progestin (a synthetic form of the hormone progesterone) to thin the uterine lining and thicken cervical mucus, making it difficult for sperm to reach an egg.

Dr. Butler is a huge fan of the copper IUD because it is non-hormonal and the U.S. Food and Drug Administration (FDA) has approved it for up to 10 years of use after insertion (though, some doctors say it can last up to 12 years). That said, both hormonal and non-hormonal IUDs come with their own list of pleasant and potentially not-so-pleasant side effects, so you must weigh the pros and cons before deciding if the copper IUD is the right form of contraception for you. Here’s what you need to know before you pair up with Paragard.

What are the pros of the copper IUD compared to hormonal IUDs?

Having a device inserted into your vagina (and on into the uterus) gives you plenty of reasons to ask a lot of questions. Your job, with the guidance of your ob-gyn, is to determine if the benefits of the copper IUD outweigh the downsides.

Let’s start with the good stuff: “The major pros of the copper IUD are that it is long-acting, it doesn’t require you to remember to do anything every day, week, or month, and it’s non-hormonal for those who want or need to avoid hormones due to side effects or health concerns,” Kelly Culwell, MD, a board-certified ob-gyn in Sacramento, California, tells SELF.

Not having to remember to take a pill every day is a big benefit of both types of IUDs. “The copper and hormonal IUDs are similar in terms of the way they are inserted, and they don’t require you to remember to do anything—sometimes called a ‘set it and forget it’ method, so they are both good options for people who can’t remember to take a pill every day,” Dr. Culwell says.

Plus, IUDs are tiny, so you and your partner will not feel it during sex. (Just note that it does have two strings that hang through your cervix and into your vagina). The doctor will shorten the strings once the IUD is in place, allowing your health-care provider to periodically check to make sure it’s still there, should any issues arise.)

With that said, let’s jump into the specific benefits of the copper IUD compared to hormonal IUDs:

The copper IUD lasts a lot longer than hormonal IUDs.

When it comes to long-lasting birth control, the copper IUD comes out on top. According to the Mayo Clinic, it’s considered a long-acting method to prevent pregnancy for up to 10 years.

By comparison, hormonal IUDs are only recommended for three to six years, depending on the brand. Of course, you can have any of them removed sooner, which is great news if you eventually decide you want to get pregnant. What’s more, fertility returns almost immediately after removal, making IUDs an excellent birth control method if baby fever ever kicks in.

Cost and efficacy are on par with hormonal IUDs.

Both the cost (which we dig into more below) and the efficacy of hormonal and non-hormonal IUDs are similar. The copper IUD’s effectiveness is seriously impressive (over 99% effective at preventing pregnancy), but the non-hormonal IUDs are pretty impressive too. According to a 2017 review published in Perspectives on Sexual and Reproductive Health, IUDs, both hormonal and non-hormonal, have the lowest failure rate of all contraceptive methods.³ What’s more, research from 2014 published in the journal American Family Physician shows that the copper IUD fails just 0.6% to 0.8% of the time.⁴ That boils down to fewer than one out of 100 people getting pregnant in the first year of using the copper IUD, which is a pretty excellent success rate.

It can be used as emergency contraception.

One other benefit that’s unique to the copper IUD is it can act as emergency contraception if needed, preventing pregnancy with nearly 100% efficacy after unprotected penis-in-vagina sex.¹ The caveat is you’ll need to get one inserted within five days after having unprotected sex to be effective, according to the Centers for Disease Control and Prevention (CDC). Additionally, the copper IUD and the hormonal IUDs are easily taken out, making it a great choice if getting pregnant becomes a priority.

It’s a good option for people who are sensitive to hormones.

Most people using a hormonal IUD don’t notice the same types of hormonal side effects that you might have with the combination birth control pill (which has estrogen and progestin), but Dr. Culwell points out that some people who are really sensitive to hormones might find they have side effects like mood changes. In that case, the non-hormonal copper IUD might be the best fit.

Source: SELF