Iud and weight loss

Is Weight Loss with Mirena Possible?

For those who are not familiar, Mirena is a brand name that is actually referring to a system of birth control that many women use. With Mirena, a device is actually being inserted in the woman’s body that releases small amounts of progestogen levonorgestrel into the uterus. Mirena as a system of birth control provides birth control in a 5-year period span and among its side-effects is either losing or gaining weight.

The levonorgestrel is the active ingredient that can be found in Mirena. It is the substance that is responsible for the contraceptive and other healing effects of the birth control system. Using Mirena will change a layer of the uterus called endometrium that will affect a woman’s ovulation. The contraceptive will also be the cause of the thickening of the cervical mucus which prevents sperm from passing into the uterus.

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Weight Loss with Mirena

Among the possible side effects of Mirena is losing or gaining weight. It is said that there are more testimonials of women gaining weight compared to losing it when using the birth control system. However, a study conducted by a Brazilian university that was published in the journal “Contraception” in August of 2000 used Marina as a test subject for over a five-year testing period. The study found out that there were no significant increases or decrease in the subjects’ weight compared to other subjects that use the different forms of a birth control system.

In another related study conducted by the Oregon National Primate Research Center located at the Oregon Health and Science University, a group of monkeys was given different forms of birth control. The result showed that the monkeys with normal weight did not have a significant change in weight after they were given the birth control system. The obese monkeys, according to the result, did lose weight.

Mirena and the Estrogen Hormone

According to medical research, a woman usually loses or gain weight when using a birth control system because of the substance called estrogen. However, Mirena does not contain the hormone estrogen though some women lose or gain weight while in the Mirena birth control system. Weight loss with Mirena is still considered a myth that has not been proven by any related medical facts and studies.

The manufacturer of Mirena has listed as part of the possible effect of the birth control system is losing or gaining weight. However, there are many instances that the possible changes in the weight of the user were not caused by the contraceptive. There are no proven and conclusive medical studies yet that are pointing Marina as the primary reason for the weight changes among its users.

IUD like Mirena Tide to Modest Weight Loss – a Report

In an article published by the HealthDay in 2012, women who have used an IUD or intrauterine device such as Mirena have lost a conservative amount of weight while using the birth control system. Researchers were using different medical records of about 223 women who have used a different type of IUDs. After two years, the researchers followed them up to gather data and results.

Based on the report, the women used two types of IUD, the non-hormonal and the hormonal IUD like Mirena. The results showed that both groups of women have shown in losing about 1 percent of their weight while using the birth control system. The result, however, was unreliable as the data did not use enough women to make the results conclusive and realistic.

Other Mirena IUD Side Effects

The manufacturer of Mirena has recently faced lawsuits filed by customers who have experienced injuries because of the device that was inserted in their uterus was migrating and puncturing the wall. Other cases of complaints that they received include the device traveling to the abdominal cavity, causing damage to other organs such as the liver and colon.

There were other side effects that other women reported such as daily bleeding that causes these women to be lethargic, depressed, and losing their appetites. Other notable side effects that were recorded include severe cramping, fatigue, irritability, lack of sleep, loss of interest or painful sex. These side effects were testimonies from former users who have experienced different side effects from using Mirena as their contraceptive.


Mirena has been marketed as a birth control system that offers 99% effectivity. However, there is still no evidence of the contraceptive as the cause of losing weight among its users. When using Mirena as your contraceptive, it is much better to first consult your doctor for your safety and just follow an exercise or diet regimen when you want to lose weight.

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IUD Use Tied to Modest Weight Loss

TUESDAY, May 8, 2012 (HealthDay News) — Women who use an intrauterine device (IUD) as birth control may not have to worry about gaining weight after the device is implanted, new research suggests.

Researchers compared the medical records of 223 women aged 15 to 44 who were using two different types of IUDs, following them for up to two years later.

About half of the women had a non-hormonal IUD containing copper while others used a hormonal IUD that released low levels of a progestin hormone called levonorgestrel (LNG) every day.

Women in both groups appeared to lose about 1 percent of their body weight in the first and second years of having an IUD.

The study was scheduled to be presented Monday at the American College of Obstetricians and Gynecologists annual meeting in San Diego.

“We really expected to see weight gain, and we didn’t even expect that there would be weight loss,” said study author Dr. Erika Kwock, an obstetrician and gynecologist at Kaiser Permanente Northern California in Santa Clara.

Although previous research has not found associations between hormonal or non-hormonal IUDs and weight gain, Kwock thought that the women in her study would put on pounds “just because over time people tend to gain weight regardless of contraception,” she said.

However, Kwock pointed out that the weight loss among the women in her study is probably not a reliable result. Her study did not include enough women to allow for a statistical analysis to show that the women actually shed pounds.

Still, “the numbers are encouraging that there is not a weight difference for LNG IUDs and copper IUDs,” Kwock said.

Dr. Jill Rabin, head of urogynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y., said, “This study is interesting because it opens the door for more questions and more research.”

But there were not enough women in the study to know if the IUDs were associated with weight changes, Rabin added.

“People are always worried about weight gain whenever you mention a hormone, even though weight gain is miniscule in our experience,” Rabin said. “But I don’t think we’ve answered the question, certainly not with the LNG, and not even with oral contraceptives.”

Many women in the study received Kaiser insurance through work, Kwock said. Otherwise they were diverse and probably representative of the women nationwide, she added.

Kwock and study co-author Dr. Julie Livingston looked at a number of factors in the Kaiser medical records of these women, such as weight, age, race, medical conditions that might cause them to gain weight (such as diabetes and thyroid disease) and whether they were taking an antidepressant.

They found no differences for any of these factors between LNG and copper IUD users.

In addition, weight loss, albeit small, seemed to be similar between the LNG and copper IUD users; however this result might not be real, Kwock again cautioned.

Many women start on an IUD after they have had a baby, so Kwock and Livingston compared the proportion of women in each group who had received their IUD within two months of childbirth but found no differences.

The weight loss that the researchers saw in each group was not just due to the fact that some of the women were losing their “baby fat”, Kwock said.

“A lot of the doctors we work with really recommend IUDs for new moms because they are busy and they don’t have time to remember to take pills,” Kwock said.

“One of my favorite forms of birth control is the LNG because it has so many benefits — women get lighter periods and have less cramping, while the copper IUD can actually make periods more heavy,” Kwock said.

However, some patients prefer copper IUDs and it really depends on the patient, Rabin said.

More than with IUDs, women really worry about gaining weight on the pill, and while this cannot be ruled out, most research does not find this to be the case, said Laureen Lopez, a family planning researcher at FHI 360 in Durham, N.C.

“We’ve concluded that women need to have more appropriate counseling. A lot of people unfortunately gain weight over time, and you need to look at dietary patterns and exercise and not blame a contraceptive for which there may be little evidence,” Lopez said.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Can Copper IUDs Cause Weight Gain?

Weight gain can be an issue for women of all ages. The last thing you want to worry about when choosing birth control is gaining weight. Yet weight gain is a reported side effect of many birth control methods. Is the copper intrauterine device (IUD) one of them?

What Is an IUD?

An IUD is a T-shaped, plastic device implanted into the uterus to prevent pregnancy. There’s only one type of copper IUD, and it’s called ParaGard. A copper wire is coiled around the stem of the device and copper sleeves cover each arm. ParaGard continually releases copper into the uterine lining. The copper is lethal to sperm and helps prevent fertilization.

Other types of IUDs release hormones into the body. These hormones thicken cervical mucus to help prevent sperm from moving towards an egg. All IUDs have a string attached so you can make sure it’s in place. This string also helps your doctor remove the device. If you want to become pregnant, an IUD can be removed any time.

IUDs don’t prevent sexually transmitted diseases (STDs). If you’re at high risk of contracting one, you’ll need to use condoms as well.

How Effective Are IUDs?

IUDs top the list of effective birth control methods with less than one pregnancy per 100 women each year. Once it’s inserted, the ParaGard copper IUD helps prevent pregnancy for up to 10 years. Hormonal IUDs help prevent pregnancy for three to five years.

Side Effects and Risk Factors to Consider

Since a copper IUD has no hormones, the side effects are less severe than those of hormonal IUDs or other forms of hormonal birth control. The side effects can include:

  • anemia
  • a backache
  • breakthrough bleeding, or bleeding between periods
  • cramping
  • vaginal inflammation
  • pain during sex
  • severe menstrual pain
  • heavy periods
  • vaginal discharge

In rare cases, an IUD is expelled from the body. This is more likely to happen if any of these apply:

  • you’ve never been pregnant
  • you have heavy periods and severe menstrual pain
  • you’ve expelled an IUD before
  • you’re under age 20
  • you had the IUD inserted immediately after childbirth or after an abortion in the second trimester

There’s a slight possibility of perforating the wall of the uterus, particularly during placement. If perforation occurs, the IUD should be removed and surgery may be needed. Perforation may cause infection, scarring, or damage to other organs.

Copper IUDs and Weight Gain

Weight gain isn’t listed as a side effect of ParaGard. Anecdotal evidence from women using the device indicates IUDs cause weight gain, but scientific evidence is inconclusive.

A study published in Contraception assessing weight changes in Brazilian women using copper IUDs found that weight increased, especially in older women. It was also determined that the women tended to gain weight during their reproductive years independent of IUD insertion. Because of this, weight gain may have been related to age.

A more recent study published in the European Journal of Contraception & Reproductive Health Care compared weight gain in women who used hormonal contraception or IUDs. The study found users of both types of birth control gained significant weight over a 10-year period.

Although these studies indicate IUD users experienced weight gain, it’s unclear if the gain was due to the IUD or normal aging and lifestyle factors such as diet and exercise. Removing the IUD didn’t necessarily result in weight loss. More research is needed to put an end to the debate about weight gain and IUDs.

Should You Get an IUD?

Birth control is a personal choice that should be weighed carefully. Most women can safely use a copper IUD, but you should consider other options if you have any of these risk factors:

  • uterine abnormalities that interfere with placement
  • a pelvic infection
  • uterine or cervical cancer
  • unexplained vaginal bleeding
  • allergies to any components of the IUD
  • Wilson’s disease, which causes the accumulation of copper in the brain and other organs
  • a high risk of having an STD
  • a history of problems with an IUD

Which Birth Control Is Right for You?

The Takeaway

A copper IUD is a great option for women who want to avoid hormonal birth control or want the convenience of not having to think about birth control in the long term. When it comes to weight gain, the definitive verdict is still out. Eating a healthy diet and staying active may help reduce your risk of packing on extra pounds. Talk to your doctor if you’re interested in using a copper IUD but are concerned about weight gain.

Stuart Tyson I never thought I’d say this, but I love my birth control–and not just because it keeps me from having more kids. The Pill I used to take worked, sure, but every month I’d have some PMS-induced Hulkish freak-out that made me feel (and seem) crazy. It wasn’t until I’d had my second child–and my 242nd meltdown–that I considered a change. A friend had gotten an IUD and raved about it, so I pumped her for information and cross-checked it with my other friend, Google. My gynecologist loved the idea, so at 34, I dropped the Pill and got ParaGard, a non hormonal IUD. My husband was a tad suspicious of the idea of a copper rod chilling in my uterus, but psyched that my swinging pendulum of emotions was gone. We were both happier.

When I mentioned this revelation to my girlfriends one night over cocktails, it sparked a long conversation about our birth control hits and misses, which turned out to be mostly misses. Some of my friends were dealing with mood issues like I used to, some suffered through low libido or heavy periods, and one showed us the black sticky residue still on her butt from the patch she’d stopped using months ago. Another friend had hilarious stories about the NuvaRing hula-hooping around her husband’s penis, and another had resorted to “pulling and praying.” What I took away from this overshare: We all put up with a lot in the name of contraception.

“Women will go years dealing with a birth control they don’t like,” says ob/gyn Hilda Hutcherson, M.D. “I think it’s because they don’t know what else is out there.” And even if something has been working for you, it might not be right as you get older and after you have kids. “There isn’t one perfect solution for your whole reproductive life,” says Rebecca Booth, M.D., a Louisville, KY–based ob/gyn and the author of The Venus Week: Discover the Powerful Secret of Your Cycle… at Any Age.

So, what to do? First, gather info on your own–talk to friends, read the stories here, find details online–before you see your doc. “The typical gyn visit is 15 minutes, so no doctor is going to give you a dissertation on all the various methods available,” says Hutcherson. Use that precious time to discuss the options you like in light of your personal health history. And if you do make a switch, be patient. “Unless you’re having something really serious, like extreme bleeding or pain, give a new method three months before deciding whether it works for you,” Hutcherson says.

Bottom line: As with many things (sex life, hair, marriage), you don’t have to settle for so-so birth control. These women didn’t give up their search for a better match, and it paid off. You may wind up with something different–these aren’t the only choices–but you won’t know how much better you can feel until you try.

Stuart Tyson

She lost the extra weight

Suzy P., 39, mom of two (ages 4 and 2)

What she tried: Pill> IUD> Pill

Her birth-control breakthrough: Suzy switched to ParaGard after her second child and was happy that there were no hormones involved. But after she’d weaned her daughter and the baby was sleeping through the night, “I still seemed like I had a newborn, that’s how exhausted–and fat–I felt,” she says. She started to suspect she actually needed the hormones to feel balanced. After two cycles on the Pill again, she was back to normal. “I lost the weight, I had energy–even my skin looked better,” she says. “It wasn’t the IUD’s fault, but I am glad I got it out.”

What you need to know: There are women who just plain feel better on the Pill. The added estrogen and progestin suppress ovulation and the hormonal spikes that can affect moods, skin, energy levels, and appetite. “A lot of patients tell me they want to go natural and try non hormonal birth control, but it isn’t always better,” Booth says. While about 15 percent of women report worse mood swings on the Pill, many feel it gives them a more even keel. Others swear by what the Pill does for their skin. There isn’t one Pill that’s guaranteed to speed metabolism, but with some trial and error, you might find one that does that for you. Taking the Pill also allows you to manipulate your cycle; if you skip the week of placebo pills, you can avoid a period for a vacation or an event (a completely safe thing to do).

Stuart Tyson

Less worry, better sex

Amanda C, 33, mom of three (ages 8, 6, and 3)

What she tried: Pill> Hormonal IUD

Her birth-control breakthrough: “I always forgot to take the Pill,” Amanda says. “Or I forgot to take it at the same time every day.” She and her husband sometimes remembered to use a condom as backup, but she felt worried pretty much all the time. The Pill eased her dysmenorrhea (“crazy pain during my period,” she explains), so she didn’t want to give up the hormones that helped. Mirena delivers hormones, so she got the benefit of pain relief without having to remember to take the Pill. It’s been great for the couple’s sex life, too, because now Amanda doesn’t get a period at all (not uncommon with Mirena). “That’s awesome,” she says.

What you need to know: An IUD gives you long-term protection: great for moms spacing out their kids, and for women who are done having children–but not done having sex (especially if tubal ligation seems too permanent). Mirena is also prescribed to combat heavy periods–and getting rid of those can definitely change your life.

Stuart Tyson

Bad periods, gone

Deb M., 40, mom of one (age 5)

What she tried: Pill> NuvaRing

Her birth-control breakthrough: When her first post-pregnancy period back on the Pill came with heavy bleeding, Deb knew something was up. “In 20 years on the Pill I’d never had a problem,” she says. She endured the bleeding for two weeks, knowing that the first period (or few) after having a baby could be different, then said, Enough. Her doctor suggested the NuvaRing. It was just the ticket for Deb’s body–and periods. “I love it!” she says. “Only having to change it once a month versus taking a pill daily is very freeing.”

What you need to know: The ring works like most Pills (three weeks on, one week off), though if you want to skip your period, you just pop in a new one instead of skipping a week–Deb does that to stave off menstrual headaches. The flexible plastic ring is inserted into the vagina (by you, like with an applicator-free tampon), where it dispenses ovulation-suppressing hormones. Some women get a mucousy discharge, which is not problematic and often considered a benefit because of the added lubrication during sex.

Stuart Tyson

No more thinking about birth control — like, ever

Marie G., 36, mom of three (ages 9, 4, and 1)

What she tried: Pill> Spermacidal> Foam> Condoms> Tubal Ligation

Her birth-control breakthrough: When Marie and her husband were almost–but not quite–ready to have kids, she stopped taking the Pill and bought some spermicidal foam, which is supposed to kill sperm on contact. So much for that: Nine months after trying it, her first son was born. She and her husband were thrilled, but for the next eight years, when they weren’t trying for more kids, her husband wore condoms. “I didn’t mind, but he was less enthused,” says Marie. And they both hated the extra step. When Marie got pregnant with her third child, she was confident that she would be her last, so she arranged to have her tubes tied. “The doctors asked me over and over if I was sure, and I was,” she says. The procedure took about 20 minutes after her C-section, and the recovery was no longer than with her other births. “I never have to worry about getting pregnant again, and I can just enjoy sex, whenever, wherever,” she says.

What you need to know: Totally done having kids? Think you’re too old to get pregnant–but hearing about a 47-year-old new mom freaks you out? Welcome, tubal ligation. A doctor clamps, ties, or cuts the fallopian tubes to prevent an egg from entering. Another permanent option: Essure, a tiny stainless-steel coil that’s inserted into each of your fallopian tubes, creating scar tissue that prevents sperm from passing. And then there’s vasectomy, which is a great, safe, female-parts-not-required option. Because maybe it’s time for your guy to step up.

Stuart Tyson

Her libido is back in business!

Kate R., 34, mom of one (18 months)

What she tried: Pill> Different Pill> Better Pill

Her birth-control breakthrough: Kate tried two different birth control pills over the years, but felt pretty much the same on both: She had a regular period, which she liked, and zero interest in sex, which she didn’t. “I loved my husband, but I’d pray that he’d have to work late so I didn’t have to tell him I wasn’t up for it,” she says. She also endured dark moods and irritability, which also affected her marriage. “I swear I think I actually told him I wanted a divorce once because he forgot to pick up wine,” she says. “I became a nagging, bitchy, sexless wife, and I hated it.” After hearing all this, Kate’s doctor switched her to a low-dose Pill (with lower levels of both estrogen and progestin). “This one worked so well–better moods, a cycle you could still set a watch to, and my libido was finally back!” says Kate. “I can’t believe I waited so long to make a change. I feel like the best possible version of myself and I love it.” So does her husband.

What you need to know: One of the most common complaints about birth control pills is low libido. While some women love that traditional Pills suppress testosterone (for the clear skin), others find that their sex drive goes missing without it. There are several low-dose Pills on the market; just be aware that many must be taken at the exact same time every day in order for them to be effective. “I see many patients suffer because they’ve grown attached to their Pill and they don’t want to go through the hassle of making a change,” says Booth. “But no one should have to live like that.”

Stuart Tyson

Birth Control 101

Thinking about making a switch? Here’s what’s what:

PILL: The most popular form of contraception comes in three varieties: the combination Pill (estrogen and progestin), low-dose combo, and progestin-only (the “mini Pill”).

IUD: Intrauterine devices are small plastic or copper rods inserted in the uterus by a doctor; they prevent sperm from reaching the egg.

RING: NuvaRing is a flexible plastic ring that delivers both estrogen and progestin through the tissue in the vagina.

IMPLANT: Nexplanon is a matchstick-size rod that is placed under the skin of your upper arm and releases progestin. It lasts for three years.

SHOT: Depo-Provera is a shot given by a doctor every three months. It contains progestin, and its effects can last six to 10 months after the final shot.

STERILIZATION: Tubal ligation surgery prevents the fallopian tubes from carrying eggs to the uterus. Essure is a device that creates scar tissue so that the egg and sperm can’t meet (no surgery required). For the guys: Vasectomy cuts the tubes that carry sperm from the testicles.

Choosing a method of contraception is a very individualized and personal decision for women—the best pill, best patch, or best IUD for you might not be the right choice for your best friend, and vice versa. About that IUD, though: When it comes to the most effective methods, experts strongly urge the use of LARCs, or long-acting reversible contraceptives. These set-it-and-forget-it methods include the implant and a handful of different IUDs, which collectively boast the lowest failure rates of all forms of contraception.

This month, Kyleena, the newest IUD offering from pharma company Bayer, became available to consumers. More options are always a good thing, especially when it comes to birth control. But it can also be overwhelming—and means you’ll want to do some extra research before making a decision you’re comfortable with.

Here’s what the experts say you should know and consider when choosing the best IUD for you.

IUDs can be divided into two categories: hormonal and nonhormonal.

Kyleena, Skyla, Mirena, and Liletta all work by releasing the hormone levanogestrol, a form of progestin. The main way it works is by thickening cervical mucous and blocking sperm. ParaGard is a nonhormonal IUD made of copper, a material that produces an inflammatory response in the uterus that’s toxic to sperm.

When deciding between the two types, doctors want you to think first and foremost about your period—specifically, how much you bleed.

“For most women, hormonal IUDs are going to give them a bleeding profile that’s complete amenorrhea or occasional light bleeding,” Nerys Benfield, M.D., M.P.H., director of the division of family planning and the fellowship in family planning at Montefiore Health System and assistant professor at the Albert Einstein College of Medicine, tells SELF. There are women who love the idea of not having a period—especially if you’re someone who suffers through a heavy one normally. But “other women find that frightening,” Kristyn Brandi, M.D., instructor of obstetrics and gynecology at the Boston University School of Medicine, tells SELF. It’s perfectly safe to not have your period when using an IUD, she adds, so it really comes down to personal preference.

Different hormone amounts can impact your period differently.

Generally, you should think about it this way: The higher the hormonal dosage, the more likely it is your period will become lighter or stop altogether. Mirena and Liletta have the most levanogestrol, at 52 mcg. “Twenty percent of women in clinical trials for Mirena became amenorrheic,” Yesmean Wahdan, M.D., practicing ob/gyn and associate medical director at Bayer Women’s Healthcare, tells SELF. It’s even FDA-approved to alleviate heavy periods. Studies also show that 1 in 5 women will stop having their period within the first year of using Liletta, but it doesn’t have an FDA approval for that use specifically. The new Kyleena has 19.5 mcg, and Skyla is the lowest, with 13.5 mcg. It’s likely your period will become lighter than normal on a lower dosage IUD, but there’s also a greater chance you’ll have some spotting and irregularity in the first few months after insertion.

Some women may not want their periods to change at all and should consider the nonhormonal IUD.

“Other women do not want to have their periods change and may opt for the ParaGard IUD for this,” says Brandi. A copper IUD isn’t likely to change your bleeding patterns, but is known to make periods heavier and crampier the first few months after insertion. “Anecdotally, for most women we see one to two months where bleeding is significantly heavier and then it typically starts to improve,” Benfield explains. For some, this persists. If you already have a heavy period, a copper IUD might not be the best route.

Period heaviness aside, some women want to avoid hormonal birth control for other reasons.

“Some women choose the nonhormonal methods because they are turned off by the idea of using hormones,” says Brandi. “This may be due to personal, cultural, or religious reasons.” Or if you’ve had breast cancer in the past, you may be advised to use a nonhormonal method of birth control. Other women may have had bad experiences with other hormonal birth controls with side effects like nausea, hair loss, and weight gain, so are hesitant to use a hormonal method again, says Benfield. She adds, though, that all IUDs are low hormonal compared to other methods. “They’re all considered super low and lower than anything else.” None of the IUDs contain estrogen, and they have a “localized mechanism of action,” Wahdan says. This means that the hormones work locally right in the uterus, versus the systemic effects of other hormonal methods like the Pill. This also means that you might lose some of the desirable side effects of hormones, like less acne and fewer PMS symptoms.

Some of the other differences among IUDs aren’t quite as important, but are worth factoring into your decision.

Each IUD has a number of years for which it’s proven to be effective. Mirena and Kyleena are approved for up to five years, Liletta and Skyla are approved for up to three years, and ParaGard is approved for up to 10 years. “However, all methods can be discontinued earlier than this if a woman decides she no longer wants to use the IUD,” Brandi says. If you know you don’t want kids for five years, going with the longer-lasting one can eliminate an extra removal and insertion—which can be quite unenjoyable. But if you decide after a year or a week it’s not for you, there’s no real harm in getting an IUD removed (just don’t try doing it yourself, please!). “If it ends up not being something that seems to work well for you, it’s easy to remove by coming into the clinic,” says Benfield. They don’t call them reversible for nothing.

IUDs are also marketed by size. “Kyleena and Skyla are 2 mm smaller than the others,” Benfield says. “I find that all of the IUDs can be placed comfortably in 99.9 percent of women,” she adds. For those who have a failed attempt with one of the larger IUDs, it’s worth trying a smaller one to see if that works. “Every woman’s cervix and uterus is unique so certainly I would place whatever IUD the women decided based on the other things we talked about, but that is one other small consideration,” she explains.

Technically, some IUDs are FDA approved only for women who have had children while others are approved for those who have not, but doctors prescribe any of them to any woman regardless of whether or not they’ve had kids before. The experts we spoke to said it doesn’t really matter.

Bottom line: If you’re OK with having a lighter period (or no period at all) or have a particularly heavy period, a hormonal IUD is your best bet. If you want to avoid hormones, or want to keep your period how it is, the copper version might be your best match.

It’s important to talk to your doctor about all these factors, discuss your medical history, and ask questions based on the research you’ve done. Getting exactly what you want out of your birth control is important, so never feel shy telling your doctor what that is.

Birth control is pretty damn important to lots of women—and, frankly, the easier it is to use, the better.

Sure, the Pill is fine and the ring gets the job done, but when you want some real, pregnancy-prevention staying power, it’s time to bring out the big guns: IUDs.

Remind me again, what are IUDs?

Intrauterine devices (IUDs) fall under the category of long-acting reversible contraceptives. This means that they prevent pregnancy for years but can be removed to restore fertility.

IUDs are 99 percent effective in protecting against pregnancy compared to 85 percent for condoms and 91 percent for the pill, according to Planned Parenthood. Basically, they are the best of both worlds: highly effective birth control you barely have to think about, says Sherry Ross, M.D., an ob-gyn and author of She-Ology: The Definitive Guide To Women’s Intimate Health. Period.

There are two categories of IUDs: hormonal and non-hormonal. There’s only one type of non-hormonal IUD—ParaGard. There are four hormonal IUDs currently approved by the FDA.

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Most women are a good candidate for at least one type of IUD, though you’ll need to have a conversation with your doctor to figure out the best move, says Ross.

Sounds great, but um, aren’t IUDs painful?

All IUDs have the same basic look—again, plastic and T-shaped—and they’re all inserted through the cervix into your uterus. There are small strings on the end that protrude through the cervix into your vagina, letting you know that the IUD is still in place doing its thing.

Insertion, honestly, is different for everyone. For some women, especially those who’ve had children, it’s a minor annoyance; for others it can be extremely painful, particularly if the doctor needs dilators to open up your cervix more for insertion.

The good news is that the worst of it is over in a few minutes and the whole appointment shouldn’t take more than a half hour, says Ross. The bad news: While everyone’s different, there’s a chance that you could experience cramping or spotting for three to six months after insertion, according to Planned Parenthood. Removing it, thankfully, is usually pretty simple and pain-free, requiring a short doctor’s visit, she adds.

Here’s everything you need to know about the five different IUDs available right now:

1. ParaGard

How it works: Paragard is the only brand of non-hormonal IUD in the U.S. It’s wrapped in thin copper, which causes an inflammatory response in your body. This helps prevent sperm from getting through your cervix, and any little swimmers that do make it up there are neutralized by the copper ions, which are toxic to sperm.

Side effects: The inflammation caused by the copper blocks sperm, yes, but can also increase menstrual bleeding, both the duration and the flow, says Ross. Other side effects include anemia, increased cramps, and random spotting, she adds.

How long it lasts: According to ParaGard’s website, the device lasts for 10 years.

Who it’s best for: Women who want to avoid synthetic hormones for any reason, have a normal to light flow, and want the longest-lasting option.

Who should avoid it: If your cramps and bleeding are already bad, then a non-hormonal IUD probably isn’t for you, says Ross.

2. Mirena

How it works: Mirena releases 20 micrograms of levonorgestrel, a synthetic form of progesterone, per day. This hormone thickens your vaginal mucous, thins out your uterine lining, and can prevent your ovaries from releasing an egg, all of which prevent any rogue sperm from latching onto an egg and fertilizing it.

Side effects: Because it thins out your uterine lining, the most common side effect is having a significantly lighter period or no period at all, says Ross. Other issues may include nausea, breakthrough bleeding, ovarian cysts, and mood changes.

How long it lasts: Five years, according to Mirena’s website.

Who it’s best for: Women with super-heavy periods.

Who should avoid it: If you are prone to ovarian cysts or react badly to progestin, take a pass, says Ross, as Mirena could up your risk of those. If you’re hesitant about not having a period at all, skip this one, too.

3. Liletta

How it works: Liletta works exactly like the Mirena, except it uses slightly less levonorgestrel, releasing 19.5 micrograms per day—and that amount decreases a little each year after (that doesn’t hinder its effectiveness, though).

It was developed as a cheaper alternative to the Mirena (not all insurance plans cover IUDs). Women without health insurance can get Lilletta at a reduced cost through public-sector (a.k.a., free) clinics.

Side effects: Just like with Mirena, you may experience nausea, ovarian cysts, breakthrough bleeding, and mood changes. Many women also experience a lighter period or have no period at all.

How long it lasts: Four years, according to the Food and Drug Administration (FDA).

Who it’s best for: Women without health insurance or whose insurance doesn’t cover IUDs.

Who should avoid it: Women who react badly to synthetic progesterone or are prone to ovarian cysts should steer clear.

4. Kyleena

How it works: Kyleena works just like Mirena and Liletta but contains slightly less of the hormone levonorgestrel, releasing 17.5 micrograms a day—the second lowest dose you can find in a hormonal IUD.

Side effects: Again, this is similar to Mirena and Liletta, meaning side effects include nausea, ovarian cysts, breakthrough bleeding, and mood changes. It can also lessen or stop your period, but the effect isn’t as pronounced due to the smaller dosage.

How long it lasts: Five years, according to Kyleena’s website.

Who it’s best for: Women who still want ample protection, but also want to get their period regularly.

Who should avoid it: Women who react badly to synthetic hormones.

5. Skyla

How it works: Skyla works just like all four previously mentioned IUDs, but contains the smallest amount of levonorgestrel, releasing just 14 micrograms a day. It’s also the smallest in size, which means it may be easier to insert, particularly in women whose cervix is tighter, says Ross. (Worth noting: The size difference is pretty minimal.)

Side effects: The same as all the hormonal IUDs: cysts, nausea, mood swings, lighter bleeding. But because the dosage is lower, many women find the side effects to be less bothersome than IUDs with higher doses.

How long it lasts: Three years, per Skyla’s website.

Who it’s best for: Women who haven’t had children or have a tight cervix, or those who want to keep getting periods while they’re protected.

Who should avoid it: Women who would like protection for more than three years.

Charlotte Hilton Andersen Charlotte Hilton Andersen has been a health and fitness writer for 12 years and is the author of The Great Fitness Experiment.

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  • Do IUDs (like Mirena) cause weight gain?

    Like all medications, birth control can have side effects. They’re important to when choosing the method that’s right for you. Birth control side effects may include acne, breakthrough bleeding, mood changes, and more. Weight gain is a common concern among women choosing birth control, but it’s a misconception that IUDs cause weight gain. To answer some frequently asked questions about IUD weight gain, we talked to Christina Madison, Pharm.D., FCCP, BCACP, AAHIVP, founder of The Public Health Pharmacist and clinical researcher of women’s health.

    What is an IUD?

    An IUD, or intrauterine device, is a small, T-shaped plastic device placed in the uterus to prevent pregnancy. With less than 1% risk of pregnancy each year, IUDs are the most effective form of birth control available. IUDs are a great choice for those who often forget to take their daily birth control pills. After insertion, an IUD lasts anywhere from three to 12 years. It can be used by women of all ages, according to the CDC. They are also a reversible contraception option, allowing you to go back to regular fertility once your IUD is removed.

    There are two types of IUD products: copper and hormonal. While both are effective in preventing pregnancy, there are some key differences to keep in mind.

    Copper IUDs

    Copper IUDs are hormone-free. They use plastic and copper coil instead of levonorgestrel. Copper is a natural spermicide, killing sperm before it can reach an egg. Copper IUDs, like ParaGard, can be used for up to 12 years.

    Hormonal IUDs

    Sometimes referred to as intrauterine systems, hormonal IUDs release small amounts of a progestin hormone called levonorgestrel into the uterus, which prevents sperm from reaching and fertilizing an egg. These IUDs can last anywhere from three to seven years.

    One of the most common hormonal IUD brands is Mirena, manufactured by Bayer. Mirena prevents pregnancy for up to five years but may remain effective for up to seven years.

    The cost of Mirena varies, but Bayer recently reported that 95% of women are covered with little to no out-of-pocket costs. The list price of Mirena is $953.51, which comes out to about $15 per month over five years. If your insurance doesn’t cover it, there are Mirena coupons available.

    Other common brands include Skyla, Liletta, and Kyleena. Each hormonal IUD brand is different, so be sure to consult with your OB-GYN on which is right for you.

    What are the side effects of an IUD?

    Both hormonal and copper IUDs do much more than prevent pregnancy. For example, Mirena treats heavy bleeding, which benefits those who experience endometriosis-related pain. ParaGard, the copper IUD, is also used as emergency contraceptive since it begins working immediately.

    Side effects of intrauterine dosage forms, like the Mirena IUD, are typically less severe than those seen with oral contraceptives, according to Dr. Madison.

    While IUDs are 99% effective, there are some common side effects to be mindful of, including:

    • Cramping and back pain after placement
    • Irregular bleeding and spotting during your menstrual cycle
    • Irregular periods, which may become lighter or even stop
    • Ovarian cysts, which usually disappear
    • Heavy menstrual bleeding or longer periods with copper IUDs

    Rare but serious side effects of IUDs could include the following:

    • Potential risk of pelvic infection within 20 days after insertion
    • The IUD may slip or move and will need to be taken out by a professional
    • Expulsion of the device from the uterus

    Mirena side effects

    Possible side effects of IUDs vary from patient to patient, and by the type of IUD used. The Mirena IUD may have additional, hormone-based side effects like:

    • Headaches
    • Acne
    • Breast tenderness
    • Mood swings
    • Nausea
    • Fatigue

    Since Mirena and other hormonal IUDs use the progestin hormone instead of estrogen, some patients may experience weight gain or hair loss due to lower estrogen levels. Mirena weight gain and hair loss are uncommon and may be related to a number of other health issues, like stress or other illnesses.

    “Benefits of using these highly effective and long-acting products outweigh the risk of potential side effects,” says Dr. Madison, but make sure to consult with your doctor to determine if an IUD is the right option for you.

    IUD weight gain

    The majority of IUD users do not experience weight gain. Copper, non-hormonal IUDs do not cause any weight gain, whereas about 5% of patients using hormonal IUDs report weight gain. Since Mirena is a hormonal IUD, Mirena weight gain is possible, if unlikely.

    “The perception of weight gain from these products is widely thought of but has not been substantiated,” says Dr. Madison. “There was no difference in body weight or composition seen among products after 12 months of continuous use.” While you may have some weight gain after getting your IUD, it should subside.

    Weight gain can happen with hormonal IUDs due to the hormone, progestin, used. Any IUD weight gain is likely not an increase in body fat, but instead an increase in water retention. The hormone progestin may increase water retention that causes bloating, typically adding about five pounds. The amount of weight gained will vary from patient to patient, but any water retention will likely go down three months post-insertion.

    It’s important to know that gaining any weight post-insertion is likely due to the patient’s lifestyle as opposed to the IUD itself. Many American women naturally gain two pounds each year, entirely unrelated to any hormonal contraceptives, according to Yale Medicine.

    Consider making some lifestyle changes to avoid weight gain after getting an IUD. Exercising regularly, healthy eating, and all other common weight loss methods should minimize the chances of any weight change after getting an IUD.

    Should bloating not subside three months after insertion, consider speaking with a healthcare professional about other options. Copper IUDs, like Paragard, have not been linked to IUD weight gain, making them a great alternative.

    What birth control doesn’t cause weight gain?

    Should an IUD prove to be not the best birth control method for you, there are plenty of other contraceptive options to consider. Consult your healthcare provider about what would work best for you. Some common birth control options include:

    • Birth control pills
    • The Xulane patch
    • Depo-Provera, or other birth control injections
    • The contraceptive implant, like Nexplanon
    • Vaginal rings, like NuvaRing

    Hormonal birth control methods get a bad reputation for causing weight gain. Any weight gain reported while taking birth control is likely natural, like aging or your metabolism slowing down.

    Only one form of birth control has been linked to weight gain, and that’s the injection Depo-Provera. If you’re looking to avoid weight gain, stay away from any injectable contraceptive. These injectables have been shown to activate signals that control hunger, resulting in weight gain in some patients.

    As you consider other birth control options, keep in mind that some, like the pill, injections, the patch, and vaginal rings, have 10% yearly failure rates due to human error.

    “Choosing the best contraceptive product is very individualized,” says Dr. Madison, so make sure to speak openly and honestly with your gynecologist about which birth control method is right for you.

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