Birth Control Options: The Levonorgestrel Intrauterine Device (IUD)

Copper T IUD
Levonorgestrel IUD
Progestasert IUD

WHAT IS THE LEVONORGESTREL IUD?

The FDA approved Mirena, the levonorgestrel-releasing intrauterine system, at 6 pm on December 6, 2000. Mirena is as effective in preventing pregnancy as tubal ligation (better than 99 percent) and lasts for five years, or until removed. This method has been available for 10 years in Europe and has been used by approximately 2 million women worldwide. An IUD is a small device which is placed inside the uterus. The vertical arm of this IUD contains levonorgestrel. This hormone is a progestin much like the progesterone a woman’s ovaries produce each monthly cycle. Each week the Levonorgestrel IUD gives off about the same amount of levonorgestrel as a woman gets when she takes one or two of the minipills called Ovrette. The levonorgestrel causes the cervical mucus to become thicker so sperm cannot reach the egg. Among typical couples who use this IUD, one in 1,000 will experience an accidental pregnancy in the first year.

WHAT ARE THE ADVANTAGES?

• It is the most effective reversible method ever developed.
• It prevents ectopic pregnancies and pelvic inflammatory disease; it decreases menstrual cramping and dramatically decreases menstrual blood loss (a 97% reduction in menstrual blood loss in one study). Some women experience an absence of menstrual bleeding after one year.
• This IUD may be left in place for at least 5 years (probably effective for 8 or more years).
• IUDs are safe, inexpensive over time, and provide extremely effective long-term contraception from a single decision.
• One of the costs of any contraceptive is the cost to you should your contraceptive fail. Given the extremely low failure rate of Mirena, a person using this method is far less likely to have the emotional and financial expenses associated with an unintended pregnancy.
• All you have to do is check for the strings each month.
• May be used by postmenopausal women on estrogen therapy to protect the endometrium against endometrial cancer.
• Once Mirena is removed, fertility returns rapidly. Approximately 8 out of every 10 women who want to become pregnant will become pregnant in the first year after Mirena is removed.

WHAT ARE THE DISADVANTAGES?

• Use of an IUD often changes the menstrual cycle. There may be more bleeding days than normal for the first few months and less than normal after 6 to 8 months. If your bleeding pattern is bothersome, contact your clinician. There are medications which can help you have a better pattern of bleeding.
• The IUD provides no protection against sexually transmitted infections. Use condoms if there is any risk.
• There is a high initial cost of insertion.
• The Levonorgestrel IUD is not yet available in the United States (as of the end of 1999).
• Women who have a recent history of pelvic inflammatory disease (PID) are not appropriate candidates. Use of IUDs has been associated with an increased risk of PID.

WHERE DO I GET A LEVONORGESTREL IUD?

Most clinics insert IUDs when a woman has her period or within 7 days of the start of the period. If the risk of pregnancy can be excluded it may be possible to insert an IUD at other times.

WHAT IF I HAVE SEX AND DON’T USE BIRTH CONTROL?

Did you know that for 72 hours after sex, you can take emergency contraceptive pills to avoid becoming pregnant? AND for 5 to 7 days after sex, you can have an IUD put in, so you won’t become pregnant? Not all clinicians know about this. If you want more information or would like the phone numbers of clinicians near you that prescribe emergency birth control, call the toll-free number: (1-888) NOT-2-LATE or (1-800) 584-9911. Some of these sources of help are free. PLAN B is the emergency contraceptive pill that causes the least nausea, the least vomiting, and has the lowest failure rate.

The Pill | The Mini-Pill | Birth Control Shot | Abstinence  | Cervical Cap

Breastfeeding | Vasectomy | Female/Male Condom Choices

Contraceptive Film (VCF) | Natural Family Planning  |  IUD's

Emergency Contraceptive Pills (ECP) | Vaginal Spermicides

Tubal Sterilization | The Ring | The Patch

Wyoming Health Council

Copyright ©2004 Wyoming Health Council. All rights reserved.