How to Navigate: Hormonal vs. Non Hormonal IUDs

Updated: Sep 17


My first time starting birth control was when I was 16. I remember not knowing how to go about it on my own, so I asked my mom if it was okay to go on the pill because “my periods were irregular,” a lie I told her because I was too scared to tell her I was starting to have sex (Sorry - that’s a story for another blog). Anyways, my mom agreed to take me to the doctor. . I was surprised that It wasn't much of a “consultation” - I basically told my doctor I wanted to start the pill and she wrote me a prescription. I do not remember being coached on side effects or any alternative options. Being more naive about the importance of doing my own research, without much consideration, I started taking the pill. Pretty quickly, I felt like it wasn't right for me - I was constantly forgetting to take it, frequently paranoid about getting pregnant, and frustrated dealing with the array of side effects. Still, I felt there was no other adequate option to protect against unwanted pregnancy, so I just stuck with it. This experience lasted about 6 years, until I heard about the IUD.


When I realized there are other viable methods besides the pill, I was ready to make the switch. I was nervous because I wasn't sure what would happen to my body when I stopped the pill, yet excited to try something new like the IUD. I remember researching all the different brands, how they work, and trying to figure out the best one for me. I ended up going with Mirena, and I am happy to say that 3 years later, it worked out!


That being said, this is my own personal experience. Everyone is different and has different preferences. So, let’s talk science backed research all about IUDs so that you can make informed decisions.



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First off, what is an IUD ?

The IUD stands for intrauterine device, it is a small T-shaped piece of plastic that sits in the uterus. IUDs are also known as LARCs – long-acting, reversible contraceptives, because they are exactly that! IUDs remain active anywhere from 3-12 years and when you decide to remove your IUD, your fertility will go back to normal.


There are two types of IUDs: Hormonal and Non-Hormonal.


Non-hormonal IUD

As the name suggests, the non-hormonal IUD contains no hormones. In fact, the non-hormonal IUD uses the properties of copper to prevent pregnancy. It works by damaging and changing the way sperm move, preventing the sperm from reaching the egg. As we know, if sperm does not reach the egg, no fertilization can occur, therefore no pregnancy.


Because there are no hormones being released, this may be a better option for people who would prefer a non-hormonal contraceptive, have experienced unwanted side effects from other forms of hormonal birth control, or cannot use hormonal birth control for medical reasons. Before deciding on a birth control method, talk to your doctor about medical conditions that may interfere with hormonal birth control.


Additionally, an important factor to note about the copper IUD is that it can be used as an emergency contraceptive - actually it is the most effective emergency contraceptive method. If you get the IUD inserted within 120 hours (5 days) after having unprotected sex, it is over 99% effective against pregnancy! In comparison, emergency contraceptive pills like Plan B will vary in effectiveness depending on time taken since unprotected sex.

In Canada, there are multiple brands and types of copper IUDs that contain various amounts of copper and last a range from 3-12 years . Popular brands include Flexi-T 300, Liberte, Mona Lisa, and Nova-T.


Hormonal IUD

The hormonal IUD uses a synthetic version of progesterone, called progestin, to prevent pregnancy. The progestin hormone contained in IUDs is called levonorgestrel. The IUD releases tiny amounts of levonorgestrel straight into the reproductive system. Progestin prevents pregnancy by thickening the mucus in the cervix to stop sperm from reaching or fertilizing an egg. It also thins the lining of the uterus to partially suppress ovulation. In other words, it prevents the egg from leaving the ovaries and the sperm from reaching the egg. No sperm + no egg = no pregnancy.


Since the hormonal IUD does contain hormones, there are some risks of side effects that you would see with other forms of hormonal birth controls such as acne, bloating, or breast tenderness. However, most birth control users notice these effects only last the first few months. There are actually some important benefits to consider about the hormonal IUD, most notable, many people experience lighter periods or no period all together. This might be a deciding factor for someone who naturally experiences longer, heavier periods. Plus did I mention that hormonal IUD users have noticed it has helped with cramps as well! In addition to reduced bleeding and cramps, there are other medical benefits of the hormonal IUD. Research suggests that hormonal IUD may prevent endometrial cancer and alleviates symptoms of endometriosis and PCOS.


In Canada, the three main hormonal IUDs are Jaydess, Mirena, and Kyleena.

  • Jaydess contains 13.5mg of levonorgestrel and last up to 3 years

  • Mirena contains 52mg of levonorgestrel and can last up to 5 years

  • Kyleena contains 19.5mg of levonorgestrel and works up to 5 years


Why hormonal when I can go non-hormonal?

This mostly depends on personal preferences - unless your doctor suggests one over the other based on medical reasons. As stated above, there are benefits and disadvantages to both. Here are some pros and cons that IUD users have mentioned for their reasoning behind their own choice.


As your birth control best friend, we'll tell you the hard truth.

Tough love, honey.



Hormonal

​Non Hormonal

Hormones

Contains small amount of hormones released directly into uterus

Contains no hormones - may be better for individuals who prefer a non-hormonal method or whose doctor advises against the use of hormonal birth control

Menstrual Bleeding

May reduce bleeding to light spotting or stop bleeding all together

May cause longer and heavier bleeding

Cramps

May help reduce period cramps and pain

May increase period cramps and pain

Side Effects

You may experience side effects from hormones such as acne, headaches, breast tenderness - however, this is less common than other methods of hormonal birth control

Does not carry the same risk of hormonal side effects

Duration

Can remain in place for 3 to 5 years


Can last for 3 to 12 years

Emergency Contraceptive

Cannot be used as an emergency contraceptive

Can be used as an emergency contraceptive up to 5 days after unprotected sex

STI Protection

Does not protect against STIs

Does not protect against STIs


Benefits of both kinds of IUDs


1. Once it's in, it's in.

What I like best about the IUD is that once it's inserted, you don't really have to think about it for a long time. Hormonal IUDs can work up to 5 years and the copper IUD can last up to 12 years! Once the IUD is inserted, there is no need to worry about taking the pill or changing the ring (my biggest ailment with the pill). However, it is important to remember that the IUD does not protect against STIs.


2. Effectiveness

Both the copper and hormonal IUD are extremely effective. The hormonal IUD is 99.8% effective against pregnancy and the copper IUD is 99.2% effective. This is an extremely small difference between the two, you can be confident with both!


3. Cost

Although the IUD may seem more costly as you are paying everything up front, once you break it down by month, the IUD is much more cost effective than other forms of birth control - especially with insurance.


Disadvantages of the IUD - and what to do about them:

1. Getting the IUD inserted – Pain and cramping

As with many aspects of birth control, getting the IUD inserted affects everyone differently. Based on my personal experience, it felt like a really bad period cramp that lasted a couple days. In preparation, it may be helpful to get yourself some over-the-counter medication like Advil or Aleve, a heating pad, and anything else that helps you relax after the procedure. It is also advised not to have sex, use a tampon, or put anything in your vagina for at least 24 hours after insertion.


2. After IUD is inserted

  • Spotting

Most women experience light spotting after the IUD is inserted. This may last 6-8 months while your body is getting used to it. The hormonal IUD tends to cause lighter or no period, while the copper IUD may cause periods to be longer and heavier. Prepare yourself with some pads, panty liners, or to be environmentally friendly,