Should I Get A Copper IUD Or Hormonal IUD?

by Rachel Sanoff

Finally catching up with women in other countries, many sexually active American women are now selecting the IUD as their preferred method of long-term birth control. While still used far less frequently than condoms or the pill, its use has doubled in the last few years. IUD stands for intrauterine device. It a t-shaped object that a doctor inserts into your uterus in a five-minute procedure. You can choose to get a hormonal IUD or a copper IUD, which is hormone-free So, what are the benefits of the copper IUD vs hormonal?

There are two hormonal IUDs — Mirena and Skyla — and one copper IUD, called ParaGard. They each have their strengths and weaknesses for different types of women. The IUD only has a 1 percent failure rate (the birth control pill has a 9 percent failure rate), and can prevent pregnancy for up to a decade! It's as effective as getting your tubes tied without the long lasting infertility and it is extremely popular for personal use among female gynecologists (which is an awesome sign). If at any time you decide you want to get pregnant, you just have to get the IUD removed in a quick procedure, and you will instantly regain your baby-making powers.

I am a woman with a recently super dramatic medical history that makes hormonal birth control extremely dangerous for me. This means that even my non-gynecological doctors double check that I am not on any hormonal birth control and educate me about ParaGard, as it is the only long term contraceptive that I can safely use (besides barrier methods). While I do not currently have the copper IUD, I have learned a lot about its pros and cons. Moreover, I know a lot of women, ranging from their early 20s to their late 30s in age, who have had the IUD (hormonal or copper) inserted. I talked to 10 of them and perused several medical resources in order to provide some basic information about reasons women choose the IUD to keep them babies away, the benefits of both hormonal IUDs and copper IUDs, and the side effects that can occur for women with IUDs. It is especially important for women to communicate with each other openly about their experiences with various birth controls since medical professionals have a habit of not taking women's medical concerns/preferences seriously, not staying updated with birth control research — giving women incorrect information about their bodies and contraceptive options, or speaking about every woman's body as if it is the same — providing a limited number of options to diverse female patients. (Side note: if a gynecologist tries to tell you that you can't have the copper IUD because you have not yet given birth, they are wrong. The FDA removed that warning in 2005 after research revealed incorrect reasoning, but a few old school gynos have decided to ignore that medical fact. So be alert!)

Why do women choose the IUD?

Long-term Protection:

The IUD can be used for up to three years (Skyla), five years (Mirena), or ten years (Paragard)!!! Once inserted, you never have to think about the IUD again (unless of course it's personally too uncomfortable for you or the procedure was recent; there is an “adjustment period” when your body becomes accustomed to its new friend.) But that means you no longer have to remember to swallow a pill everyday, change a ring in your vagina, or worry about condoms (unless you need to protect yourself against STIs — IUDs do NOT protect against STIs or HIV!!!)

Understandably, this makes the IUD extremely desirable and freeing for women. Suddenly, reproduction no longer has to be a daily worry or responsibility. And, as aforementioned, should you at any time decide you want to get pregnant or change birth control methods, the IUD can be removed. I spoke to a woman in her 30s with children who has had her copper IUD for nine and a half years. She was able to have it removed and reinserted throughout these nine and a half years, depending on her desire to have children. She loves the IUD because, while she doesn't plan on having anymore kids, she isn't yet ready “to shut down her reproductive system” with tubal litigation.

Little To No Hormones:

Aside from its magically long-lasting powers and the more carefree attitude it allows women to adopt, the IUD provides a birth control option that doesn't pump women full of the hormones that have caused many of us to feel terrible. Of course, lots of ladies swear by the pill or other hormonal treatments, and that's wonderful! Unfortunately, that's not the case for all sexually active ladies. Too many women become sick from hormones, or can't safely take them at all, for there to not be more options in 2015.

Specifically, some women cannot take any oral contraceptive because additional estrogen is very harmful for them. This includes women who suffer from migraines or have histories of strokes, heart attacks, or blood clots. While other women are eligible for hormonal methods, they are negatively affected by weight gain, acne, depression, anxiety, fatigue, aches, or even temporary blindness (and the list goes on)! Mirena, Skyla, and Paragard significantly reduce, if not altogether eliminate, the nasty hormones that have plagued so many women on their quests to avoid pregnancy.


If you don't have access to affordable healthcare, the IUD is an amazing investment. Instead of paying for a new pack of pills or a NuvaRing every month (which can cost up to $50 and $80 a month, respectively), you only have to pay once at the beginning for the IUD insertion. It may cost several hundred dollars at that appointment, but after that, you won't have to pay for ANY birth control for 3-10 years – assuming you decide to keep the IUD for the entire time that it is effective.

While it is possible to get access to free birth control pills at Planned Parenthood, that still isn't always ideal. I spoke with a 30-year-old woman who was deciding between the pill, NuvaRing, and an IUD. She learned about studies researching hormonal birth control and how it may be less effective for women with higher BMIs. As a woman over 170 pounds, the IUD felt like the safest choice for her. And thanks to the implementation of the Affordable Care Act, which means insurance companies have to cover co-pays and additional fees for FDA-approved contraception, she only had to pay $40 for her IUD, which will last for five years. Compare that to $40 a MONTH for five years.

The Benefits Of Hormonal IUDs: Mirena & Skyla

The two hormonal IUDs are called Mirena and Skyla, 'cause us gals love birth control with fun names! That being said, both work by “releasing a low amount of the progestin, levonorgestrel,” and the said hormone thickens mucous in the cervix and thins the uterine lining, making it harder for sperm to enter. Skyla is a bit smaller than Mirena, releasing 14 mcg of progestin daily, as opposed to 20 mcg. Both still release less hormones than other birth control options. Moreover, because the IUD is taking up residence in your uterus, fertilized eggs cannot easily implant themselves. It's like a uterus fort! Mirena is 99.8 effective at preventing pregnancy and Skyla is 99.1 percent effective at preventing pregnancy.Some of the hormonal IUD benefits, aside from the fact that you will not give birth when it's not part of your life plan, include lighter periods – if any periods. Some women have also reported experiencing less painful cramps, or they report less full-body aches, and instead have cramps in more focused areas. They can reduce endometriosis pain and lessen endometrial cancer risks. Also, the thickening of cervical mucous lessens the risk of pelvic inflammatory disease (PID) by making it harder for STIs to enter. But again, use a condom for protection against STIs and HIV.

The Benefits Of Copper IUDs: ParaGard

The copper IUD, or ParaGard, is also like a uterus fort! But minus the side effects from hormones. While the copper IUD similarly takes up space in the uterus to prevent implantation of fertilized eggs, the small amount of copper also “impairs sperm motility” or its ability to wiggle its way inside your womb. ParaGard is 99.2-99.4 percent effective at preventing pregnancy.

Besides successfully telling sperm it may not pass on a regular basis, the copper IUD can also act as emergency contraception if inserted 5-7 days after unprotected sex. It also lessens the risk of endometrial cancer. It is the only hormone-free birth control option for women that doesn't require her to rely on her partner or momentarily stop sexual activity to utilize a barrier method. And, again, it lasts for up to 10 YEARS.As you can see, there are so many reasons why women turn to the IUD and love their IUDs. However, like every other single form of birth control, there are reasons why it may not be right for you or why you may end up removing it.

No Birth Control Is Perfect...

General warnings: There is a 1 percent chance that the insertion process will cause uterine perforation, which can lead to serious infections if left untreated. IUD expulsion, or when the IUD gets pushed out of the uterus, can happen, though not frequently – about .05 percent-8 percent of women who get the IUD deal with this problem. Like all forms of birth control, it can fail or cause health problems. BEING FERTILE IS A CHORE, Y'ALL.

The copper IUD is obviously dangerous for women with a copper sensitivity. It can also make periods heavier and cramps worse. If you have the option to use Mirena or Skyla, and you also already have painful periods, then the ParaGard may not be ideal for you. But you might love the hormonal ones. Remember, those ones make your period lighter.

I spoke to one woman who has Mirena, and she began suffering from yeast infections on a regular basis after its insertion. That does not happen to all women with IUDs, but it's a frustrating side effect for her that you may want to bring up with your doctor. Still, even she plans to keep her IUD because of all of its positives.

The insertion procedure is also quite painful for a lot of women. It is pretty hard to predict how much it will hurt because every woman's body and pain tolerance is different. Some women only describe it as very uncomfortable, like really terrible cramps. I talked to a 25-year-old woman who had already suffered from incredibly painful cramps for her entire menstruating life; she hardly experienced any pain during the insertion because her pain tolerance was already so high. Other women are in pain for days and have to take at least one day off so they can just lay in bed to recover.

(Pro tip: every woman I spoke to suggested scheduling the appointment on a day when you don't have any other responsibilities. You'll need to relax, gurl!) An “adjustment period” follows the insertion, wherein your body gets used to the foreign object. For a lot of women, this means Advil, Tylenol, heating pads, and sleep to battle the headaches, cramps, and body aches. Unfortunately, the adjustment period can last a bit over a month, but the eventual peace of mind is so worth it for many women.

Choose What's Best For You And Your Body!

One thing that struck me when I spoke to these specific 10 women is that they either loved their IUDs, or still planned to keep their IUDs regardless of any frustrating or painful side effects as it was still their most affordable, safest option — at least for the time being. And, thankfully, if they ever change their minds, they can have it easily removed.

Remember, while that is the case for these women, it's impossible to know which is your personal best birth control method until you've actually tried it and have spoken with a doctor you trust. Every single contraceptive has both its fans and its h8rs. It's your body so it's your decision.

Here's to finding the birth control method that neither makes us sick nor lets us down as we navigate the confusing and overwhelming path to reproductive freedom!

Images: Sarah Mirk/Flickr; Giphy (4)