Mirena vs. Copper IUD: Which Is Right for You?
Mirena vs. Copper IUD: Which Is Right for You?
If you want birth control you don’t have to think about every day, an IUD is one of the mos
t effective and convenient choices available. An IUD (intrauterine device) is a small, T-shaped device placed in the uterus during a quick office visit. Once it’s in, it protects against pregnancy for years, and fertility returns quickly after it’s removed. And most IUD insertion and devices are covered under most insurance plans such as Blue Cross/Blue Shield, Cigna and United Healthcare (please contact your insurance company to verify benefits as each patient's plan is different).
There are two (2) primary IUD options for patients: hormonal IUDs, such as Mirena, which release a small amount of the hormone levonorgestrel, and the copper IUD, Paragard, which contains no hormones at all. Both work very well. The best choice depends on how you feel about hormones, what your periods are like now, and how long you want protection.
Mirena and the Copper IUD at a glance:
Mirena (hormonal) | Paragard (copper) | |
Active ingredient | Levonorgestrel, a progestin hormone (52 mg) | Copper; no hormones |
How it works | Thickens cervical mucus and thins the uterine lining | Copper makes the uterus inhospitable to sperm |
FDA-approved length of use | Up to 8 years | Up to 10 years |
Effectiveness | More than 99%; about 0.2 pregnancies per 100 users in the first year | More than 99% |
Effect on periods | Usually lighter over time; about 20% stop having periods by one year | Periods may be heavier and longer, especially at first |
Also treats | Heavy menstrual bleeding (approved for up to 5 years) | Can serve as emergency contraception if placed within 5 days of unprotected sex |
Fertility after removal | Returns quickly | Returns quickly |
Benefits of Mirena:
Lighter, easier periods. After an adjustment period, most women bleed less, and about 1 in 5 stop having periods altogether within the first year.
Treats heavy periods. Mirena is FDA-approved to treat heavy menstrual bleeding for up to 5 years in women who also want birth control, and it reduces blood loss significantly.
Less cramping for many women. Because the uterine lining stays thin, period pain often improves.
Long-lasting protection. One device prevents pregnancy for up to 8 years.
Very low hormone dose. The hormone acts mainly inside the uterus, so the amount reaching the rest of the body is much lower than with birth control pills. It contains no estrogen, which makes it an option for many women who can’t take estrogen.
Highly effective. In clinical trials, about 0.2 out of 100 women became pregnant in the first year of use.
Benefits of the copper IUD (Paragard):
Completely hormone-free. Paragard’s only active ingredient is copper. It’s a good fit for women who prefer to avoid hormones or who have had side effects from hormonal birth control.
The longest-lasting option. One device prevents pregnancy for up to 10 years.
Your natural cycle stays the same. You keep ovulating and having regular periods, which some women prefer.
Works right away. Protection begins as soon as it’s placed.
Can double as emergency contraception. Placed within 5 days after unprotected sex, a copper IUD is the most effective form of emergency contraception, and it then keeps working for years.
Highly effective. More than 99% effective at preventing pregnancy.
What to expect, and which one may suit you:
Insertion takes only a few minutes in the office. Most women feel cramping during placement and for a day or two afterward. Over-the-counter pain relievers usually help. A follow-up visit confirms the IUD is in place.
Side effects are usually temporary:
Mirena: irregular bleeding or spotting is common in the first 3 to 6 months, then bleeding usually decreases. Some women notice headaches, breast tenderness or mood changes.
Paragard: periods may be heavier and longer, with more cramping, especially in the first several months. This often improves over time.
With either IUD, the device can occasionally slip out (expulsion), and very rarely it can push into the wall of the uterus during insertion. Your doctor will review these risks with you.
Mirena may be a better fit if you:
have heavy or painful periods
would like lighter periods, or none at all
are comfortable with a low dose of hormone
Paragard may be a better fit if you:
want to avoid hormones entirely
have light or normal periods now
want the longest possible protection, or need emergency contraception
Neither IUD protects against sexually transmitted infections, so condoms are still recommended when STI protection is needed.
Talk with Dr. Martin-Johnston about your options
The right IUD depends on your health history, your periods and your plans. At Midwest Gynecology in Hoffman Estates, Dr. Meredith Martin-Johnston places and removes both Mirena and Paragard IUDs and can help you decide which fits you best. We care for women throughout Chicago’s northwest suburbs, including Palatine, Schaumburg, Barrington, Lake Zurich and Arlington Heights.
Call 847-558-2822 to schedule a consultation.
This article is for general information and isn’t a substitute for medical advice. Talk with your doctor about which birth control is right for you.
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