My Mirena IUD Experience- Deciding Which IUD was Right for Me

Mirena, ParaGard, Kyleena, Liletta, Skyla- with so many IUD options out there now, how did I decide on Mirena? Well, let's talk about the differences between the IUDs!  And through this entire thing, please keep in mind that the option that is best for me might not be best for you- contraception is highly personalized.

IUD- Intrauterine Device

IUDs are in two main categories: hormonal and non-hormonal. Mirena, Kyleena, Liletta, and Skyla all work by releasing a hormone into the uterus. ParaGard on the other hand, is a nonhormonal IUD made of copper.

Because I have PCOS and issues with heavy bleeding- I knew I wanted a hormonal IUD, but let's explore ParaGard before diving into those!

ParaGard's working component is the copper coil- because it doesn't contain hormones it's a great option for those wanting to avoid hormones, those who HAVE to avoid hormones, or those who have normal periods to begin with. The copper IUD works by being hostile to sperm. (Which is why I personally think they should have spelled it ParaGUARD but hey, that's just me. I like to picture it with a battle helmet putting the swimmers to rest.) Basically copper is a very effective spermicide, copper ions are released in the uterus and stay there- sperm enters, copper ions prevent sperm from moving very well (it actually detaches the sperm from it's tail) and then phagocytosis of the sperm occurs. (To shorten that to not- science words, cells attack and devour the nonmobile sperm.) ParaGard may also thicken cervical mucous in some- but not others.  ParaGard is effective for up to 10 years, over 99% effective, and can even be used as emergency contraception for up to 5 days after non-protected sex.

The cons of nonhormonal IUDs? Well, the main one is your bleeding and cramps may increase- in some cases significantly. That is the main factor that I knew I couldn't handle- even on hormones I bleed significantly, increasing it is not appealing at all.

Copper IUD on the right 

Now, getting into the hormonal ones- this comparison is a lot more straightforward because to be honest? The differences are very slight. Because I'm getting my IUD through the Arch Program- Liletta wasn't an option for me but I included it for comparison.

How do hormonal IUDs work? They release Levanogestrol, a form of progestin into the uterus. Levanogestrol works by thickening your cervical mucous, making it harder for sperm to be mobile. It also thins the lining of your uterus making implantation less likely, but that's not the main way it prevents pregnancy- however that is how hormonal IUDs help with heavy bleeding. Unlike with other methods (combination pill, mini pill, arm implant) the hormones of the IUD stay mostly localized in the uterus- very minuscule amounts make it elsewhere.

All IUDs mentioned here are over 99% effective in preventing pregnancy- so here's a quick run down of the differences.

Mirena-  52 mg of levonorgestrel. Initially, he hormone is released at a rate of 20 mcg/day. This decreases as time goes on, Mirena is approved for up to 5 years.

Kyleena- 19.5 mg of levonorgestrel released at a rate of 17.5 mcg/day after 24 days. This rate decreases progressively to 9.8 mcg/day after 1 year and to 7.4 mcg/day after 5 years. Kyleena is approved for up to 5 years.

Liletta- 52 mg of levonorgestrel, released at a rate of  18.6 mcg/day initially and declines progressively to 16.3 mcg/day at 1 year, 14.3 mcg/day at 2 years, and 12.6 mcg/day at 3 years after insertion. Liletta is approved for up to 3 years.

Skyla-  14 mg levonorgestrel released at a rate of 14 mcg/day after 24 days and declines to 5 mcg/day after 3 years. Skyla is approved for up to 3 years.

Skyla and Kylenna both boast about being smaller than other IUDs, which they say makes them more suitable for younger women and women without children- however in reality they are only about 2mm smaller than the other IUDs and all IUDs can be used in women without children. Your doctor will help you determine what size is right for you.

Not too much of a difference!

Besides the hormone levels and how long they are approved for.. what's the difference between hormonal IUDs? Not much. Because the hormones in Mirena and Liletta are higher you are more likely to stop having a period on those (1 in 5 women compared to about 1 in 17 on the smaller ones), but all of the hormonal IUDs can lighten your period. They are all over 99% effective, though Mirena is 99.8% effective verses 99.1% effective of the smaller ones, again- minuscule details.

All IUDs are safe, effective, and won't affect your fertility. There are horror stories circulating about how dangerous IUDs are however- the modern ones aren't. The one those stories are based off of is known as the Dalkon Shield which caused a higher rate of infections and injuries in its users, even death. However take one look at the thing and it's easy to see how that happened:

The Alien Facehugger of IUDs

The Dalkon Shield is no longer on the market, for obvious reasons. The risk of serious injury with modern day IUDs is less than 1%. Ovarian cysts may occur but usually go away on their own (as someone with PCOS that's just another day for me), the IUD may not be suitable for women who are prone to pelvic infections. Bleeding and spotting is common to increase in the first 3-6 months after insertion, especially with your first IUD.

As always, talk to your doctor to find out what is best for you! For me, even though I don't have children, Mirena was the best option to help control my bleeding, it's the only IUD specifically approved to treat heavy bleeding- for others it won't be the right choice.

I am about 2 weeks away from insertion, so I'm here hoping this is how it will go:

IUD squad goals, af.