Intrauterine devices (IUDs) are a safe and effective contraceptive option that has gained a lot of traction over the last few years. This form of birth control provides long-lasting and reliable results and doesn’t require any regular maintenance. 

When deciding which method of birth control is best for you, there are many factors to consider, including the cost, efficacy, ease of use, etc. KyleenaMirena and Paragard Copper IUD are among the IUDs available in Canada.

What is an IUD?

An IUD is a ‘T’ shaped birth control device that is placed into a woman’s uterus through the cervix to prevent pregnancy. An IUD has two thin strings attached to the bottom that hang down from the vagina when inserted. These strings help the user locate the IUD and ensure it is in place.

An IUD works by preventing the sperm from fertilizing the egg. There are two types of IUDs that both prevent pregnancy, but in slightly different ways.

Know your IUD

In Canada, there are currently two types of IUDs available: 

  • Copper IUDs – The copper material of these non-hormonal IUDs prevents pregnancy by creating an environment that is unfavourable to sperm cells. This environment reduces the sperm cells’ ability to fertilize the woman’s egg. Learn more about Copper IUD
  • Hormonal IUDs – The hormones in these IUDs also produce an environment that is unfavourable to sperm cells. These IUDs make the mucus within the cervix thick. The dense texture of the mucous prevents sperm cells from reaching the egg. In addition to this, the hormones in these IUDs can prevent ovulation. Without ovulation, eggs cannot leave the ovaries. If there are no eggs for the sperm cells to fertilize, pregnancy cannot exist. Learn more about Mirena IUD and Kyleena IUD

How do IUDs work?

IUDs are inserted inside a woman’s uterus, changing the lining of the uterus, preventing fertilization and implantation of an egg to occur. Furthermore, the insertion of the IUD causes an inflammatory reaction, producing a substance, making it a toxic environment for the sperm to survive.

IUD Insertion Procedure

After going through your medical history, possible risks, and obtaining consent, the medical professional will have you lie down on the examination table to prepare for the insertion of the IUD.

  • The whole procedure and IUD insertion takes roughly 5 minutes.
  • Pregnancy check before insertion is mandatory to ensure that the woman is not pregnant while the IUD is being inserted.
  • The doctor will also test for Urinary Tract Infection before the procedure to prevent push back of the bacteria, which may cause further complications.
  • The spectrum is placed inside the vagina, and the IUD insertion can be performed at any point during the menstrual cycle.
  • Do plan for some downtime recovery after the procedure, and do not include physical activity shortly after.

IUD procedure

Similar to a routine pap smear, a speculum is used to open the walls of the vagina. An antiseptic solution is then used to sanitize the area. Another instrument inserts, positions and secures the IUD in the uterus. The trimming of the strings is the final step before the procedure is complete.

How to prepare for IUD insertion

  • Eating a light snack or meal before the IUD is inserted is advisable to prevent dizziness.
  • Drinking lots of water and staying hydrated before the procedure is also recommended, as a urine sample might be needed as part of the process before insertion.
  • If you experience discomfort and pain, consult your doctor if taking Tylenol or Advil is recommended.

While the result may be desirable, the IUD insertion procedure continues to be a source of fear and apprehension. The most common concern being – Is getting an IUD painful?

When should I expect Pain during my IUD Insertion Procedure?

The insertion of the speculum at the beginning of the procedure may cause discomfort for some. This discomfort is not any different than that of a routine pap exam. The insertion and positioning of the IUD may be a source of pain and cramping for some. A numbing medication injected into the cervical canal during the procedure can help with this discomfort.

  • Some may experience cramping, or dizziness, while others may faint when they try to stand up immediately after the procedure.
  • Mild bleeding might occur 3-6 months post procedure, and this is normal. For some, it may take a few months to stabilize and for the body to get used to having the IUD inserted.
  • Take pain relief to relieve discomfort

What should I expect after the IUD Insertion Procedure is Complete?

  • Some people experience dizziness and lightheadedness after the procedure; having someone close to get you home safely is recommended.
  • Back pain and cramping may continue throughout the day. Speak to the medical professional before or after the procedure to determine which over the counter pain medication would be appropriate to use if required.
  • Episodes of spotting and cramping may continue in the months following the IUD insertion, but these symptoms should subside once your body has become used to the device (usually 4-6 months).

Is Getting an IUD Worth the Pain of the Procedure?

Everyone is different, and therefore, everyone will have a different experience during an IUD insertion procedure. Some report minimal discomfort and cramping, while others describe intense pain. The good news is the procedure itself usually lasts no more than 5 minutes.

Many women would consider 5 minutes of soreness and pain, for up to 10 years of carefree contraception, a fair compromise. Taking over the counter pain medication approximately one hour before the appointment will help ease any potential pain or discomfort.

Effectiveness of IUDs

Annually, less than 1% of those with an IUD get pregnant, making them one of the most reliable methods of birth control available. Aside from the efficacy of the device itself, IUDs have an additional advantage:

Once inserted, IUDs work as they are meant to and don’t require any maintenance or additional action. Human error (e.g. forgetting to take your birth control pill) can cause undesirable results (pregnancy) with some of the other “hands-on” contraceptive methods that are currently available.

More than 99% effective. Meaning, 1 out of 100 people who use the IUD method of birth control get pregnant each year.

IUD and Weight Gain

In spite of all the considerations to weigh in on when it comes to selecting a contraceptive method, the first and most common question amongst girls and women continues to be, “Will an Intrauterine Device implant make me gain weight?”

Copper IUD and Weight Gain:

Weight gain is not one of the listed side effects of the Copper IUD. This type of Intrauterine Device is non-hormonal and is said to be unlikely to cause weight gain. However, Copper IUD users do still seem to gain weight gradually over time. Studies show that this increase in weight is comparable to the weight gain of those who aren’t using any form of Intrauterine Device or birth control.

The similarities in weight gain between Copper IUD users and those who are not using any type of contraceptive help validate the fact that Copper IUDs are unlikely the reason behind an increase in body weight.

Mirena & Kyleena IUDs and Weight Gain:

These are hormonal IUDs and may cause weight gain. However, this weight gain may be due to water retention. Progestin, the hormone in both Mirena and Kyleena IUDs, can cause water retention, which in turn leads to bloating. 

This type of weight gain is not an increase in body fat percentage, but rather the body getting used to the introduction of progestin into the bloodstream. The bloating should subside within a few months.

  • Kyleena weight gain – When it comes to weight gain and whether it is directly correlated with the copper IUD, there is no proven scientific data to support the fact. Oftentimes, weight gain while on birth control coincides with lifestyle changes. A healthy balanced diet, regular exercise and staying hydrated with lots of water is recommended to maintain a healthy weight. 
  • Mirena weight gain – Weight gain while on Mirena, is not listed as a common side effect. It ultimately depends on the person’s situation and their lifestyle choices made on a daily basis.
  • Kyleena vs Mirena weight gain – The difference between Kyleena – the copper IUD and Mirena – the hormonal IUD, is that the hormonal IUD may cause weight gain, however, the weight gain is associated with water retention that will subside within the first few months of having inserted the IUD. 

Progestin Levels in Mirena and Kyleena Intrauterine Devices:

It is worth noting that the Kyleena IUD contains lower levels of progestin than the Mirena IUD, while still providing similar results from a contraceptive standpoint. These lower levels of progestin may result in less weight gain due to water retention. 

While the Kyleena may have lower levels of progestin, the Mirena is the preferred IUD for those who require both a method of contraception as well as treatment for heavy menstrual periods. These variables should also be taken into consideration when deciding which IUD is best for you.

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Why do People Gain Weight with IUDs?

Women are more likely to gain weight in their reproductive years, with or without an IUD. This natural weight gain may also be due to lifestyle choices and changes, including stress, a lack of physical activity, changes in work/life balance, etc. 

That said, everyone is different. Any variances in the body’s natural balance of hormone levels can trigger changes, including weight gain. Any weight gain related to the IUD itself should be minimal and temporary.

What should I Do if I Gain Weight?

When any form of weight gain occurs, the first step is to evaluate your current diet, activity levels and stress levels for any cues as to why your weight may be creeping up. 

It is important to note that subtle changes in weight, with or without an IUD, is not an immediate cause for concern, as this type of weight gain is normal. 

If the weight gain is significant or worrisome, or if the healthy lifestyle changes you have made don’t seem to be making an impact, connect with your doctor/medical professional for advice.

Advantages of IUDs

  • Copper IUDs – Copper IUDs are the perfect option for someone looking for a long term birth control method but does not want to use a contraceptive with hormones. Since copper IUDs start working right away, they are useful as an emergency birth control option. Additionally, hormonal reactions like mood and skin changes are not a concern.
  • Hormonal IUDs – In addition to their intended benefits, users of hormonal IUDs may also enjoy the privilege of regular, less painful menstrual periods. Some users report a cessation of their periods altogether. The thick cervical mucus that a hormonal IUD creates may also be helpful in preventing pelvic inflammatory diseases.
  • Both Hormonal and Non-Hormonal IUDs – Both hormonal and non-hormonal IUDs share several advantages, including their efficacy, longevity, and the lack of maintenance. These devices can also be removed by your medical professionals if required.
  • They’re long lasting and can be in the woman’s body anywhere from 3 to 10 years, depending on the type of IUD inserted
  • IUDs are reversible, and if a woman decides to have it removed, her body goes back to her normal cycle almost immediately. Additionally, depending on what kind of an IUD is taken out, a woman may be able to conceive right away.
  • They don’t mess with estrogen, meaning, fewer side effects when compared to the pill.
  • Another benefit to having an IUD inserted is the ability to insert right after delivery, as well as safely breastfeed the baby.
  • Copper IUDs can be used for emergency contraception if inserted within the first 5 days after unprotected intercourse.

Disadvantages / Side effects of IUDs:

  • Copper IUDs – Some users of the copper IUD experience extremely uncomfortable menstrual periods. Those who already suffer from painful periods may choose to avoid this option. People with allergies to copper should also avoid this type of IUD.
  • Using a copper IUD isn’t for everyone, and may come with notable side effects. Some of the more common are irregular bleeding between periods, menstrual like cramps and heavy bleeding during the cycle.
  • Hormonal IUDs – A hormonal IUD may be a poor choice for those who have received treatment for breast cancer or those with liver disease. These types of IUDs may also be unsuitable for those with certain types of cancer (endometrial or cervical cancer).
  • Some of the more common side effects of having IUD with hormones are: headache, acne, cramping or pelvic pain, nausea, vomiting or bloating.
  • Both Hormonal and Non-Hormonal IUDs – There are a few instances where both hormonal and non-hormonal IUDs should be avoided.
  • Changes as sometimes come with regular menstrual cycles. The main side effects of using an IUD is the irregularities it may cause with the monthly bleeding patterns, as well as mild bloating, cramping and mood.
  • If an IUD is left inside the body past its expiry date, in rare cases, it might cause infection and as a result infertility, if left untreated.
  • IUDs of any kind are not recommended for those with an active pelvic infection. Those with a uterus with an abnormal shape should also avoid IUDs.

Final Thoughts

While there are some risks involved with getting an IUD, the benefits far outweigh the negatives for most people. But for the most part, this procedure is well tolerated and provides peace of mind for many years to come. And, if you prefer an effective “hands-off” solution that allows you to have control over when (and if) you choose to conceive. IUDs are a flexible and attractive choice for women looking for a long-term birth control solution.

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