Hormonal intrauterine device

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A type of long-acting reversible contraceptive device


A hormonal intrauterine device (IUD) is a small, T-shaped plastic device that is inserted into the uterus to provide long-term contraception. It releases a hormone called levonorgestrel, which is a type of progestin. This device is considered a form of long-acting reversible contraception (LARC) and is highly effective in preventing pregnancy.

Mechanism of Action

The hormonal IUD works primarily by releasing levonorgestrel into the uterine cavity. This hormone thickens the cervical mucus, making it difficult for sperm to enter the uterus and fertilize an egg. Additionally, levonorgestrel thins the endometrium, reducing the likelihood of implantation should fertilization occur. In some cases, it may also inhibit ovulation.

Types of Hormonal IUDs

There are several types of hormonal IUDs available, varying in size, hormone dosage, and duration of effectiveness. Common brands include:

  • Mirena: Effective for up to 7 years, releases 20 micrograms of levonorgestrel per day.
  • Kyleena: Effective for up to 5 years, releases 17.5 micrograms of levonorgestrel per day.
  • Skyla: Effective for up to 3 years, releases 14 micrograms of levonorgestrel per day.
  • Liletta: Effective for up to 6 years, releases 19.5 micrograms of levonorgestrel per day.

Insertion and Removal

The insertion of a hormonal IUD is a procedure typically performed by a healthcare professional. It involves placing the device through the cervix into the uterus. The procedure can cause discomfort, but it is usually brief. Removal is also performed by a healthcare provider and involves gently pulling on the IUD strings to extract the device from the uterus.

Benefits

Hormonal IUDs offer several benefits, including:

  • High effectiveness in preventing pregnancy (over 99%).
  • Long-term protection, ranging from 3 to 7 years depending on the type.
  • Reduction in menstrual bleeding and dysmenorrhea (painful periods).
  • Rapid return to fertility upon removal.

Side Effects

Some users may experience side effects, particularly in the first few months after insertion. These can include:

  • Irregular bleeding or spotting.
  • Headaches.
  • Breast tenderness.
  • Mood changes.
  • Ovarian cysts.

Contraindications

Hormonal IUDs are not suitable for everyone. Contraindications include:

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