Which IUD should I choose?

If you're thinking about getting an intrauterine device (IUD) for contraception, you might be wondering which one is best for you. In Australia, there are three types of IUDs available: Mirena, Kyleena, and the Copper IUD. Each has its own benefits and drawbacks, so let's break it down to help you decide.

Kyleena size comparison

There are three IUDs to choose from in Australia:

1. Mirena - levonorgestrel 52mg

2. Kyleena - levonorgestrel 19mg

3. Copper IUD

Mirena —

• Mirena can stay in place for up to 8 years.

• Mirena is larger than Kyleena but similar in size to the Copper IUD.

• The Mirena is inserted in a similar way to the other IUDs. Some people experience cramping during and after insertion, but pain relief options can help.

• Mirena is over 99% effective at preventing pregnancy.

Best suited for:

• Mirena is a good choice for both people who have had children (parous) and those who haven’t (nulliparous). Because it's slightly larger, some people who haven’t had children may find insertion more uncomfortable. If we can time the insertion during or just after your period, the insertion tends to be more straightforward. It is also one of the best methods to reduce or stop heavy menstrual bleeding or irregular cycles.

Risks:

• Irregular bleeding or spotting in the first 4-6 months

• Possible hormonal side effects like mood changes or breast tenderness ( though this is much less likely than other hormonal methods such as The Pill)

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Kyleena —

• Kyleena can stay in place for up to 5 years.

• Kyleena is smaller than Mirena and the Copper IUD, making it a good option for people who prefer a smaller device.

• Kyleena is over 99% effective at preventing pregnancy.

Because it is smaller, Kyleena may be slightly easier and more comfortable to insert than Mirena, especially for people who haven’t had children.

Best suited for:

• People who have never been pregnant (nulliparous) because of its smaller size. It is also a good option for those who want a lower dose of hormones than Mirena.

Risks:

• Irregular bleeding or spotting, especially in the first few months

• Possible hormonal side effects (probably less than with Mirena)

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Copper IUD —

• The Copper IUD can stay in place for 5 to 10 years, depending on the type.

• The Copper IUD is similar in size to the Mirena.

• The procedure is the same as with hormonal IUDs, and some cramping is normal during and after insertion. The Copper IUD does not contain hormones, which can be a benefit for those who want a completely non-hormonal option.

• The Copper IUD is over 99% effective at preventing pregnancy. It can also be used as emergency contraception if inserted within 5 days after unprotected sex.

Best suited for:

• The Copper IUD is suitable for both parous and nulliparous people. However, those who already experience heavy or painful periods may find that the Copper IUD makes this worse.

Risks:

• May cause heavier, longer, or more painful periods

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Which One is Right for You?

• If you want long-term contraception with light or no periods, Mirena might be the best choice.

• If you want a smaller IUD with fewer hormones, Kyleena is a great option.

• If you prefer a hormone-free method, the Copper IUD is your best bet.

All IUDs are highly effective, long-term contraception options, but the right one for you depends on your body and preferences. Talk to your doctor to discuss what suits you best!