Many misconceptions persist on the IUD . Given the latest scientific studies that seem to support the adverse effects felt by some users of Mirena , the most common hormonal IUD, it is time to take stock of these long-lasting intravaginal contraceptives . Overview to form an objective idea.
Copper IUD: oxides that inactivate spermatozoa
This plastic element surrounded by a copper wire plays two roles: it inactivates the spermatozoa by releasing copper oxides, which renders them incapable of fertilizing the ovum, and induces a small local inflammatory reaction which prevents the implantation of a possible embryo. Its effectiveness rate is 99.2% according to the World Health Organization (WHO).
Its advantages: it respects the natural course of the menstrual cycles since it does not deliver any hormone likely to disturb the good functioning of the body.
A great asset for all those who fear taking hormones or those to which hormones are not recommended, in case of cysts or breast tumors, for example.
It can be placed in almost all women, as there are also in short version, small models adapted to the uterus of nulliparous girls, (who have not yet had children). It can also be used for emergency contraception (catch-up).
"IUD insertion within five days of being at risk of pregnancy is more effective than taking a morning-after pill," said Dr. Teddy Linet, Obstetrician Gynecologist, co-author of "My Gynecologist Guide" (Pocket ed.)
Its disadvantages: since it does not distill any hormone in the body, it does not diminish the volume of menstruation or premenstrual syndrome (bloating, migraines, mood swings and fatigue occurring before the period).
A handicap when suffering from painful haemorrhagic rules. It can even result in a transient increase in menstrual volume, "50% higher in the first six months," says Dr. Linet.
The hormonal IUD (or SIU), type Mirena: hormones continuously
It contains a reservoir that continuously releases hormones derived from progesterone, levonorgestrel . It diffuses on the wall of the uterus and prevents the mucosa from developing excessively.
No fertilized egg can therefore implant there. "It also thickens the mucus of the cervix, which prevents sperm from passing," says Dr. Linet. Its effectiveness rate is 99.8% according to the World Health Organization (WHO).
Its advantages: it significantly reduces the volume of the rules, and sometimes even removes them. Some gynecologists prescribe it for non-contraceptive purpose to women who suffer from very heavy rules.
It also clears the PMS . Besides the standard format (Mirena), there is also since 2014 a mini format, marketed under the name of Jaydess.
Finer and shorter, it releases only 5 to 13.5 micrograms of hormones per day, against 10 to 20 micrograms for Mirena.
Its disadvantages: the absence of rules can disturb some women, who are more reassured to have them. In addition, it has side effects: risk of irregular and unpredictable bleeding ("spottings"), weight gain, eruption of acne and hair in women predisposed .
Not to mention the many disturbances never reported before, but recently reported by hundreds of women with a Mirena (depression, anxiety, dizziness, hair loss, heaviness in the abdomen ...).
This device, currently being evaluated by the European Medicines Agency (EMA), was supposed to have only local action .
However, a February 2017 study **, conducted at the Erasmus Medical Center University in Rotterdam, suggests that Mirena's contraceptive hormones affect the brain and could thus be responsible for the mental disorders of which some patients complain.
Even though IUDs are designed to protect against long-term pregnancy (5 to 10 years for copper IUDs and 3 to 5 years for hormonal devices), they can be removed at any time if desired or in case of too much side effects.
* with Agnès Ledig, midwife
** www.researchgate.net/publication/314138176_The_levonorgestrel-releasing_intrauterine_device_potentiates_stress_reactivity
