Copper IUD or Mirena for PCOS Birth Control?

By Amy Medling, founder of PCOS Diva

There are many forms of contraception available to women with Polycystic Ovarian Syndrome (PCOS). While there is no one-size-fits-all approach for the best birth control for everyone with PCOS, some methods are better than others. The question is whether to choose hormonal versus non-hormonal methods.

Beyond contraception, the hormonal birth control pill is often prescribed as a therapy for women with PCOS as a band-aid to cover symptoms. I’ve written extensively and interviewed several experts for the PCOS Diva podcast about the pros and cons of the pill for PCOS.  Learn more about PCOS and the birth control pill here.

The next popular option is an IUD like Mirena®, Liletta, Kyleena®, Skyla®, and Paragard (copper). So, is Mirena or the copper IUD a good choice for PCOS birth control?

What is an IUD?

An intrauterine device (IUD) is a T-shaped device inserted into the uterus as a long-lasting, reversible form of birth control. They commonly make periods shorter and lighter, and with an expected failure rate of less than 1%, they are an appealing option.

IUDs come in two types, hormonal and non-hormonal (copper). The non-hormonal copper IUD causes local inflammation and makes an environment harmful to sperm and prevents fertilization. The hormonal IUD (Mirena) contains progestin which thickens cervical mucus to block sperm and may also prevent ovulation.

Is a hormonal IUD like Mirena good for those with PCOS?

Mirena is a hormonal IUD. It is over 99% effective at preventing pregnancy for up to 5 years. Possibly the most appealing feature for women with PCOS is that periods may become shorter or lighter or may stop all together over time. For those who have endometriosis or heavy periods, this is most welcome.

Mirena uses progestin which is a synthetic form of the hormone progesterone to prevent pregnancy. Progestin thins the uterine lining, thickens cervical mucus, and inhibits sperm movement. It can partially suppress ovulation as well and can prevent your ovaries from releasing an egg.

The introduction of synthetic hormones (progestin) is not something I recommend. There is a big difference between your body’s natural progesterone and synthetic progestin. Learn more about the difference here.

Mirena is generally considered safe, but there is a low risk of side effects including headache, acne, breast tenderness, and mood changes such as anxiety or depression.  Anecdotally, some women associate symptoms such as low libido, hair loss, weight gain, yeast infections, and chronic pelvic pain.

Is a non-hormonal IUD like Paragard good for those with PCOS?

Paragard is a non-hormonal copper IUD. It is a copper wrapped T-shaped device inserted into the uterus as a long-lasting, reversible form of birth control. Paragard releases copper that bathes the lining of your uterus, creating an inflammatory reaction that’s toxic to sperm and eggs therefore preventing pregnancy. Because there are no hormones, the copper IUD allows for normal ovulation and can be used when breastfeeding.

Very rarely, the copper in an IUD can cause copper excess especially if you have a condition which affects your liver’s ability to filter copper. This in turn can cause higher anxiety, headaches, and other symptoms.  It is important to test copper levels and supplement with zinc which can offset higher copper levels.

Are Mirena or Paragard a good option for birth control with PCOS?

I am not a fan of any birth control that introduces synthetic hormones into our bodies. I believe that Fertility Awareness combined with barrier methods are best for women with PCOS because they have no impact on hormones.

Fertility Awareness and Monitors with PCOS

One of the best things someone with PCOS can do it track their cycle even if it is irregular or nearly absent. Your period tells you a lot about your overall health whether you are trying to conceive or not. Tracking can be tricky with PCOS. Here is more information about how to make it work for you.

• How to Choose the Right Fertility App and Monitor
• The Best Ovulation Predictor Kit & Fertility Monitoring for PCOS [Podcast with Kate Davies]
• My Favorite PCOS Fertility Tool [Podcast with Rob Miles]

Amy Medling, best-selling author of Healing PCOS and certified health coach, specializes in working with women with Polycystic Ovary Syndrome (PCOS), who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill, and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet, and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health, and happiness.  

Resources:

• “Hormonal IUD (Mirena).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 26 Feb. 2020, www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354.
• “Copper IUD (ParaGard).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Feb. 2020, www.mayoclinic.org/tests-procedures/paragard/about/pac-20391270.
• Susan Rinkunas November 12, and Susan Rinkunas. “Everything You Need to Know Before Getting an IUD.” Health.com, 12 Nov. 2020, www.health.com/condition/sexual-health/what-is-an-iud.