IUD and menstruation: what impact on menstrual flow?

While the pill remains the most common method of contraception used by women in France, many women opt for the contraceptive IUD. Some women prefer not to have to think about their contraception on a daily basis. In any case, contraception is a personal choice that should be discussed with your health care professional, who will be able to give you the best advice.

What is a contraceptive IUD?

It is difficult to choose a contraceptive method when you know what relationship contraception and menstruation can have! The intrauterine device, or IUD, is a T-shaped contraceptive device, measuring about 3.5cm long and 3cm wide. The doctor will place it in theuterus. It is a very effective method that offers excellent efficacy and can be used regardless of age or if you have had children before.

The copper IUD will work thanks to the action of the copper which will prevent the spermatozoa from reaching the ovum by acting as a spermicide. It will also provoke an inflammatory phenomenon in the uterus which will prevent the nidation of the embryo due to a thinning of the endometrium.

The hormonal IUD acts by diffusing a small quantity of progestogen hormones on the wall of the uterus. The hormones will thicken the secretions of the cervix, which will block the passage of spermatozoa. The lifespan of the copper device is 10 years compared to 5 years for the hormone device.

What are the effects of an IUD on menstruation?

Whether it is made of copper or hormonal, it will tend to modify menstruation.

The hormonal IUD

The hormonal IUD and menstruation are directly linked by the presence of progesterone in the IUD, such as the Mirena in France. Indeed, this method often causes less abundant periods, which can even disappear over time for one woman out of 3 (amenorrhea). The hormonal method can be a good solution for people suffering from heavy menstrual flow. There may be a risk of uncontrolled bleeding, but this generally only lasts for the first few months.

The copper IUD

This is a natural contraception, without hormones. The copper IUD has no impact on menstruation, which allows women to keep their periods natural.
Unlike the hormonal IUD, the copper IUD is known to cause much heavier and longer periods. Be careful if you already suffer from heavy or bleeding periods, or menstrual pain (for example with endometriosis).

Should I choose my IUD according to my period?

If you have a very heavy or bleeding period, it is better to think before inserting a copper IUD. The hormonal IUD does not present any particular contraindication. However, since it works with hormones, it can cause the classic side effects and undesirable effects that we know about with hormonal contraception: acne, risk of mood swings, headaches, reduced libido, swelling of the breasts, etc...

How is an IUD inserted?

The insertion is done by a doctor, gynecologist or midwife, after an initial appointment where the risks of uterine fibroids, vaginal infection or pregnancy are ruled out: in short, that you have no contraindications to the insertion of an IUD. The IUD is inserted at the beginning or end of menstruation. This confirms that you are not pregnant and also makes it easier to implant the device, since the cervix is open during menstruation.
The insertion is done through a speculum: it is passed through the vagina to be placed in the uterus. The insertion should not hurt and only takes a few minutes. Will you have a wire sticking out? Don't worry, the IUD wires are used when the IUD is removed and can be cut shorter if they get in the way during sex.

Does the flow of menstruation change directly after an IUD is inserted?

Menstrual periods following IUD insertion are modified. For the hormonal version, they will be reduced but anarchic bleeding may appear. With the copper version, the price to pay is generally a heavier and longer flow for a few months after insertion, or even longer. We strongly advise you to use a menstrual panty, especially at night, to avoid too much irritation with repeated use of traditional sanitary protection.

Do periods return to normal after the IUD is removed?

In general, menstrual periods eventually stabilize and return as close to normal as possible. However, for the copper IUD, the volume of blood loss remains greater overall. With the hormonal method, periods tend to remain lighter. Frequently, women on the hormonal IUD have no discharge at all. Of course, every woman is different! You can use a period panty adapted to your current flow to limit your discomfort if necessary.

What are the alternatives to the contraceptive IUD?

There are many contraceptive methods: birth control pills, implants, patches, male or female condoms, diaphragms, vaginal rings, spermicides... All of them have different degrees of effectiveness, advantages and disadvantages on the libido which will be more or less important depending on each person's preferences. Your general practitioner or health professional will be able to guide you. Note that the choice of contraception and the mental burden related to it, in a couple should not rest solely on the woman! Remember also that only condoms protect against STIs and STDs!

FAQ about IUDs and menstruation

Why insert an IUD during my period?

The IUD is usually inserted during the menstrual period because it is at this time of the menstrual cycle that the cervix is open thanks to the evacuation of the endometrium, which greatly facilitates its implantation.

What are the disadvantages of the IUD in terms of menstruation?

It will generally cause longer periods, with a greater volume, but also more painful. This is obviously not systematic and not to the same degree for all women.

How to stop bleeding following the insertion of an IUD?

Uncontrolled bleeding can occur after the insertion of a hormonal IUD. If it persists after a few months, make an appointment with your gynecologist: this method of contraception may not be suitable for you. When a copper intrauterine device is inserted, it is also normal to have some bleeding the following days.

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