Should I Use an IUD to Regulate My Periods?

“Dear KnowYourV, I’m 17 years old and I am active in many different sports like track, La Cross, biking and water sports. Every month my period comes very regular but it lasts for 6-8 days and it is very heavy and I pass clots for at least 3-4 days. I’ve heard birth control can help regulate periods and decrease bleeding. I have also seen commercials on TV that talk about the Mirena IUD and that it can do the same. The thing is I just don’t know if I am too young for an IUD or if I should use some other kind of birth control? I’ve heard if you are young, and have never had children, you should never use an IUD. Is that true?"

Thank you for your question Mimi. I know so many women of child-bearing age that have questions regarding birth control and IUDs (Intrauterine Devices). There are a lot of things to consider when deciding to start taking birth control. Things like; bleeding patterns, how much bleeding with each cycle, PMS, menstrual migraines, pain with periods, whether you have tried birth control before and had undesirable side effects, whether you want permanent or reversible birth control, etc. etc.

The trend today with so many women is to try to use more natural products and steer clear of products that artificially alter the body’s natural chemistry. That is why we are seeing a renewed interest in IUDs.

These 2nd generation IUDs are designed a little different than the IUDs of old, and these changes have really made all the difference. Let’s remember that “the pill” and other hormonal birth control have only been around for about 35-40 years for extensive use by the public. Prior to that, couples had few choices (such as condoms, spermicidal jellies, and IUDs). We’ve come a long way. So what are our choices for birth control today? Reversible types include; temperature chart or rhythm method, condoms, spermicidal jellies/ovules, several types of hormonal birth control ("the pill", the ring, the patch, the injection), IUDs (Mirena or Paragard). You can also choose from two permanent types: tubal ligation (laparoscopic or at time of cesarean section) or hysteroscopic tubal blockage like the ‘Essure’.

So let’s take a look at how IUDs work because there is a lot of misunderstanding about this. Today’s IUDs are shaped like a capital letter ‘T’ with a string attached to the bottom of the ‘T’. It is placed during the menstrual cycle for two reasons; first, during the menstrual cycle the cervix is slightly open so the IUD can slide up into the uterus easier and second, because the cycle is a confirmation that there is not an early pregnancy. The string is there for easy removal, to monitor correct placement and insure that it is still in place and has not fallen out or migrated out of the uterus and up into the abdomen (which is extremely rare). The string is only seen on speculum exam by your doctor and does not hang out through the vagina like a tampon string.

Currently there are two types of IUDs, the Mirena and the Paragard. The Paragard is can be placed in the uterus for about 10 years and has been around longer than the Mirena. It is known as the “copper T” because the copper in the stem is what causes the cervical mucus to thicken, creating a barrier and preventing the sperm from passing through into the uterus and on to fertilize the egg. The Mirena IUD can be placed in the uterus for about 5 years. It releases progesterone from the stem to thicken the cervical mucus and thin the uterine lining. The abnormally thick mucus prevents the sperm from swimming through to reach the egg. The progesterone can also work to thin the uterine lining, which will prevent abnormal uterine bleeding and irregular menstrual periods. That is why sometimes the IUD is used instead of surgery to help treat irregular bleeding.

The main problem with the IUDs of the past was that they used a soft cotton string. This type of string acted like a wick to absorb the vaginal moisture and bacteria from the vagina and allowed it to travel up into the uterus. The use of these typed of IUDs caused many women to become infertile as the infections caused severe scaring of the fallopian tubes. The strings on the IUDs today feel like fishing line and are a monofilament type of substance which prevent bacteria from attaching and traveling up inside the uterus where the IUD is. The new IUDs are safe, and with the new type of string we no longer see these types of super infections.

So, Mimi, that is where the rumor started long ago that IUDs were not the best birth control for someone who has not had children. But now that is no longer the case. In fact, the Mirena would be a good choice for you as it lessens menstrual bleeding and cramping, and you don’t need to remember to take it. More women are choosing it as it doesn't artificially introduce hormones into our bodies to regulate menstrual cycles and it allows you to remain on a regular cycle and to ovulate, it just blocks the sperm from meeting the egg. So give your Gynecologist a call, this may be the right choice for you.

I hope you all have a wonderful week, and please keep writing in with your questions as we love to hear from you.