Comprehensive Guide to Intrauterine Devices (IUDs): Insertion, Pros, Cons, Advancements

Intrauterine devices (IUDs) are one of the most reliable methods of hormonal contraception available today. With growing awareness about family planning and innovative hormonal contraceptives, IUDs have gained popularity for their efficacy, safety, and long-lasting effects. This blog comprehensively guides you through everything about IUDs, along with upcoming advancements.

What are Intrauterine Devices (IUDs)?

IUDs are compact plastic T-shaped contraceptive devices that are put inside the uterus to prevent pregnancy. These are the most commonly used types of long-acting reversible contraceptives (LARCs), which offer effective contraception with minimal maintenance. IUDs are significantly less likely to fail than other methods. After insertion, a woman doesn’t have to worry about birth control until it’s time to replace it, as an IUD can be effective for 3 to 12 years.

What are Types of IUDs?

There are two types of IUDs:

Hormonal IUD: Hormonal IUDs come in a T-shaped, plastic form, which releases the progestin hormone levonorgestrel, which helps prevent pregnancy. Hormonal IUDs last between 3 to 6 years, depending on the brand.

Mirena, Liletta, Kyleena, and Skyla are four types of hormonal IUDs available in the United States. Other countries have several other hormonal IUDs available.

The growing availability of hormonal contraceptives in emerging markets, driven by expanding healthcare infrastructure and improving economic conditions in North America, is fueling the market growth for hormonal contraceptives in the region. The United States and Canada dominate the market share, supported by advanced healthcare systems, extensive research and development activities, and high consumer spending on healthcare products. According to Polaris Market Research, the global hormonal contraceptive market size was valued at USD 16.73 billion in 2023. The industry is expected to upsurge from USD 17.45 billion in 2024 to USD 24.60 billion by 2032, recording a CAGR of 4.4% during 2024-2032.

Copper IUD: Copper IUDs are made of copper and plastic, which don’t release any hormone; instead, they release a small amount of copper into the uterus, which prevents fertilization. Copper IUDs can last up to 10-12 years, depending on the brand.

ParaGard is the only FDA-approved copper IUD available in the United States today. Other countries have several other copper IUDs available.

In October 2023, Sebela Women's Health Inc., a part of Sebela Pharmaceuticals, revealed data from a Phase 3 open-label study of the investigational Copper 175 mm2 intra-uterine device (IUD), a reliable and alternative method of contraception. Recent data from three women's health congresses supports the investigational, next-generation, hormone-free IUD, as shown in its pivotal phase 3 trial. The strong endorsement from these conferences reinforces the effectiveness and safety profile of the hormone-free IUD, which has shown promising results in its pivotal Phase 3 trial.

Insertion and Removal

IUD insertion can be performed at any time during the menstrual cycle in a healthcare provider’s office, provided the woman is not pregnant. However, the uterus position and the depth of the uterine cavity must be considered before insertion. Removal is also simple and can be done at any time.

The use of IUDs varies widely by region and country. As of April 2024, the United Nations reported that 169 million people worldwide use intrauterine devices (IUDs) as a form of contraception, making them the most popular reversible birth control method. This figure includes both hormonal and non-hormonal IUDs, with copper IUDs being the most widely used. IUDs are particularly popular in Asia, where nearly 30% of users rely on this method.

Benefits of IUDs

• IUDs are more than 99% effective at preventing pregnancy.
• Provides long-term protection for several years with less or zero maintenance.
• They are safe for post-pregnancy and breastfeeding women.
• IUDs can be cost-effective forms of birth control.
• Once inserted, you don't need to worry about birth control. You need to check the thread each month after your period to ensure it has not moved.
• After removal, you can become fertile again.

Brand-Specific Advantages:

• Mirena and Liletta are said to reduce heavy periods and period pain.
• Paragard prevents pregnancy pregnant post inserting five days of having unprotected sex

Considering Possible Side Effects of Using An IUD

• When first inserted, you may experience cramping that lasts for a few days.
• Sometimes, your IUD can come out by itself. This usually happens within the first few months after being inserted.
• As an IUD is not suitable for everyone. Some of you may experience breast tenderness, headaches, skin changes, or mood fluctuations.
• Hormonal IUDs may cause irregular periods or spotting, especially in the first few months.
• In severe cases, an IUD may puncture the uterine wall, necessitating surgical removal.
• Chances of infection: Around 1 in 300 users may develop an infection when the IUD is initially inserted.
• Ectopic pregnancy: It's very unlikely to become pregnant while using an IUD. However, if pregnancy does occur with an IUD in place, the risk of an ectopic pregnancy is higher.

Recent Launches in Intrauterine Devices (IUDs)

In June 2023, PREGNA INTERNATIONAL LTD., a women’s contraceptive products developer, announced that it has raised its private equity funding of $16 Million or 130 Crore from INDIA LIFE SCIENCES FUND III (ILSF III) for a minority stake.

In April 2024, Bayer introduced a new digital platform designed to offer personalized contraceptive information and resources. This launch represents a major advancement in combining technology with reproductive health management, enhancing access to tailored contraceptive guidance and support.

Advancements in Intrauterine Devices (IUDs)

Compact Devices: New developments in intrauterine technology are providing small and more flexible devices capable of reducing the risk of pain and discomfort during insertion.

Lower-Dose Hormonal IUDs: Some newer hormonal IUDs release lower doses of hormones, reducing adverse effects like high menstrual flow and cancer. These lower-dose hormonal IUDs provide effective contraception.

Smart IUDs: The concept of "smart IUDs" is expected to hit the market in upcoming years. These IUDs could detect the position and performance of the device in the uterus. Additionally, these devices are equipped with sensors that can detect distances of up to 5 mm and are connected to a smartphone app, enabling women and healthcare providers to monitor the IUD’s effectiveness and identify any issues early.Top of FormBottom of Form

Looking Ahead

Biodegradable IUDs: With continuous innovations, we can expect even more options and features in IUDs. There are many innovations in the row in long-term contraception. Researchers are conducting studies to address long-term use concerns and simplify device removal associated with biodegradable intrauterine devices (IUDs). These IUDs are made from natural materials.

Non-hormonal IUDs: As of July 2024, a chemist at Western University is working on a new non-hormonal intrauterine device (IUD) that doesn't have significant side effects. The new device is likely to be a significant advancement for those seeking hormonal-free contraception.

Male IUDs: The development of male contraceptive options is progressing. For instance, in November 2022, medical device company Contraline introduced the first hydrogel-based male contraceptive device – ADAM. According to their clinical trial, the device blocks sperm from traveling through the vas deferens and has not reported any serious adverse events post-trial. The Virginia-based company further plans to file for an investigational device exemption with the FDA by the end of 2024, aiming to start the clinical testing and seek FDA approval for ADAM.