IUD vs. NuvaRing: Know Your Options

Medically reviewed by Nicole Galan, RN on February 11, 2016Written by Kimberly Holland on February 11, 2016

Deciding Which Birth Control Is Right for You

If you’re exploring your birth control options, you may be wondering how intrauterine devices (IUDs) compare with the vaginal ring called “NuvaRing.” These two types of birth control are very different. Choosing the one that’s right for you might depend on your preference and how convenient it is for you.

If you don’t want to rely on your doctor to place and ultimately remove an IUD, you may like the flexibility of NuvaRing. However, if you prefer long-term pregnancy prevention benefits and a hands-off approach, you may want to go with an IUD.

Use this guide to help you find one that best fits your lifestyle and your preferences for contraception choices.

Intrauterine Devices (IUDs)

An IUD is a T-shaped device that your doctor will place in your uterus. IUDs can either be copper, such as ParaGard, or hormonal, such as Mirena, Skyla, or Liletta.

Both types of IUDs provide long-term protection against pregnancy. Mirena protects against pregnancy for five years, and Skyla and Liletta last for three years. The non-hormonal ParaGard protects against pregnancy for up to 10 years.

IUDs are extremely effective at preventing pregnancy. Less than 1 percent of women who use an IUD will become pregnant each year. Additionally, women who have an IUD inserted within five days, or 120 hours, of unprotected sex can reduce their risk of pregnancy by 99.9 percent.

Hormonal IUDs release a steady stream of hormones into your body. These hormones prevent pregnancy in three ways. First, the IUD partially stops ovulation. Ovulation occurs when an egg is released from your ovaries into your fallopian tubes and eventually your uterus. If this egg meets a sperm, the sperm could fertilize it and create an embryo. Without an egg, fertilization isn’t possible.

Hormonal IUDs also thin the lining of your uterus. This prevents a fertilized egg from attaching and developing. Additionally, hormonal IUDs increase the production of thick mucus on your cervix. This thick, sticky lining blocks sperm from entering your uterus and fertilizing an egg.

Mirena vs. ParaGard vs. Skyla: Choosing the Right IUD

Copper IUDs continuously release copper into your uterus. Copper creates an inflammatory response in your uterus that kills sperm. This reduces the chances of fertilization if an egg is released from your ovaries during ovulation.

Cost of an IUD

NuvaRing

NuvaRing is a hormonal contraception device. It’s a thin, flexible ring made of transparent plastic. For it to work, you need to insert the ring into your vagina. The ring will remain in your vagina for three weeks. On the fourth week, you remove the ring and you’ll have a period. After this week, you’ll insert a new ring and begin the cycle again.

If it’s used correctly, NuvaRing is very effective. The ring is 99 percent effective when it’s used as directed. If you’re late putting the ring in or otherwise use the ring incorrectly, this rate drops to 91 percent.

NuvaRing works by releasing a steady stream of hormones into your body. This stream of hormones prevents pregnancy in two ways. First, the hormones stop ovulation. Second, the hormones thicken the mucus that lines your cervix. Sperm have a difficult time penetrating this thick, sticky mucus. This keeps the sperm from reaching an egg if one was released during ovulation.

What Are the Side Effects?

As with any form of birth control, both NuvaRing and IUDs can cause side effects that range from mild to severe. If you’re considering using either, keep these possible side effects in mind.

The side effects of IUD use include:

  • mild to moderate pain following the IUD insertion
  • cramping and back pain once the IUD is in place
  • heavier periods and worsening menstrual cramps, which occurs with ParaGard
  • irregular periods for the first three to six months of use, which occurs with Skyla and Mirena
  • breakthrough bleeding or spotting for three to six months after insertion

The side effects of NuvaRing use include:

  • nausea
  • vomiting
  • breakthrough bleeding between periods
  • breast tenderness and sensitivity
  • increased vaginal discharge
  • vaginal irritation
  • infection

Rare side effects of all forms of hormonal birth control, including NuvaRing, may include:

  • a heart attack
  • a stroke
  • blood clots

What Causes These Side Effects?

With hormonal birth control, you change your body’s chemistry. When you do this, you introduce the opportunity for hormone-related side effects. Shifting hormones in either direction can cause changes. In some cases, this change is desired, such as stopping ovulation. In other cases, the hormone shift isn’t desired or intended. Increased hormones can cause blood clots and stroke.

Risk Factors to Keep in Mind

Your doctor may rule out some forms of birth control if you a health profile that could increase your odds of having side effects or complications.

For example, hormonal contraception may not be right for you if you:

  • are over age 35
  • have high blood pressure
  • have a history of heart attack
  • have high cholesterol
  • are very overweight
  • have inherited blood-clotting disorders or vein inflammation
  • have diabetes
  • smoke
  • may have prolonged bed rest in your very near future.

Because an IUD is an implanted device, there’s a risk that the device might not stay in place. Although your doctor will check the device’s placement after it’s initially inserted and during your annual checkup, the device may still slip at any moment. If it does, this increases your risk for complications, such as a tear in tissue.

Other risks include:

  • an infection in the uterus or pelvis, often caused by bacteria that were present on the IUD when it was placed
  • an IUD pushing through the walls of a uterus that can move around and possibly damage other organs if it’s not found
  • ectopic pregnancy

What Should You Do If Your IUD Falls Out?

You may be more likely to experience these risks if you:

  • have weak pelvic floor muscles
  • have a history of pelvic infections
  • have a sexually transmitted infection
  • have an allergy to copper

Talking with Your Doctor

Your doctor can be a great resource for all of your birth control questions. If you’re currently on one form of birth control but interested in another, make an appointment to discuss your questions, concerns, and interests. If you haven’t started any form of birth control, have a discussion with your doctor at your next appointment.

Before you make any decisions, ask your doctor’s opinion. You should also do some of your own research. You may want to consider these questions:

  • How much upkeep are you looking for?
  • Do you plan on getting pregnant within the next few years?
  • Does this method carry any added risks for you?
  • Are you paying out of pocket, or is this covered by insurance?

When you feel confident in your choice, ask your doctor to prescribe that form of contraception if a prescription is required. If you decide later this isn’t the best option for you, keep trying until you find one that fits your lifestyle needs. Many options are available, so keep looking until you find the one that’s right for you.

Outlook

Both types of birth control are very effective at reducing your risk of an unplanned pregnancy. These methods are also very safe. When you’re deciding between an IUD and a vaginal ring, remember that you can change your mind at any point. Whatever you choose, give it a few months to begin working properly before you make a decision to change. You may find that the method works just as you expected and that any side effects you may experience can fade.

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