IUD vs. Birth Control Pills: Know Your Options

An IUD is a small T-shaped device that’s inserted into your uterus by your doctor. Insertion only takes a few minutes. A small string is left hanging into the vagina so that you can periodically check to see if the IUD is still in place. If it’s not, you’ll need to see your doctor right away. Never try to move or remove an IUD yourself.

The IUD ParaGard is made of copper. The IUDs Mirena, Skyla, and Liletta are made of plastic. Some IUDs contain the hormone progestin, which is slowly released over time. Both types work by making it harder for sperm to reach the egg. The hormonal IUD may also stop the ovaries from releasing eggs.

Most women can use an IUD without an issue. Depending on the type you choose, it can continue working for three to 10 years. Fewer than one out of 100 women using an IUD get pregnant each year.

Learn more: Choosing the right IUD »

Once an IUD is inserted, there are no monthly costs. When you decide you no longer want it, your doctor can remove it quickly. Once it’s out, it shouldn’t interfere with your ability to get pregnant.

Some women have lighter periods when using a hormonal IUD. Other women experience fewer cramps. You may stop having a period altogether.

Oral contraceptives, or birth control pills, contain synthetic versions of the female hormones estrogen and progesterone. The synthetic version of progesterone is called “progestin.” Combined oral contraceptives contain both hormones. There’s also a progestin-only pill, known as the minipill, for women who don’t want to take estrogen.

These hormones prevent your ovaries from releasing eggs. Cervical mucus is thickened, which makes it difficult for sperm to reach the egg. The hormones also alter the uterine lining to make implantation less likely if an egg somehow is released and fertilized.

The pill is more than 99 percent effective when taken as directed. This means taking the pill every day at the same time. The efficacy is lowered if you miss a dose or take the pill at irregular intervals each day.

Depending on the type you take, you may experience lighter and more regular periods. With extended cycle pills, you may have three or more months between periods. You may also have fewer menstrual cramps.

IUDs and birth control pills can both cause side effects. These can range from mild to severe and should be taken into consideration before use.

Side Effects of an IUD

The potential side effects of an IUD include:

• headaches
• backaches
• acne
• breast tenderness
• changes in mood
• changes in weight
• vaginal discharge
• pain during sex
• discomfort and light pain during insertion
• cramping for several days after insertion
• spotting, irregular periods, or heavier periods for the first few months

More serious IUD side effects are rare. These can include:

• dislodging or expulsion
• pelvic inflammatory disease
• a perforation of the uterus during insertion

Side Effects of Birth Control Pills

Birth control pills share many of the same side effects of hormonal IUDs. Potential side effects of birth control pills include:

• spotting or irregular periods
• headaches
• nausea
• sore breasts
• changes in mood
• changes in weight

For many women, these side effects usually go away once your body adjusts. If these side effects continue, you may wish to discuss options for other birth control pills with your doctor.

A rare, but serious side effect of the pill is the formation of blood clots. Sudden swelling of the leg may indicate a blood clot. If this occurs, it’s usually in the legs or lungs. Shortness of breath and chest pain are both symptoms of a clot in the lung.

You shouldn’t use an IUD if you need treatment for cervical or uterine cancer. Tell your doctor if you:

• have unexplained vaginal bleeding
• previously had a uterine perforation while having an IUD inserted
• had a pelvic infection within the past three months
• think you currently have a sexually transmitted disease (STD) or other infection

Women with breast cancer or liver disease shouldn’t use the hormonal IUD.

Women who have never had a baby are more likely to experience the IUD moving out of place. This can increase the risk of pregnancy or perforated uterus. If the IUD can’t be repositioned properly, it may need to be removed.

Learn more: What should you do if your IUD falls out? »

You’re more likely to develop pelvic inflammatory disease if you had an existing pelvic infection when the IUD was inserted. You may need antibiotics and possibly treatment for the specific type of infection. An untreated pelvic infection can affect your fertility.

The pill isn’t safe for everyone. Be sure to tell your doctor if you:

• are a smoker
• have a personal or family history of blood clots
• have a history of high blood pressure or heart disease
• take other medications (birth control pills can interfere with some)

A blood clot is life-threatening, and smoking while on the pill can compound your risk.

Neither form of contraception offers protection from STDs, so you may need to use barrier protection also.

Whether you’re ready to start birth control for the first time or planning to switch from one method to another, your doctor is a great resource for any questions you may have.

Before choosing a birth control method, you may want to consider these questions:

• Do you want to deal with daily upkeep?
• Do you plan on getting pregnant in the next few years?
• What health risks are associated with this method?
• Will this method be covered by insurance?

Once you’ve made your decision, stick with this method for a few months to see if your body adjusts. There are several different IUDs and countless birth control pill options available, you can keep looking if it isn’t working out. You and your doctor can work together to find the best option for you.

If you think you’ll remember to take the pill every day and you’re in good health, the pill may be the option for you. If you decide to try the pill, keep in mind that there are several kinds. Your doctor will be able to explain the pros and cons of each type.

If you have an IUD, you won’t have to take a pill every day. It’s a good option if you can’t tolerate the pill, if you’re a smoker, or if you have a preexisting heart condition. If you decide you’d prefer an IUD, talk to your doctor about which type of IUD is best for you.

Whatever you choose, be sure to report unusual symptoms to your doctor.