What to Know About Getting an IUD for Endometriosis
Some people use hormone-releasing intrauterine devices (IUDs) as one treatment for endometriosis. The condition can cause uncomfortable symptoms, including pain, cramps, irregular period bleeding, and problems with your bowel and bladder.
IUDs generally are prescribed for the relief of pain associated with endometriosis. IUDs are long-acting and reversible birth control. They are shaped like the capital letter "T" and inserted into the uterus. Certain IUDs provide a slow release of the hormone progestin, which may help with endometriosis symptoms.
This article discusses how an IUD might help with endometriosis, how it works, who should choose one, and the potential benefits and side effects of IUDs.
Maskot / Getty Images
How Does an IUD Help With Endometriosis?
Endometriosis symptoms result from inflammation caused with tissue like that of the uterus forms as lesions in areas outside the uterus. Medication is targeted to decrease estrogen since this hormone stimulates endometriosis lesions.
The way IUDs treat endometriosis is not well understood. However, research shows that the hormonal medications in IUDs can help to:
Decrease estrogen production
Stop new blood vessels from growing in the endometrial tissue (decrease bleeding)
Decrease growth of the endometrial tissue in abnormal locations
Decrease the inflammation
Hormone-releasing IUDs are recommended for recurrent endometriosis treatment. An IUD can help with pelvic pain but can cause unwanted side effects, including irregular period bleeding and weight gain.
The best treatment for endometriosis is the surgical removal of the areas of abnormal growth. Treatments like the insertion of an IUD focus on decreasing the symptoms caused by endometriosis and are effective for some people.
Learn More:How Endometriosis Is Diagnosed
Types of Birth Control
"Birth control" is a broad term used for multiple approaches to prevent pregnancy. There are various birth control options available. Effectiveness varies depending on the method chosen, how well the method is followed (consistency), ease of use, and side effects.
Birth control options are generally divided into two categories: hormonal and nonhormonal. Hormonal birth control typically uses estrogen and/or progesterone medications to prevent pregnancy. These include:
IUDs (some types)
Nexplanon (arm implants)
Depo-Provera (a shot)
Minipill (progestin only)
The pill (estrogen and progesterone)
NuvaRing (vaginal hormones)
Emergency contraception (Plan B)
Nonhormonal birth control prevents pregnancy without the use of sex hormones. Some types of nonhormonal birth control include:
What Is the Best Birth Control for Endometriosis?
Each person is different, and your health history needs to be considered before selecting a birth control method. A healthcare provider will help you to find the best options to address endometriosis and to help prevent pregnancy.
Some people find that an IUD is beneficial because it prevents unwanted pregnancy and reduces the symptoms of endometriosis. Hormonal birth control options, including hormone-releasing IUDs, can help treat the symptoms of endometriosis by decreasing bleeding and inflammation of the abnormally located tissue.
How IUDs Work
IUDs are placed directly into the uterus, typically in the office during a medical appointment or at the hospital. The way IUDs prevent pregnancy depends on the type your provider inserts.
Types of IUDs
IUDs can be divided into two main types: copper and hormonal.
ParaGard, a copper IUD, does not contain medication. It prevents sperm from fertilizing an egg, greatly decreasing the possibility of getting pregnant. Due to the lack of hormones released from copper IUDs, they are ineffective in treating endometriosis.
Hormonal IUDs are made of plastic and contain hormones released slowly over time. The hormone-releasing IUDs contain levonorgestrel (a type of progestin hormone) and are available in the United States under these four brand names:
Who Should Use an IUD for Endometriosis?
If you are interested in using an IUD for endometriosis treatment, reach out to your healthcare provider and discuss the potential benefits and risks that may apply to you. Most people with a vagina and uterus can use an IUD. An IUD might help treat endometriosis, depending on your symptoms.
An IUD is not the right choice for everyone seeking endometriosis treatment. Mirena and other hormonal IUDs are not recommended for people who:
Are pregnant
Wish to become pregnant now
Have a pelvic or genital infection, such as pelvic inflammatory disease (PID)
Can get infections easily (multiple sex partners or an impaired immune system)
Have certain kinds of cancer
Experience unexplained vaginal bleeding
Are allergic to any of the components or medications
Should avoid taking hormone-based medications (history of stroke, heart attack, high blood pressure, or problems with blood clotting)
Benefits of Using an IUD for Endometriosis Relief
An IUD can provide relief from many of the symptoms of endometriosis. For most people, endometriosis is a chronic disease, and interventions focus on managing pain and heavy bleeding.
Mirena, one of the hormone-releasing IUDs, has the following benefits:
Decreasing blood loss from heavy periods (menstrual bleeding)
Decreasing menstrual cramps (dysmenorrhea)
Preventing the return of endometriosis after surgical treatment
Side Effects and Risks of IUDs for Endometriosis
Most IUDs' side effects occur in the first few months after insertion. For most people, the side effects fade away over time. Some common side effects include:
Pain or cramping in the abdomen
Irregular bleeding (spotting between periods or missed periods)
Headache or migraine
Severe side effects can include:
Severe infections, including PID
Perforation (IUD going into or through the wall of the uterus)
Expulsion (IUD coming out)
Learn More:IUD Risks and Complications
Contact your provider or seek emergency care if you have fevers in the first few weeks of IUD placement. If you have severe pelvic or abdominal pain anytime your IUD is in place, seek medical care immediately.
Insertion
IUDs are available by prescription only and are inserted by a healthcare provider in an office or clinic. Listen carefully to the recommendations from a provider about additional birth control methods you may need after insertion. Depending on the timing of insertion related to your period, your IUD may not prevent pregnancy immediately.
Related:What to Expect During an IUD Insertion
Pregnancy and Endometriosis
For some people, endometriosis can affect fertility and decrease their ability to become pregnant. This is especially true if endometriosis has caused scarring in the abdominal cavity over time (often called adhesions). Discuss your desires for pregnancy or birth control with a healthcare provider and work together to find the treatment options that are right for you.
Alternative Treatment Options
Discuss your endometriosis symptoms and desired treatment outcomes with a medical professional. There are various treatment options available depending on your symptoms and health history. A provider should review any treatments you have tried in the past and the goals for your care.
Discuss any treatments you are considering with a provider before starting them, including home remedies or over-the-counter (OTC) medications, as not all treatments are safe for everyone. Some possible alternatives to an IUD to treat endometriosis include:
Surgery to remove endometrial lesions
OTC pain medications like Tylenol (acetaminophen) or Advil (ibuprofen)
Other hormonal birth control like pills, patches, and rings
Lifestyle and dietary changes may be helpful for some people
Summary
Endometriosis is a chronic condition with a variety of symptoms. Heavy bleeding and pelvic pain are very common. Having an IUD inserted by a medical provider may be an effective treatment if it is safe for your health. IUDs are not right for everyone. They need to be prescribed and inserted by a healthcare provider. If an IUD is not right for you, there are other treatments you can explore with your healthcare team.
