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Heavy bleeding, unpredictable periods, acne, and hair growth where you don’t want it.
For many women, Polycystic Ovary Syndrome (PCOS) brings a heap of frustrating and difficult symptoms that can play havoc with your day-to-day life.
Managing PCOS often means figuring out the right treatment options available to you — and hormonal IUDs can sometimes come up in that conversation.
Hormonal intrauterine devices (IUDs) are a popular choice for providing reliable, long-term contraception. And they may also help with managing your PCOS symptoms.
Here’s what you need to know about getting an IUD and PCOS — including the potential benefits, drawbacks, and what to watch out for when you’re deciding what’s right for you.
The basics: IUD and PCOS
PCOS is a common hormonal condition that impacts how the ovaries work and when ovulation occurs. The most common symptoms of PCOS include irregular periods, difficulty getting pregnant, weight gain, acne, and excessive hair growth (hirsutism) or hair loss.
As Dr. Caledonia Buckheit, OB/GYN, explains, “PCOS is an ovulatory disorder which can lead to periods of prolonged anovulation, and thereby infrequent menses.”
And IUDs? An IUD, or intrauterine device, is a type of contraception. It’s a safe, non-surgical, T-shaped device made of plastic that’s inserted into the uterus and is 99% effective at preventing pregnancy.
There are two types of IUDs you might come across, and they work in two different ways:
- Hormonal IUD: A hormonal IUD releases the hormone progestin into your body to prevent pregnancy. A hormonal IUD can be used to manage some symptoms of PCOS, including reducing heavy periods and, in some cases, minimizing pelvic pain.
- Cooper IUD or non-hormonal IUD: Unlike a hormonal IUD, a copper IUD or non-hormonal IUD doesn’t contain the hormone progestin. A copper IUD prevents pregnancy by releasing copper into the uterus. This IUD isn’t as effective at reducing the symptoms of PCOS, and it can sometimes make your periods heavier or longer.
Which IUD is best for PCOS?
A hormonal IUD is the best type of IUD for managing the symptoms of PCOS. A copper IUD doesn’t contain hormones, so it doesn’t have a significant impact on the symptoms of PCOS.
According to Dr Buckheit, “A progesterone-containing intrauterine device can be a great option to provide contraception, but also to maintain a healthy uterine lining, whether you are ovulating or not.”
A hormonal IUD can help PCOS in a few different ways, including:
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- Reducing heavy bleeding
- Maintaining a healthy uterine lining
- Reducing the risk of endometrial cancer
In terms of the best brand of IUD for PCOS, that’s something you’ll need to discuss with your doctor, as it depends on your needs. In the US, the FDA has approved four brands of hormonal IUDs: Kyleena®, Mirena®, Skyla®, and LILETTA®
All four brands of hormonal IUDs are suitable for PCOS, but it’s essential to consult a healthcare professional to understand which option is best for you.
Friends? The benefits of hormonal IUDs and PCOS
Can an IUD and PCOS be besties? There are a range of potential benefits of using a hormonal IUD if you have PCOS.
Here are some top reasons why an IUD can be beneficial:
- Effective contraception: IUDs provide long-term, reliable birth control without the need to remember to take a daily pill or make frequent visits to the doctor's office.
- Improving heavy or irregular periods: Hormonal IUDs can reduce and even stop your periods, helping to manage some of the most annoying issues caused by PCOS.
- Reducing endometrial cancer risk: The progestin in hormonal IUDs like Mirena® thins the uterine lining, lowering the risk of endometrial hyperplasia, a condition caused by infrequent ovulation where the lining of the uterus becomes too thick, and reducing the risk of endometrial cancer.
A 2020 review found hormonal IUDs used for 3-6 months are more effective than oral progesterone for reducing the risk of endometrial hyperplasia progressing into endometrial cancer.
Frenemies? What to watch for with a hormonal IUD and PCOS
Hormonal IUDs aren’t right for everyone, and in some case,s they can make the symptoms of PCOS worse. Here are some potential drawbacks to watch out for with PCOS:
- IUDs don’t address the root causes of PCOS: A hormonal IUD can ease some of the symptoms of PCOS, but they don’t address the underlying hormonal and metabolic imbalances that may be the cause of PCOS.
- Risk of increased androgen-related symptoms: If you’re switching from oral contraceptive pills (OCPs) to an IUD, you may find some androgen-related PCOS symptoms get worse, such as acne, excessive hair growth, and hair thinning or hair loss.
- Possible side effects: There’s also a risk of experiencing side effects from the hormonal IUD, including mood changes, headaches or migraine, irregular bleeding, increased discharge, cramping, and pelvic pain.
A healthcare professional will be able to provide you with the best recommendation for your needs, especially if you’re concerned about androgen-related symptoms and potential side effects.
As Dr Buckheit explains, “You can also pair an IUD with an anti-androgenic treatment like spironolactone to manage bleeding and hyperandrogenism if estrogen-containing methods aren’t right for you.”
Choosing an IUD and PCOS
So what’s the verdict? The truth is, the best birth control for managing PCOS varies from person to person. There are a wide range of factors to take into account when you’re choosing whether or not an IUD is right for you, including the nature of your symptoms, your lifestyle, and any other health conditions.
To understand if an IUD is right for you, talk to a healthcare professional. They’ll be able to advise on whether or not an IUD is the best option for you, which IUD is recommended for managing your PCOS symptoms, and potential risk factors.
Is there a relationship between IUD and PCOS?
Hormonal IUDs can help reduce some symptoms of PCOS by releasing progestin into the body. A hormonal IUD can help to reduce the amount and frequency of your bleeding on your period, as well as reduce the risk of endometrial hyperplasia. There’s no evidence that birth control causes PCOS.
Does PCOS get worse with an IUD?
No, PCOS generally doesn’t get worse if you have a hormonal IUD. Hormonal IUDs release progestin, which can work to improve many of the symptoms associated with PCOS, including helping to reduce heavy bleeding and pelvic pain.
Can I get pregnant with an IUD and PCOS?
An IUD is 99% effective at preventing pregnancy. But there are some cases where you can get pregnant with an IUD and PCOS. If you can’t feel the threads of your IUD when you check for them, it could be a sign that your IUD is not positioned correctly or has come out. You’ll need to have it checked by a healthcare professional to make sure everything is where it should be.
Understanding the link between an IUD and PCOS
Living with PCOS is no walk in the park. PCOS can be difficult and stressful to deal with, and finding the right methods to manage your symptoms of PCOS often takes time and some experimentation.
For some people, a hormonal IUD can be a helpful tool in reducing certain symptoms of PCOS, but it’s not right for everyone.
To find out if an IUD is suitable for you, speak to your healthcare provider — they can work with you to choose the best treatment plan for your needs, including taking into account your PCOS symptoms, lifestyle, and long-term health goals.
With the right treatment, self-care, and support, it’s possible to manage PCOS and take back control of your life. It starts with baby steps.