Hormonal IUD and menstruation: effects on the cycle and menstrual flow

The hormonal IUD is a contraceptive method used by many women to avoid pregnancy or to regulate their menstrual flow. What impact does this contraception have on menstruation?

What is a hormonal IUD?

The hormonal IUD is placed in a woman's uterus. It's a small, highly flexible piece of plastic resembling the letter T, containing a dose ofsynthetic hormones which are released over a period of 5 years, with a contraceptive efficacy of almost 99.9%. The hormones released are progestins similar to those found in certain pills. This contraceptive will therefore have an impact on the production of the uterine mucous membrane and on uterine secretions, to prevent pregnancy through the implantation of an embryo. Levonorgestrel makes the uterine mucosa very thin. This makes implantation impossible. The IUD and menstruation are linked by their impact on uterine tissue.

This method of contraception is inserted by a health professional. The IUD is inserted using a speculum. Insertion is generally painless. The IUD is removed by a healthcare professional, using a thread.

The hormonal IUD is an internal contraceptive, like the copper IUD, the diaphragm and the female condom.

Is there a difference between IUD models?

The hormonal IUD is very different from the copper one. Many women refer to the hormonal version as the menstruation-free IUD. But what are the differences between all the IUDs on the market, and what are their effects and impacts?

There are four main brands of hormonal intrauterine device on the market. Your gynecologist or midwife will suggest an IUD based on your state of health, weight, menstruation and history.

Most of the devices on the market all dispense a progestin called levonorgestrel. Here's a table summarizing each IUD model and its properties.

How does the hormonal IUD affect menstruation?

This contraceptive method has a direct impact on the various menstrual phases. In fact, by releasing hormones, it impacts the creation of the endometrium, which lines the cervix and thickens over the course of the month to accommodate a pregnancy. Like the contraceptive pill, it will potentially have an impact on menstrual bleeding. While the copper IUD will increase the volume of menstrual periods, the hormonal IUD will considerably reduce them.

Little or no menstrual bleeding

When a hormonal IUD is inserted, women tend to experience the following menstrual symptoms:

• amenorrhea, an absence of periods
• very lightmenstrual flow
• Blood loss outside the menstrual period, also known as spotting.

The reason is that this contraceptive does not preventovulation, but acts on thethickness of the uterine mucosa, making it very thin. This prevents an embryo from taking hold. As the uterine tissue is thinner, blood loss during menstruation is reduced, as there is less tissue to evacuate.

Bleeding after insertion

After the IUD has been inserted, you may experience some spotting as a result of the doctor's insertion.

• Spotting may occur during the first few months, as the uterine lining takes on a new consistency. 20% of women stop bleeding altogether after a few months' use.
• Other menstruating women will experience very light, light-colored blood loss (because the blood will dilute with the thicker cervical mucus), or brown blood loss (because small amounts of blood will take longer to eliminate and will have time to oxidize).

You may also experience cramps and pain after insertion.

Other effects: greater risk of acne

When taking hormonal contraception, especially when it contains progestogens, it's possible to experience acne outbreaks. In fact, the IUD is contraindicated for anyone with a history of severe acne.

The hormonal IUD can also have undesirable effects, such as :

• breast pain and swelling,
• nausea and migraines,
• reduced libido.

Some menstruating women may experience dizziness, chronic fatigue and changes in irritability.

When is it not advisable to wear a hormonal IUD?

As you can see, the hormonal IUD has a significant impact on the menstrual cycle and menstruation. It also has an impact on the entire endocrine and hormonal system. It is therefore important to discuss any contraindications to the use of a hormonal IUD with your gynecologist or midwife.
It is contraindicated in the event of :

• abnormal vaginal discharge, such as very heavy periods or spotting
• Illnesses such as thrombosis, pulmonary embolism, phlebitis, uterine cancer or neurological migraines.
• In the case ofuntreated STIs or STIs that have been untreated for less than three months.
• All women who have had an infection following childbirth, abortion, aspiration or curettage will not be able to wear an IUD for three months.
• It will never be inserted before 6 weeks after childbirth.
• Finally, all women whose cervix istoo large

What are the advantages of a hormonal IUD compared with a copper device?

The positive points of a hormonal IUD compared with a copper IUD are to be assessed with your midwife, doctor or gynecologist. Every woman is unique and will have different needs. The main advantages of both forms are ease of use and 99.9% protection against unwanted pregnancy.

• The hormonal IUD will have an impact on menstruation, reducing or eliminating it altogether. People suffering from heavy periods, endometriosis or adenomyosis will experience fewer symptoms.
• The main advantage of the copper IUD is that it contains no hormones, so it does not increase the risk of arterial or thromboembolic disease. It will act on spermatozoa. It is also suitable for breast-feeding women.

FAQ on hormonal IUDs and menstruation

Why do I get my period with a hormonal IUD?

What are the side effects of the hormonal IUD on menstruation?

Is bleeding normal with a hormonal IUD?

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