Hormonal IUD vs. Birth Control Pill: What's Actually Different?
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A hormonal IUD and oral contraceptive are NOT the same thing!
Hormonal IUDs (such as mirena and kyleena) and oral contraceptives are often grouped together as they’re both effective in pregnancy prevention and are both made of hormones, but they work in very different ways.
Understanding these differences can be really helpful for you to decide if one of these options is good for you and which would best fit your goals and symptoms.
The hormonal iud is a progestin emitting device that is inserted into the uterus. It works to prevent pregnancy by THINNING the uterine lining and THICKENING cervical fluid (which makes it hard for semen to travel). It does not inherently BLOCK ovulation, meaning most people who use it will still have cyclic hormone production - with or without bleeding depending on how thin the lining is. Most people will continue to ovulate, so the ovaries continue their normal cyclic production of esterogen and progesterone.
Pros:
Excellent for heavy menstrual bleeding as for 98% of women it will decrease blood flow.
Very effective for pregnangy prevention without needing to remember a daily pill
Can provide the progesterone component of menopause hormone therapy (hormone replacement therapy) in perimenopause.
Cons:
For someone with significant premenstrual symptoms it may NOT be the most effective as you’ll still have the ebb and flow of hormones.
There is a small percentage of people who will not ovulate. They are then NOT making hormones.
The oral contraceptive (OCP) is either estrogen + progestin or progestin only. The intention of this is to BLOCK ovulation. As such, ovulation does not occur, progesterone is not produced and there is no cyclic hormone production.
Pros:
Managing premenstrual mood symptoms. Because ovulation is suppressed, fluctuations in ovarian hormones are greatly reduced, which can improve symptoms that occur after ovulation, such as PMS or PMDD. There are certain OCPs that are BETTER for this than others
Different types of progestin and doses of estrogen can be used for different benefits. Some progestins are more anti-androgenic - which can be helpful for managing symptoms related to excess testosterone like acne or unwanted hair growth. Combinations can be chosen to manage certain symptoms.
It can also be helpful for decreasing blood flow - and many types can be used continually to skip bleeding altogether.
Cons:
It blocks ovulation - meaning there is no innate ovarian hormone production happening. For some people this can negatively impact mood and cause other symptoms. Responses are highly individualized.
Neither option is "better"—they simply work differently. Understanding those differences can help you choose if it would be helpful in your health plan; and if so which best aligns with your symptoms, health goals, and contraceptive needs.
Disclaimer:
This content is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare provider with any questions you may have regarding a medical condition or health concern. Never disregard professional medical advice or delay seeking it because of something you have read here.
Hi, I’m Dr. Janine, ND
I’m a Naturopathic Doctor currently practicing in Guelph, Ontario, Canada.
I truly believe that our enjoyment of life is closely tied to how we feel physically. When we’re healthy, we can take on anything. But when we feel off, even the simplest tasks become overwhelming. I’ve been through hormonal shifts, sleepless nights as a parent, and the stress of balancing everything. But I also know that with the right strategy, we can go from surviving to thriving—and create a healthy, thriving family in the process.
I look forward to meeting you soon.
- Dr. Janine, ND
Follow me on social media, @dr.janine.nd