iud

Mirena

It is an intrauterine device (IUD) that contains levonorgestrel, a hormonal medication that is used in many birth control methods.

An IUD is a small T-shaped device which helps prevent pregnancy. This IUD is placed in the uterus to prevent pregnancy for up to 5 years. It contains a total amount of 52 mg levonorgestrel with an initial release rate of 20 micrograms every 24 hours.

This rate decreases progressively to half that value after 5 years. Levonorgestrel is contained within an elastomer and is surrounded by a membrane also manufactured of the same elastomer.

This birth control method works by thickening the mucus of the cervix, thinning the lining of the uterus, and preventing sperm from surviving and moving in the uterus. It is highly efficient (similar to surgical tubal occlusion), with a typical-use first-year pregnancy rate of 0.1 percent.

Uses

It is indicated for intrauterine contraception for up to 5 years. Also, it is used to lessen menstrual blood loss in women who have heavy menstrual flow. According to studies, it reduces menstrual flow by approximately 90%.

Note – this IUD does not protect against HIV infection and other sexually transmitted diseases.

Side Effects And Precautions

Common side effects may include:

  • longer or shorter periods;
  • heavy bleeding;
  • light bleeding between periods;
  • irregular vaginal bleeding.

Rare side effects may include:

  • vaginal pain;
  • foul-smelling vaginal discharge;
  • fever;
  • sores on the genital area;
  • chills;
  • abdominal pain;
  • sudden leg or arm weakness;
  • drooping of one side of the face;
  • swelling of the hands, arms, feet, or legs;
  • crushing chest pain;
  • difficulty speaking;
  • yellowing of the skin or eyes;
  • painful sex;
  • long-lasting bleeding.

Do not use this IUD if you:

  • are easily prone to infections;
  • are pregnant;
  • have an untreated pelvic infection;
  • have unexplained vaginal bleeding;
  • have problems with your immune system;
  • have an intrauterine device in your uterus already;
  • have or have had breast cancer;
  • have more than one sexual partner;
  • are allergic to silicone, levonorgestrel, polyethylene, silica, iron oxide, or barium sulfate;
  • have cancer of the uterus or cervix;
  • have a liver tumor or a liver disease;
  • have large fibroid tumors, a condition of the uterus which changes the shape of the uterine cavity.

Moreover, a small amount of levonorgestrel enters the breast milk, therefore, it is better to avoid this birth control method if you are breast-feeding a baby.

Nuvaring

It is a flexible plastic ring which releases the hormones progesterone (etonogestrel) and estrogen (ethinylestradiol) after being placed into the vagina. Ethinylestradiol and etonogestrel are released from the ring at a rate of  0.015 mg/day and 0.120 mg/day respectively, each for 3 weeks.

Ethinylestradiol belongs to the class of drugs called estrogen. Also, it is a hormone produced by the ovaries. Etonogestrel belongs to a class of drugs called progestins. It is a synthetic hormone similar to the hormone progesterone, that is produced by the ovaries.

When the ring is inserted into a woman’s vagina, the hormones are absorbed through the vaginal wall and enter the bloodstream to stop the ovaries from releasing eggs. Additionally, it changes the lining of the uterus to prevent pregnancy from developing.

Uses

It is a prescription medication used to prevent pregnancy. Based on the results of a clinical study, around 1 to 3 women out of 100 may get pregnant during the 1st year they use this device.

Note – it does not protect against HIV and other sexually transmitted infections.

Side Effects And Precautions

Common side effects may include:

  • weight gain;
  • tissue irritation on your cervix or inside the vagina;
  • painful menstrual periods;
  • headaches;
  • abdominal pain;
  • depression, particularly if you had depression in the past;
  • less sexual desire;
  • vomiting;
  • allergic reaction;
  • nausea;
  • penis discomfort of the partner;
  • breast discharge;
  • hives;
  • spotting or light bleeding;
  • acne;
  • breast pain;
  • vaginal discomfort;
  • vaginal discharge.

Rare side effects may include:

  • sudden fever;
  • chest pain;
  • thoughts about hurting yourself;
  • sweating;
  • mood changes;
  • pain spreading to the shoulder or jaw;
  • body aches;
  • a severe headache;
  • loss of appetite;
  • slurred speech;
  • yellowing of the skin or eyes;
  • vision loss;
  • upper stomach pain;
  • chest pain;
  • dark urine;
  • feeling dizzy or light-headed.

Do not use this vaginal ring if you:

  • have or have had blood clots in your legs, arms, lungs, or eyes;
  • smoke and are over 35 years old;
  • have certain heart rhythm problems or heart valve problems which can cause blood clots to form in the heart;
  • have had a heart attack;
  • have liver disease, including liver tumors;
  • have an inherited condition with your blood which makes it clot more than normal;
  • have had a stroke;
  • have an increased level of the liver enzyme alanine aminotransferase in the blood;
  • have hypertension which drugs can’t control;
  • are allergic to ethinylestradiol, etonogestrel, or any of the ingredients in this vaginal ring;
  • have or have had breast cancer;
  • are pregnant or think you may be pregnant;
  • have unexplained vaginal bleeding;
  • take any Hepatitis C medication combination containing paritaprevir/ombitasvir/ritonavir;
  • have certain types of severe migraine headaches with numbness, aura, changes in vision, or weakness;
  • have type 2 diabetes mellitus with kidney, nerve, eye, or blood vessel damage.

Mirena vs Nuvaring – Differences

Mirena is a small T-shaped intrauterine device which, after insertion, releases the hormone levonorgestrel (a female hormone which can cause changes in the uterine lining and cervical mucus, making it harder for a fertilized egg to attach to the uterus and harder for sperm to reach the uterus) into the uterus.

It must be replaced with a new device after five years and can be removed by your healthcare professional any time you decide you want to become pregnant. Pregnancy rates for women less than 30 years of age after removal are 89 per 100 for women within one year.

NuvaRing is a type of vaginal ring that releases a continuous dose of the hormones ethinylestradiol and etonogestrel into the bloodstream to prevent pregnancy. If used correctly, it is more than 99 percent effective. This flexible vaginal ring must be inserted vaginally once per month.

In conclusion, Mirena must be inserted every five years while Nuvaring every month. Both have a high percentage of pregnancy prevention as well as numerous side effects.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4389381/
https://www.sciencedirect.com/science/article/pii/S0010782402005140
https://www.ncbi.nlm.nih.gov/pubmed/12618252
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770406/