
Comparing Paragard® and Hormonal IUDs: Which is Right For You?

Most women think the choice between Paragard® and hormonal intrauterine devices (IUDs) comes down to wanting hormones or not. That’s part of the process, but there’s so much more to consider. How each one changes your periods, which health problems they help with, and even how they affect your daily life matter just as much.
At Solace Women’s Care in Conroe, Texas, Farly Sejour, MD, FACOG, Natalie Gould, WHNP-BC, and our team help women sort through these contraceptive options every day. Both prevent pregnancy over 99% of the time, but your experience with each one will be completely different.
Copper works by making your uterus hostile to sperm
The copper in Paragard makes your uterus hostile to sperm and eggs; they can’t survive in that environment. Your hormones keep doing their normal thing, so you still ovulate every month like usual.
The downside is that those same copper ions that kill sperm also irritate your uterine lining. Many women see heavier, crampier periods, especially in the first few months.
Hormonal IUDs shut down your cycle
Mirena® and similar devices pump progestin straight into your uterus. This hormone does three things: it makes cervical mucus thick and gooey so sperm can’t get through, shrinks your uterine lining, and often stops you from ovulating.
The result is periods get lighter, sometimes disappearing entirely. About one in five women using Mirena stop having periods after a year. When there’s barely any uterine lining to shed, there’s not much to bleed.
Some health problems only improve with hormones
If you have certain conditions, hormonal IUDs can treat:
- Endometriosis pain
- Heavy bleeding from any cause
- Anemia from blood loss
- Some PCOS symptoms
Paragard can’t address these problems because it doesn’t affect your hormones. Women experiencing painful or heavy periods often choose hormonal IUDs even when they’d prefer to avoid hormones.
Paragard has an advantage though - zero hormone-related side effects. No mood swings, breast tenderness, or skin changes that some women get with progestin.
The timing of insertion matters for immediate protection
We can place either IUD at any time during your cycle, but timing affects when you’re protected. Insert a hormonal IUD during your first week of bleeding, and you’re covered immediately. Any other time means using backup birth control for a week.
Paragard protects you right away, no matter when we insert it. Perfect for women who need immediate coverage and can’t use hormones.
Duration differences affect your long-term contraceptive plan
Paragard costs more upfront, but it lasts 10 years. Hormonal options usually last 3-7 years, depending on the type, so they may need replacing sooner. If you’re not sure about a 10-year commitment, the lower upfront cost makes sense.
Making the choice that works for your situation
At Solace Women’s Care, we help you weigh these factors by considering your medical history, current symptoms, and contraceptive goals. The decision often comes down to what matters most - avoiding hormones, managing heavy periods, or treating other gynecologic conditions alongside contraception.
Call our Conroe office at 936-441-7100 or message us online to schedule a consultation where we can discuss which IUD option might work best for you.
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