I have heavy periods. Which birth control suits me?

Question

Hello doctor,

I am 29 and planning to start birth control, but want to avoid hormones if possible. My friend uses a copper IUD, but I have heard it can increase bleeding and cramps.

My hemoglobin level is 10.8 g/dL, and my periods are already slightly heavy. So my concerns are -

Would a hormonal IUD be a better choice in my case?
Are there any tests I should do before inserting one?
Also, do weight gain and acne occur more with hormonal pills or injections?
I am not sexually active yet, but may be soon. Should I wait until that time or get contraception placed earlier for better cycle regulation?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Based on your situation, a hormonal IUD (intrauterine device like Mirena or Kyleena) would likely be a better option than a copper IUD, especially since your hemoglobin is 10.8 g/dL and your periods are already on the heavier side.

The copper IUD can make menstrual bleeding and cramps worse, which could lower your hemoglobin further.

In contrast, a hormonal IUD releases a small amount of Levonorgestrel locally in the uterus, which typically reduces bleeding and cramps over time, and may even stop periods altogether in some women after several months.

Before insertion, it is good practice to have a pelvic exam, pregnancy test, and screening for sexually transmitted infections (STIs) if there is any risk of exposure. In some cases, your doctor might recommend an ultrasound to ensure your uterus is normal in shape and size.

Regarding side effects, weight gain and acne tend to occur more with hormonal injections (like Depo-Provera (Medroxyprogesterone acetate)) and, to a lesser degree, with combined oral contraceptive pills.

Hormonal IUDs generally have minimal systemic side effects since the hormone primarily acts locally in the uterus.

Even if you are not yet sexually active, you can choose to have the IUD placed earlier, especially if you want cycle regulation and lighter periods.

However, insertion may be slightly more uncomfortable if you have never been sexually active. Your doctor can discuss options for easing discomfort during the procedure.

In summary, a hormonal IUD would suit you better than a copper one, considering your mild anemia and heavy flow, and it can also help regulate your cycle without the higher risk of systemic side effects seen with pills or injections.

I hope this helps.

Thank you and take care.

Regards.