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Benefits of IUC

IUC offers many contraceptive benefits

  • High efficacy
  • Not dependent on adherence
  • Long-acting
  • Low hormone or no hormone options
  • Estrogen-free
  • Suitable for the vast majority of women
  • Reduces menstrual flow (with LNG-IUS) for women with heavy menstrual bleeding
  • Allows women to cycle naturally (with Cu-IUD), though flow may increase
  • Discreet
  • Avoids post-sterilization regret
  • Less expensive daily cost than any other method, including condoms
  • Favorable risk/benefit profile
  • Rapid return to fertility upon discontinuation

Non-Contraceptive Benefits of Copper IUDs

  • The use of Cu-IUD is associated with a reduced risk of endometrial cancer. Some data also suggests that the use of copper IUDs is associated with a reduced risk of cervical cancer.

Non-Contraceptive Benefits of IUS

  • LNG-IUS deliver progestin to the uterus, decreasing menstrual flow, dysmenorrhea, and other menstrual symptoms. Additionally, LNG-IUS are approved in other countries for endometrial protection for estrogen replacement therapy.
  • The use of LNG-IUS is associated with a reduced risk of endometrial and cervical cancer, though the exact mechanisms are unknown.
  • Near all published studies about non-contraceptive benefits of LNG-IUS involve LNG-20 (Mirena®). The efficacy of LNG-20 in idiopathic heavy menstrual bleeding is well established. LNG-IUS use in women with menorrhagia decreases menstrual blood loss by 79-97%. LNG-IUS’s have also been reported to decrease bleeding in women with underlying organic pathology (e.g. fibroids, adenomyosis) and bleeding disorders. LNG-20 is considered an alternative to hysterectomy or ablation. Many studies reported a reduction of dysmenorrhea and pain in women with endometriosis and adenomyosis.
  • There are many reports of LNG-20 being used as a way to protect the endometrium in women at elevated risk of endometrial cancer, including those with hyperplasia. A recent review concluded that the evidence is insufficient to conclude that a protective benefit exists. Therefore, we cannot currently recommend for or against the use of LNG-IUS for this indication.
  • While data for non-contraceptive benefits of LNG-12 and LNG-8 are limited, similar reductions in dysmenorrhea and menstrual blood loss are reported in phase II and III clinical trials, as compared to LNG-20. If a woman desiring contraception also requires menstrual management, an LNG-20 is preferred (SOGC).
  • The data is inconclusive regarding the protective effect of the LNG-IUS on the development of pelvic inflammatory diseases (PID).

Black D. and Waddington A. et al. Build Your Expertise: IUC slide deck: 37-39, 42, 61.
Costescu D. and Guilbert E. et al. Preceptorship Program on IUC insertion - Module 2
SOGC Clinical Practice Guideline, Canadian Contraception Consensus (part 3): Chapter 7 – Intrauterine Contraception