Deciding to get an IUD can feel like an empowering contraceptive commitment. But you also have a major choice to make: copper IUD or hormonal IUD? Whichever one you choose, these small, T-shaped devices are inserted into your uterus by a medical provider, and they can provide years upon years of extremely effective birth control. But they do work differently. You could opt for a hormonal IUD like Mirena, Skyla, Liletta, or Kyleena, which all use progestin to thin your uterine lining and thicken your cervical mucus, so it’s more difficult for sperm to reach an egg. Or you could go with the copper IUDeciding to get an IUD (intrauterine device) can feel really empowering—after all, these small, T-shaped contraceptive devices can provide years upon years of effective birth control.But deciding on the best IUD for you can also be a bit overwhelming. There are so many hormonal IUD options—and then there’s the non-hormonal outlier, the copper IUD.So, what makes this one different? The copper IUD, also manufactured under the brand name Paragard, is in a class of contraceptives referred to as LARCs or long-acting reversible contraceptives, Nichole Butler, MD, FACOG, a board-certified ob-gyn for the Women’s Health Center at Weiss Memorial Hospital in Chicago, tells SELF. It’s made of soft, flexible plastic wrapped with a thin layer of copper. Every type of IUD is inserted into your uterus by a medical professional, but the copper IUD is unique in that it prevents pregnancy by changing the environment in your uterus to make it toxic to sperm. In contrast, hormonal IUDs (Mirena, Skyla, Liletta, and Kyleena) use progestin (a synthetic form of the hormone progesterone) to thin the uterine lining and thicken cervical mucus, making it difficult for sperm to reach an egg.Dr. Butler is a huge fan of the copper IUD because it is non-hormonal and the U.S. Food and Drug Administration (FDA) has approved it for up to 10 years of use after insertion (though, some doctors say it can last up to 12 years). That said, both hormonal and non-hormonal IUDs come with their own list of pleasant and potentially not-so-pleasant side effects, so you must weigh the pros and cons before deciding if the copper IUD is the right form of contraception for you. Here’s what you need to know before you pair up with Paragard.Pros of copper IUD | Cons of copper IUD | Copper IUD side effects | Copper IUD cost | Copper IUD experiences | Other non-hormonal birth controlWhat are the pros of the copper IUD compared to hormonal IUDs?Having a device inserted into your vagina (and on into the uterus) gives you plenty of reasons to ask a lot of questions. Your job, with the guidance of your ob-gyn, is to determine if the benefits of the copper IUD outweigh the downsides.Let’s start with the good stuff: “The major pros of the copper IUD are that it is long-acting, it doesn’t require you to remember to do anything every day, week, or month, and it’s non-hormonal for those who want or need to avoid hormones due to side effects or health concerns,” Kelly Culwell, MD, a board-certified ob-gyn in Sacramento, California, tells SELF.Not having to remember to take a pill every day is a big benefit of both types of IUDs. “The copper and hormonal IUDs are similar in terms of the way they are inserted, and they don’t require you to remember to do anything—sometimes called a ‘set it and forget it’ method, so they are both good options for people who can’t remember to take a pill every day,” Dr. Culwell says.Plus, IUDs are tiny, so you and your partner will not feel it during sex. (Just note that it does have two strings that hang through your cervix and into your vagina). The doctor will shorten the strings once the IUD is in place, allowing your health-care provider to periodically check to make sure it’s still there, should any issues arise.)With that said, let’s jump into the specific benefits of the copper IUD compared to hormonal IUDs:The copper IUD lasts a lot longer than hormonal IUDs.When it comes to long-lasting birth control, the copper IUD comes out on top. According to the Mayo Clinic, it’s considered a long-acting method to prevent pregnancy for up to 10 years.By comparison, hormonal IUDs are only recommended for three to six years, depending on the brand. Of course, you can have any of them removed sooner, which is great news if you eventually decide you want to get pregnant. What’s more, fertility returns almost immediately after removal, making IUDs an excellent birth control method if baby fever ever kicks in.Cost and efficacy are on par with hormonal IUDs.Both the cost (which we dig into more below) and the efficacy of hormonal and non-hormonal IUDs are similar. The copper IUD’s effectiveness is seriously impressive (over 99% effective at preventing pregnancy), but the non-hormonal IUDs are pretty impressive too. According to a 2017 review published in Perspectives on Sexual and Reproductive Health, IUDs, both hormonal and non-hormonal, have the lowest failure rate of all contraceptive methods.3 What’s more, research from 2014 published in the journal American Family Physician shows that the copper IUD fails just 0.6% to 0.8% of the time.4 That boils down to fewer than one out of 100 people getting pregnant in the first year of using the copper IUD, which is a pretty excellent success rate.It can be used as emergency contraception.One other benefit that’s unique to the copper IUD is it can act as emergency contraception if needed, preventing pregnancy with nearly 100% efficacy after unprotected penis-in-vagina sex.1 The caveat is you’ll need to get one inserted within five days after having unprotected sex to be effective, according to the Centers for Disease Control and Prevention (CDC). Additionally, the copper IUD and the hormonal IUDs are easily taken out, making it a great choice if getting pregnant becomes a priority.It’s a good option for people who are sensitive to hormones.Most people using a hormonal IUD don’t notice the same types of hormonal side effects that you might have with the combination birth control pill (which has estrogen and progestin), but Dr. Culwell points out that some people who are really sensitive to hormones might find they have side effects like mood changes. In that case, the non-hormonal copper IUD might be the best fit.
So, what can you do to outsmart chlamydia? Get tested regularly for STIs—chlamydia testing can easily be done with a urine sample now. What that looks like in practice depends on your specific circumstances. For people with vaginas, the CDC recommends yearly testing if you are under 25 and are sexually active, 25 and older and having sex with multiple partners or a new partner, and if you are pregnant.2What are the signs of chlamydia?According to Hilary Reno, M.D., Ph.D., an associate professor of medicine at Washington University in St. Louis, chlamydia symptoms usually start a week after you contract the infection, but really there is no set timeline. Adding to the confusion, when you do get chlamydia symptoms, they can often be mild or reminiscent of other common ailments like a urinary tract infection or a yeast infection, or even another sneaky STI, gonorrhea.You know your body best, so if you feel like something isn’t quite right, it’s best to see a doctor. “If something has changed, and you know what your sexual activity has been, and you are having symptoms, that is an alert that you better get checked,” James Grifo, M.D, Ph.D., program director at NYU Langone Fertility Center and chief executive physician at Inception Fertility, tells SELF. In the meantime, here are some prominent chlamydia symptoms to be on the lookout for:1. Abnormal vaginal dischargeIf you are experiencing vaginal discharge, that isn’t an immediate cause for concern. Some vaginal discharge is normal as it’s the body’s way of cleansing the vagina and keeping it healthy. Changes in your discharge can also be normal, says Dr. Grifo, like during certain times of the menstrual cycle. For example, typically vaginal discharge is clear or milky but “mid-cycle you often have a runny more mucusy kind of discharge.” That’s why he says it is important to really know your body.Now, changes outside of what is normal for your body—vaginal discharge color, smell, and feel—could signal a larger issue. And there are a lot of things that can account for this outside of chlamydia, according to the Cleveland Clinic, including a yeast infection, bacterial vaginosis, gonorrhea, and trichomoniasis. If your discharge is smelly or white, yellow, or gray in color, though, that may be chlamydia.2. A burning sensation when you pee—and an urgency to goNobody likes to feel burning when they pee, but if a chlamydia infection is in the urethra—the tube that moves urine out of your body—it can cause just that or actual pain when you pee, as well as cloudy urine. You may also feel like you need to go to the bathroom often and urgently. Unfortunately, these are also classic UTI symptoms and can easily be confused for one.3. Rectal pain, discharge, or bleedingChlamydia can infect the rectum—the last portion of your large intestine before the anus— either directly through anal sex, or possibly via spread from the cervix and vagina, Dr. Soper says. Chlamydia in the rectum can cause pain, discharge, and bleeding. These are also common symptoms of proctitis, which is seen in folks who have an inflammatory bowel disease like Crohn’s disease or ulcerative colitis. Regardless, these uncomfortable symptoms are not normal, and you should get checked out ASAP to figure out what’s going on.4. Lower abdominal painObviously, abdominal pain can be caused by a number of things, not just STIs. But when chlamydia is involved, it typically only occurs if the infection has been left untreated for a while, leading to PID, per the U.S. National Library of Medicine. Other symptoms you might experience at this stage are nausea, fever, and pain during sex, but we’ll get to that next.5. Painful sex and bleeding afterwardIf having sex has gone from pleasurable to downright agonizing, it’s not something you should ignore. Chlamydia can cause cervicitis, or inflammation of the cervix, according to Johns Hopkins Medicine, making it extra sensitive during penetrative sex. Bleeding after sex is also a possibility. If the infection spreads and causes PID, that can also make sex feel painful.6. Pain in the testiclesFor people with penises, the majority of whom are asymptomatic with chlamydia, testicular pain can be an indication of a severe case of the STI, Dr. Grifo says. Swelling and tenderness may crop up, too. Another thing to watch out for is epididymitis, which happens when the epididymis, the coiled tube that brings sperm to the outside world, becomes inflamed—in this case due to a chlamydia infection, according to the Mayo Clinic.