Is My IUD Making Me Depressed?

IUDs are an extremely effective form of birth control. They keep women from getting pregnant 99 percent of the time, and they last for several years before needing to be replaced. Still, recent studies show that certain IUDs — the ones that contain hormones — might make some women depressed, anxious or, in rare cases, even suicidal.

This is a complex issue. Don’t write off intrauterine devices, as they’re officially known, without learning more.

Understanding Hormonal IUDs

IUDs are T-shaped plastic or copper devices that are designed to prevent pregnancy but have other uses too. They’re an inch or two long and wide. Your OB/GYN will insert one into your uterus during a short, uncomfortable in-office procedure. Then you likely won’t feel it again, and you’ll be all but guaranteed not to get pregnant until you have the IUD removed, which involves another in-office procedure.

Of the handful of IUDs available in the United States, most are plastic and release hormones known as levonorgestrel, a form of progestin, which is manmade progesterone. The amount varies in each product. Hormonal IUDs work in part by thickening your mucus and cutting down egg production. These IUDs last three to eight years. Non-hormonal IUDs are also available. They’re made of copper, which sperm avoid. Therefore the sperm are unlikely to make it past the IUD to reach an egg.

While IUDs are designed to prevent pregnancy, you might use them for other reasons, too:

• Prevent bleeding. You might release less blood when menstruating on IUDs with a low hormone level, or stop menstruating completely if you have an IUD with a high dose of hormones. Many patients request an IUD primarily because they don’t want to bleed.
• Ease difficult periods. If you’re a heavy bleeder, you might get an IUD to ease your cramping and blood flow.
• Moderate moods. You’re unlikely to choose an IUD specifically for this reason but, just as some studies show that hormone-based IUDs increase the risk of psychiatric issues, others show that IUDs decrease the same depression, anxiety and suicidal tendencies.
• Prevent uterine cancer. If you’re at risk for endometrial or other uterine cancers, you might opt for an IUD that releases levonorgestrel. The hormone might prevent these cancers and even treat the earliest stages.

Age, Alternatives and Other Factors

While researchers continue to search for solid information on who might be harmed or helped by the hormones in IUDs, they’re finding relevant related issues.

• Age matters. Teenagers aren’t likely to get IUDs, but research shows that they may be more prone to depression when on an IUD than other females. Note that depression and related issues tend to be high in this age group generally.
• First-timers could be at risk. Depression risk might be higher, too, if a hormonal IUD is a woman’s first form of hormonal birth control.
• Other hormonal birth control methods have similar risks. Birth control pills are made with hormones, too, as are implants, patches, injections and vaginal rings. The doses of hormones can be higher, so those products might also have a risk of depression.

So It Safe To Get an IUD?

If you want a birth control method that works well and doesn’t require you to take pills or make doctor visits regularly, IUDs are likely a good choice. Know going in that the IUD might cause depression, anxiety or suicidal thoughts. If you see that happening to you, go back to the doctor and have your IUD removed.

• Use common sense. If you’re already at risk of any of these psychiatric conditions, do not use an IUD or any hormonal birth control method without a doctor’s consent.
• Go low. Choose an IUD with no hormones or the type with the lowest dose of hormones. They’ll work just as well at preventing pregnancy. Just know you’ll still need your tampons.
• Start older. Women 26 to 35 are the most likely to use IUDs. You could use another effective method until you reach this age group.

If you or your partner ever have sex with other people, be sure to use a condom, too, as IUDs are excellent at preventing pregnancy but offer no barrier against sexually transmitted diseases.

Keep your options open. IUDs are a great form of birth control. Just be sure to have yours removed if you suspect it’s affecting your mental health.