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IUDs on the horizon

New super-effective birth control options may be coming soon to a uterus near you.

It may not be a Hover Board, but a new intrauterine device (IUD) is definitely cause for excitement in our book. Already, more U.S. women are using IUDs than ever before, and the arrival of Skyla and LILETTA mean even more options.

Given the increasing popularity of IUDs and the cultish following they inspire for some happy users, it’s about time the U.S. started catching up with Europe, where there are a dozen IUDs approved for use. With Skyla and LILETTA making four options on the U.S. market, let’s just say we’re feeling optimistic.

First up, Skyla (Mirena’s lil’ sis)

In 2013, the same company that makes the Mirena IUD introduced Skyla, an IUD that works in the basically same way as Mirena. Both release a low dose of the hormone levonorgestrel, which thickens cervical mucus and blocks sperm. Both are over 99% effective.

So what’s the difference?

  • Skyla is slightly smaller than Mirena, which means it may be more comfortable than Mirena, especially for young women and women who haven’t had a child.

  • Because of the smaller frame, Skyla has a slightly lower-dose of hormones, which means it only lasts for three years instead of Mirena’s five.

  • Unlike Mirena, Skyla is marketed to women who haven’t had a child. Confused? Lots of women who haven’t had children are already using Mirena, but the group of women who participated in the tests of Mirena for the FDA didn’t include women without children, so the company that makes Mirena is forbidden to advertise to them. Skyla, on the other hand, was tested and approved by the FDA for women with no children, so it can be marketed directly to those women.

LILETTA, a lower-cost hormonal IUD

A non-profit company called Medicines360 recently released a new IUD called LILETTA. Their goal was to make an affordable, highly effective IUD that women with or without children would be able to use. LILETTA is the same size as the Mirena, releases the same low dose of hormone, and should work for up to five years, though it has only been approved for up to three at this point. Details here.

And over yonder, on the horizon…

There are some super-innovative IUDs out there, but the companies that make them don’t have plans to bring them to the U.S.—at least not yet. We’re not holding our breath for these, but we think they’re cool enough to mention.

A painkilling copper IUD?

In China, there’s a T-shaped copper IUD that works in a similar way to ParaGard, but also slowly releases a non-steroidal anti-inflammatory drug (NSAID). The NSAID in the IUD is called indomethacin, and it’s similar to ibuprofen. Lots of women take ibuprofen pills to help manage period pain and cramps. Putting the NSAID right where it’s needed—in the uterus—also seems to work. Preliminary studies show that women using the copper-indomethacin IUD have slightly less bleeding during their periods compared to before they got the IUD. They also have less bleeding compared to women who used other copper IUDs; in fact, women using ParaGard usually report a slight increase in bleeding and discomfort during their periods, which tapers off over time.

The copper-indomethacin IUD is just as effective as other copper IUDs at preventing pregnancy, but more women continue using it over time. Researchers in China are now working on developing a new version of this IUD that will use a narrower tube to place it in the uterus.

Have a ball—in your uterus.

Another interesting IUD in development is calling itself the “Intrauterine Ball,” or IUB. It’s being tested for safety and effectiveness in a small study in Hungary. The IUB has slightly less copper than a ParaGard, in the form of little beads on a flexible, spherical wire frame. The frame is made of memory metal, a material safely used in other medical devices. The memory metal coils into the shape of a sphere as it’s pushed from the placement tube into the uterus. Once it’s in place, the IUB is designed to flex and change shape—and it doesn’t have any pokey edges. The idea is that the flexible frame will cause less discomfort and reduce the number of women whose IUDs are expelled by the uterus. We’re so on board with that plan—stay tuned for the results of the study…

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