Different Types of IUDs

The major IUDs being manufactured today are made of plastic, and are either copper-containing or levonorgestrel-releasing. While some women in different parts of the world may still be using older inert devices (plastic only), the manufacturing of such devices is believed to have ceased. The most modern copper devices have the highest copper content (measured by square millimeters of copper surface and noted in the product’s name); these include the TCu-380A, the Multiload ML375, and Nova-T380. Each of these devices was preceded by products with less copper surface, some of which are still being manufactured today. This brief review will focus only on the major copper and levonorgestrel devices.

Today’s Copper IUDs

Today’s modern copper IUDs are highly effective (less than 1% failure rate in the first year of use). A recent comprehensive review on copper IUDs¹ made the following observations, comparing the TCu380A to the ML375:

• the TCu380A has the lowest failure rates
• the ML375 may cause the fewest bleeding and pain problems after 2 years of use
• the ML375 had a higher expulsion rate after 4 years of use
• the ML375 insertion tube has a smaller diameter that may facilitate insertion in some women, though comparisons of insertion problems revealed no differences between devices
• no information on differences in ease of removal was provided
• the two IUDs require different loading and insertion techniques, but there is nothing to suggest that one is superior to the other

T Devices: TCu-380A This device is probably the most widely used IUD in the world and is available in more countries than probably any other device. It can be used for at least 12 years. The UNFPA, IPPF, and USAID provide this IUD to partner countries.

Multiload Devices: MLCu-375 and MLCu-250 These devices are predominately used in Europe and Asia and are available in short versions for nulliparous women. The MLCu-375 provides 5 years of contraceptive protection while the MLCu250 lasts for 3 years. The UNFPA & IPPF provide these IUDs to partner countries.

Nova-T Devices: Nova-T 380 and Nova-T 200 These devices are predominately used in Scandinavian countries and other areas of Europe. The T380 device should be replaced every 5 years while the T200 device lasts 30 months.

Today’s Levonorgestrel Device

LNG-20: (known as Mirena in the US) This device was developed in the 1980s and has been approved for use in over 100 countries; it is gaining in popularity worldwide. It releases small amounts of the levonorgestrel (the progestin that is used in many oral contraceptives) over a 5 year period. The LNG-20 has many non-contraceptive benefits (increasing hemoglobin levels, treating menorrhagia, preventing anemia, mitigating tamoxifen-induced endometrial effects, providing vehicle for hormone replacement therapy).

¹ Kulier R, Helmerhorst FM, O'Brien P, Usher-Patel M, d'Arcangues C. Copper containing, framed intra-uterine devices for contraception. Cochrane Database of Systematic Reviews 2006, Issue 3.

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