Intrauterine devices (IUDs) have been shown to be effective at reducing heavy menstrual bleeding, endometrial hyperplasia and endometrial cancer in individuals with PCOS. In this article we explore the potential benefits of IUDs for individuals with PCOS.
An IUD is a device inserted into the uterus that physically prevents the implantation of a fertilized egg to prevent pregnancy.[1] IUDs are the most commonly used form of long-acting reversible contraception (LARC).[2] There are a variety of types of IUDs, including some new types and alternatives under development:
A copper IUD (also called a copper coil) is a T-shaped device that releases copper ions into the uterus to prevent implantation[3] by creating a toxic environment for sperm based on causing inflammation to the lining of the uterus and changes to the cervical mucus;[4],[5]
A hormonal IUD (also called an intrauterine system or IUS)[6] is a T-shaped plastic device that releases progestin to interfere with ovulation, thin the lining of the uterus and thicken the cervical mucus;[7]
3Daughters is developing a novel form of IUD that does not release copper or hormones and consists of three magnetically charged ellipses;[8]
Upsilon Health is developing a novel form of IUD that does not contain copper or hormones;[9] and
Elle, MD is developing an alternative to the IUD, a copper ring that inhibits sperm from reaching the egg.[10]
PCOS is sometimes associated with heavy menstrual bleeding when periods aren’t regular and the lining of the uterus (the endometrium) sheds less often.[11],[12] Hormonal IUDs have been shown to reduce heavy menstrual bleeding by thinning the lining of the endometrium;[13] it is more effective than oral progestin in reducing heavy menstrual bleeding.[14]
PCOS is linked to increased risk of endometrial hyperplasia, a pre-cancerous condition where the lining of the uterus thickens abnormally,[15] and endometrial cancer. Hormonal IUDs have been shown to reduce the cell proliferation in the endometrium, reversing endometrial hyperplasia and early stages of endometrial cancer.[16] In these studies, IUD dispensed progestins were shown to be more effective than oral progestins.[17]
Hormonal IUDs are also believed to be effective in the treatment of endometriosis and associated pelvic pain.[18] Progestin slows the growth of endometrial tissue, prevents new tissue forming and reduces the size of endometrial lesions.[19]
Side effects associated with IUDs can include:
Pain, bleeding and/or dizziness and lightheadedness as a result of the insertion process;[20]
Pelvic infection in the first few weeks after insertion;[21]
Worsening menstrual cramps (dysmenorrhea) and/or heavy bleeding (copper IUDs);[22]
Irregular or absent periods (hormonal IUDs);[23]
Recurrent thrush (a common fungal infection);[24] and
Pain or discomfort during sexual intercourse from the IUD strings.[25]
Other IUD complications include expulsion of the device out of the uterus, perforation of the uterus wall during insertion and an ectopic or high-risk pregnancy if conception occurs.[26],[27]
IUDs should not be used in certain circumstances such as:[28],[29]
If you think you may be pregnant;
You have a current diagnosis of breast cancer;
You have a sexually transmitted infection (STI) or pelvic infection;
You have issues with your uterus such as fibroids or a distorted uterine cavity;
You have issues with your cervix such as cervical cancer; and/or
You have unexplained bleeding between periods or after sex.
Reviewed by our friends at Reya Health
PARTNER SPOTLIGHT
Reya™ is a digital platform dedicated to personalized reproductive and sexual health support; Reya helps you find the right birth control option for you.

PARTNER SPOTLIGHT
Aspivix is a medical device company re-imagining Gynecology with "gentle" in mind with their innovative, soft-suction cervical device. carevix™ is clinically proven to reduce pain and bleeding during transcervical procedures including IUD insertion.

PARTNER SPOTLIGHT
Upsilon’s IUD provides an alternative non-hormonal LARC (long-acting reversible contraceptive) solution.

Sources
[1] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[2] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[3] https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/what-is-it/
[4] https://www.healthline.com/health/birth-control/copper-iud#what-it-is
[5] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[6] https://www.nhs.uk/contraception/methods-of-contraception/ius-hormonal-coil/
[7] https://www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354
[8] https://www.3daughtershealth.com/
[9] https://alumni.jhu.edu/businessdirectory/upsilon
[10] https://ellemd.ca/
[11] https://pmc.ncbi.nlm.nih.gov/articles/PMC5393469/
[12] https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics/print#
[13] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[14] https://pmc.ncbi.nlm.nih.gov/articles/PMC8090477/
[15] https://my.clevelandclinic.org/health/diseases/16569-atypical-endometrial-hyperplasia
[16] https://pmc.ncbi.nlm.nih.gov/articles/PMC8090477/
[17] https://pmc.ncbi.nlm.nih.gov/articles/PMC8090477/
[18] https://pmc.ncbi.nlm.nih.gov/articles/PMC8090477/
[19] https://www.healthcert.com/blog/iud-endometriosis
[20] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[21] https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/side-effects/
[22] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[23] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[24] https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/side-effects/
[25] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[26] https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud
[27] https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/side-effects/
[28] https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/who-can-get-it/
[29] https://pmc.ncbi.nlm.nih.gov/articles/PMC8090477/



Treatments - Devices