Potential Side Effects Of An IUD: Depression And More

An intrauterine device (IUD) is a form of hormonal birth control primarily used to prevent pregnancy. Whether you opt for a hormonal IUD or a copper IUD, there are potential side effects to be aware of, including IUD mood changes and mental health concerns. IUD depression risk may be a serious consideration for those who are looking at various types of birth control. Discussing your options with your doctor can be beneficial, and a therapist may help you navigate any mental health difficulties that arise, regardless of whether they are related to contraception.

What is an IUD, and how does it work?

An IUD, or intrauterine device, is a small, T-shaped device that is precisely inserted inside the uterus. Hormonal IUDs typically work by to thickening the cervical mucus for the purpose of blocking sperm from reaching an egg, therefore preventing pregnancy. An IUD can be considered a barrier method of contraception.

There are many types of IUDs, although they each ultimately serve the same purpose. Some examples include copper IUDs, IUDs with the hormone levonorgestrel, and IUDs with progestins, which are synthetic versions of the hormone progesterone. Regardless of whether they are nonhormonal or hormonal contraceptives, IUDs tend to be highly effective, with hormonal IUDs being slightly more efficacious at preventing pregnancy than copper IUDs.

When IUDs were first developed, many companies excluded women who had never given birth or who had certain conditions in their medical histories. Now, IUDs are more widely available. Those interested in hormonal contraceptive use can try many other options as well.

IUDs typically last three to 12 years before needing to be replaced. This is much longer compared to many other forms of hormonal contraceptives, but these devices are not permanent. 

It's important to note that IUDs should only be placed and removed by a qualified medical professional. When using IUDs to prevent pregnancy, data suggest that the rate of effectiveness is higher than 99%.

Benefits of an IUD

Many people have used IUDs in either the nonhormonal or hormonal form and have been very pleased with the results. Aside from the 99% prevention rate against pregnancy, these devices are literally inserted in the body; therefore, they can't be forgotten about or improperly used, unlike alternative forms of birth control. Furthermore, IUDs can easily be removed by your doctor. Certain IUDs are also an option for pregnancy prevention within five days of unprotected sexual intercourse.

Potential drawbacks of an IUD 

Getting an IUD involves having a device inserted into your uterus, and it takes time for the body to adjust. Some people have no difficulties with insertion, while others experience various side effects. Depending on your unique situation and preferences, an IUD may or may not be the best fit. Making an informed decision can be a helpful approach, especially when you're managing your health.

Hormonal IUDs typically release a small amount of progestin, which thickens cervical mucus and can stop ovulation altogether. This hormonal shift often leads to lighter periods, spotting, or irregular bleeding, especially during the first few months as your body adjusts to the new hormone levels. In some cases, hormonal changes can also affect mood, potentially contributing to symptoms of depression.

Can an IUD cause depression or depressive symptoms? Why research findings are mixed

Meanwhile, a 2024 systematic review found an increase in the risk of depression and antidepressant use among all contraceptive users. This risk appeared to be higher among those using the hormonal IUD, as well as the implant, patch, or ring.

In addition, a cohort study from 2023 reported the following:

• IUDs with the progestin levonorgestrel appear to be associated with a 57% increased risk of depression
• This risk was higher for adolescents and those who used this particular type of IUD as their first form of hormonal contraception

However, whether this increased risk is directly caused by IUDs is unclear. It’s possible that IUDs may contribute to depressive symptoms in some individuals but not in others. Additional risk factors, such as prior antidepressant use, education level, and more, may also impact the risks associated with progestin hormonal contraception.

Can an IUD indirectly affect mental health?

It’s possible for an IUD to indirectly affect mental health. For example, the discomfort and irregular bleeding that can sometimes arise after IUD insertion, as well as other side effects and potential risks, may lead to emotional distress. In addition, the common misconception that IUDs protect against sexually transmitted infections may affect mental health if a person contracts an STI while mistakenly believing they are protected.

What to expect after you get an IUD: Signs and symptoms to watch for

IUD insertion experiences can vary greatly. Nevertheless, various changes and risks can be associated with this device. In most cases, the majority of the side effects will subside within three to six months. If they persist past this point, you should set up an appointment with your doctor.

Physical and menstruation-related side effects of IUDs can include pain after insertion, cramping, fainting, irregular periods, heavier periods, stronger cramps, and spotting between menstrual cycles. Uterine perforation, expulsion, pelvic infection, and ectopic pregnancy are also risks to be aware of. Many factors can impact whether someone has these experiences, and not everyone experiences these effects. 

If you find yourself experiencing severe menstrual cramps after an IUD, you may do well to notify your doctor. However, if the cramps are mild, over-the-counter pain medication can make a difference. If you experience discomfort as your doctor is inserting your IUD or shortly thereafter, you should also inform your doctor. Ultimately, you know your body better than anyone, and if you have concerns about your body, comfort, or menstruation, talking to your doctor is always the wisest decision.

Mental health side effects

Hormones in certain IUDs have been linked to depression and mood swings, as well as changes in energy levels and other mental health side effects. Each person's body chemistry is different. What works well for you may not work well for someone else, and that's okay.

Individuals who have a history of depression or fall into the category of certain depression-related risk factors may be likely to develop depression after an IUD. For this reason, alternative methods of birth control and/or menstruation management may be advisable.

Bodily rejection

There are some very rare cases where an IUD can partially or fully fall out of the person's uterus. This generally takes place within the few months of insertion, but can happen at any point, although it is very uncommon. If your IUD comes out, it is possible to get pregnant, so it can be vital to use other forms of protection. Be sure to contact your doctor if your IUD falls out or you can no longer feel the strings.

When to talk to a healthcare provider: Treatment and support for mood changes after getting an IUD

If you are ever concerned about mood changes after getting an IUD, it’s recommended to talk to your doctor or gynecologist. There’s a possibility you may need to get the IUD removed if side effects are severe.

It can also be helpful to speak to a licensed mental health professional, who can help you navigate challenging emotions regardless of their cause. Signs that you could benefit from support include the following:

• Lasting feelings of sadness, guilt, or hopelessness
• A loss of interest in usual activities
• Social withdrawal
• Changes in sleeping and/or eating habits
• Persistent thoughts of death or suicide

Getting mental health support through BetterHelp

Many people enjoy speaking to therapists face-to-face, but in-person mental health care isn’t always readily available or convenient. BetterHelp online therapy can be a great alternative. Working with a therapist, whether in person or online, can help you cope with challenges in your life and provide professional support, no matter what you may be going through.

Online therapy can provide many benefits:

• Additional scheduling flexibility
• The ability to attend sessions from home or another preferred location
• The option of speaking to your therapist via video, audio, or live chat
• The opportunity to message your therapist outside of sessions
• The ability to switch therapists as needed until you find the right fit
• Extra tools and resources, like habit tracking and support groups

Research supports the use of online therapy for the treatment of various mental health disorders. For instance, a 2019 study that looked specifically at BetterHelp users who sought therapy for adult depression found that depression symptom severity was significantly reduced after three months of treatment on the BetterHelp platform.