An intrauterine device (IUD) is a small, T-shaped plastic device inserted into the uterus to prevent pregnancy. These devices are a form of long-acting reversible contraception (LARC), offering highly effective birth control for several years without daily action from the user. IUDs are recognized for their efficacy, with less than 1% of users becoming pregnant in the first year.
Understanding the Link to Headaches
IUD use can be linked to headaches for some individuals. Headaches are a reported side effect for users of both hormonal and non-hormonal IUDs, though the underlying reasons often differ. Severity and frequency vary widely. Many factors can contribute to headache development, so an IUD is not always the direct cause.
Hormonal IUDs and Headaches
Hormonal IUDs, such as Mirena, Skyla, Liletta, and Kyleena, release a synthetic progestin hormone called levonorgestrel directly into the uterus. This hormone can lead to headaches or migraines in some users. Approximately 16% of Mirena users in clinical trials reported experiencing headaches or migraines. Similarly, about 12% of Skyla users experienced headaches, and for Liletta, 10.1% reported headaches.
Headaches are thought to involve hormonal fluctuations caused by levonorgestrel release. This synthetic progestin can influence the body’s natural balance of estrogen and progesterone. Such hormonal shifts may affect neurotransmitter levels in the brain, including serotonin and dopamine, which play roles in mood, sleep, and pain perception. These changes can trigger or exacerbate headaches and migraines, ranging from mild to persistent. Existing migraine conditions might also worsen with the use of hormonal IUDs.
Non-Hormonal IUDs and Headaches
Non-hormonal IUDs, like the Paragard, operate without releasing hormones. This type of IUD prevents pregnancy by using copper, which creates an environment in the uterus that is inhospitable to sperm. Clinical trials for the Paragard IUD have not reported headaches as a direct side effect.
However, individuals using non-hormonal IUDs might still experience headaches for other reasons. A common side effect of copper IUDs is heavier or longer menstrual periods and increased cramping. This increased blood loss can potentially lead to iron-deficiency anemia, which may manifest as symptoms like tiredness or headaches. While rare, copper toxicity, particularly in individuals with Wilson disease, can also cause headaches. Headaches experienced by non-hormonal IUD users are typically attributed to unrelated factors or indirect effects.
What to Do About Headaches
If headaches occur while using an IUD, several approaches can help manage the discomfort. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can often alleviate mild or occasional headaches. Ensuring adequate rest and maintaining proper hydration may also help reduce headache frequency and intensity.
It is important to contact a healthcare provider if headaches become persistent, severe, or worsen over time. Medical attention is also advised if headaches are accompanied by other concerning symptoms, such as vision changes, fever, unusual vaginal discharge, or signs of increased intracranial pressure. A healthcare professional can assess the underlying cause, discuss management strategies, and if headaches are directly linked to the IUD and unmanageable, explore alternative contraception or IUD removal.