Benefits of Hormonal IUD

By Andrew Bishop Mkandawire, FPAM SBCC Lead.

Introduction

The reproductive health environment under World Health Organization (WHO) around the globe is providing a variety of family planning contraceptive options to men and women of reproductive age. Hormonal IUD is one contraceptive method added to the list of modern family planning choices available in Malawi. It is touted to provide pregnancy prevention and responds to women’s reproductive health problems.

A hormonal Intrauterine Device (H-IUD) is a small piece of flexible plastic shaped like a T which is placed in the uterus, and it releases a tiny amount of the hormone progestin over several years. Progestin is very similar to the hormone progesterone that our bodies make naturally.

Benefits

Women who suffer from severe abdominal cramps, heavy or prolonged periods, and anaemia from abnormal uterine bleeding can now smile because hormonal IUD has been proven to treat such reproductive health problems. The six types of hormonal IUD available at global level include Mirena, Liletta, Avibera, Kyleena, Skyla, and Jaydess and have been reported to make period way lighter. While some women also totally stop getting periods, reducing budgets for menstrual pads and increasing days of sexual pleasure, the hormonal IUD also reduces chances for uterine cancer. 

Adolescent girls and young women can now enjoy the comfort of focusing on their studies and express their confidence by completing their education and careers goals without worrying of unplanned pregnancy. This is possible as the hormonal IUD can protect woman of childbearing age for more than 5 years. However, girls are still reminded that the progestin IUD does not protect them from STI’s and HIV. The use of modern family planning methods like hormonal IUD would be a get way to responding to girl’s school dropout in Malawi. For instance, the year 2016 saw 58% of girls drop out of school and out of those remaining in school, 18% became pregnant and eight percent get married leaving only 25% of girls finishing primary school. And currently, the teenage pregnancy prevalence rate is at 29%, putting girl child education at a threat amidst availability of pregnancy prevention services available in Malawi.

The hormonal IUD has the capacity to protect 998 of every 1,000 women from unplanned pregnancies. Women of reproductive age are also assured quick return of fertility at any time they decide to discontinue the use of hormonal IUD.

If you have never wanted to hear about ectopic pregnancy, then use of progestin IUD is an answer for you. Women using hormonal IUD are reported to have as low as 10 incidences of ectopic pregnancies in every 10,000 women compared with 65 in 10,000 women who do not use any modern contraceptive method.

Ranging from 0 – 10 years, the IUD contraception gives women the freedom of choice to delay the pregnancy and lowers any burden and stress of remembering when to use the contraception as other family planning methods demand daily attention and good memory of everyday use.

Inserted hormonal IUD. Source: Claveland Clinic.

Possible problems

The hormonal IUD also known as Levonorgestrel Intrauterine Device (LNG-IUD) could have some problems in some female clients. The LNG-IUD does not protect any women against STIs or HIV/AIDS. It might not be a good choice for women who are linked to health conditions like cancer, vaginal bleeding of unknown origin, and STIs or other pelvic infections. This contraception method is also only administered by a trained health worker. 

Conclusion

The Ministry of Health (MoH) in Malawi adopted Mirena and Avibela which work up to 6 years and Liletta that works up to 5 years. The choice for the three types of IUDs was reached due to availability of the IUDs from manufacturers, cost of procurement, and likeliness to the Copper T non-hormonal IUD which edged way to market entry as currently national IUD uptake scores at 1.2 percent as compared to other approved modern contraceptive methods in circulation.

Sources:

  1. Claveland Clinic (2024), Hormonal IUD, Available at https://my.clevelandclinic.org/health/drugs/hormonal-iud-mirena. Accessed on [07th October 2024]
  2. Drugwatch (2024) Mirena IUD, Available at https://www.drugwatch.com/mirena/. Accessed on [07th October 2024]
  3. Malawi Government (2021) National family planning reference manual for Malawi. Lilongwe, Ministry of Health
  4. Planned Parenthood (2024), Birth control, Available at https://www.plannedparenthood.org/learn/birth-control/iud. Accessed on [07th October 2024]
  5. UNFPA Malawi (2016) Mother groups – Underutilized resource in girls’ education in Malawi. Available at https://malawi.unfpa.org/en/news/mother-groups-%E2%80%93-underutilized-resource-girls%E2%80%99-education-malawi#:~:text=In%20a%20country%20where%2058,and%20technical%20skills%20of%20mother.  Accessed on [09th October 2024]