Intrauterine devices (IUDs) are a popular and effective birth control option. While these implants prevent unintended pregnancies, they may not improve PMDD or premenstrual syndrome (PMS).
Medically reviewed by Valinda Riggins Nwadike, MD, MPH
Among the many different birth control options, intrauterine devices (IUDs) are a popular choice.
A healthcare professional can place these small, T-shaped devices into your uterus. They provide long-term protection from unintended pregnancies. You can opt for either a hormonal or copper IUD.
Beyond contraception, you may wonder if they can also improve symptoms of premenstrual dysphoric disorder (PMDD).
IUDs may be a good option for many people, but no evidence shows they help with PMDD. In fact, hormonal IUDs may actually make it worse. However, other options are available that may help you manage PMDD.
Can IUDs help with PMDD?
BONNINSTUDIO/Stocksy United
According to the National Institutes of Health (NIH), IUDs are among the most effective forms of birth control that are also reversible. The copper and hormonal options have different effects on your mood and body.
Many of the mood-related symptoms can also be linked with mood disorders like depression or anxiety. However, unlike with a mood disorder, they are temporary with PMDD. They recur as part of the menstrual cycle and are linked with ovulation and associated hormone changes.
Hormonal IUDs and PMDD
The NIH explains that hormonal IUDs contain levonorgestrel. After placement in the uterus, they are effective for 3–8 years, depending on the strength and type. Types include:
They prevent pregnancy by affecting the endometrium (lining of the uterus), so it is less responsive to an ovary hormone called estradiol. It also thickens the cervical mucus, which makes it harder for sperm to reach the egg.
While hormonal IUDs are effective in preventing unintended pregnancies, research does not suggest they improve PMDD.
For example, a 2019 review suggests that IUDs are not an effective option for people with PMDD. Plus, the review found that hormonal IUDs may even cause or worsen mood and depressive symptoms, especially in the first 6 months of use, both in people with and without PMDD.
The authors note that because IUDs don’t stop ovulation, this may be the reason why they don’t improve PMDD.
That being said, the review also suggests that both copper and hormonal IUDs are likely safe for those with PMDD.
Ultimately, more research is needed to learn more about how hormonal IUDs might affect people with PMDD.
If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.
Free prescription coupons
Seriously … free. Explore prices that beat the competition 70% of the time.
The 2019 review explains that copper IUDs may be a better choice for people with mood disorders and PMDD.
Since they don’t contain any hormones, they should not affect hormone levels at all, nor any premenstrual symptoms. This means they will not worsen PMDD symptoms. However, they also can’t make the symptoms better.
They may be a good birth control option for you alongside other treatments for PMDD.
Benefits of IUDs
Beyond their potential effect on PMDD, both hormonal and copper IUDs offer a range of benefits.
As noted by the NIH, they are among the most effective reversible birth control options.
The hormonal option is effective for 3–8 years, while the copper option can work for up to a decade without needing replacement. This means you don’t need to remember to take a daily pill, purchase or use condoms, or renew pill subscriptions.
Another benefit of hormonal IUDs is that they can cause lighter periods — unlike copper IUDs, which can make them longer and heavier.
Meanwhile, the copper IUD can also function as emergency birth control. If a healthcare professional places it in the uterus within 5 days of intercourse without contraception, it can prevent a pregnancy from occurring.
expulsion, where the IUD is no longer in the uterus
And, while not a side effect, it’s important to know that IUDs do not protect against sexually transmitted infections (STIs).
PMDD treatments
While IUDs may not improve PMDD symptoms, other treatments might.
A 2022 review suggests some alternative treatments for PMDD and some cases of PMS. They include:
Selective serotonin reuptake inhibitors (SSRIs): SSRIs can improve mood disorders like depression, anxiety, and PMDD. They work by changing the levels of a hormone called serotonin in the brain. They can improve PMDD within just days to weeks. Examples include sertraline (Zoloft) and fluoxetine (Prozac).
Combined hormonal contraception: These birth control pills reduce or stop hormonal changes that occur during a normal menstrual cycle. In turn, this can reduce PMDD symptoms. Examples include Yaz and Azurette.
Cognitive behavioral therapy (CBT): One-on-one CBT may improve mood symptoms that occur with PMDD.
Regular exercise: Regular physical activity may improve not just physical but also psychological PMDD symptoms.
A healthcare professional like a general practitioner or gynecologist can provide tailored guidance on which treatment could benefit you and your specific symptoms, lifestyle, and preferences.
Summary
IUDs, both hormonal and copper, are effective birth control options. They work for years without needing replacement.
However, current research does not suggest they improve PMDD or PMS symptoms. Hormonal IUDs might even cause additional mood-related side effects.
PMDD symptom management may instead include hormonal medication, antidepressants, lifestyle changes, or psychotherapy. Consider talking with a healthcare professional like a general practitioner or gynecologist for tailored treatment recommendations for you.
Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.
