is an IUCD that carries a reservoir of progesterone(around 38 mg) and releases 65 mcg of the hormone per day.

How does it work?

The hormone released in the uterus forms a thick plug of mucus at the cervical os (opening or passageway in the cervix, which is the lower part of the uterus that connects to the vagina) which prevents penetration by the sperms and thus exerts an added contraceptive effect.

Advantages  

• 40% less menorrhagia (abnormally heavy or prolonged menstrual bleeding) and dysmenorrhoea (painful menstrual cramps) compared to Copper T

Disadvantages  

• Expensive
• Requires yearly replacement

is an IUCD that has a reservoir of LNG progestogen (containing around 52mg) and 20 mcg is released daily.

How does it work?

It does not suppress ovulation (release of egg) or lactation (breastfeeding), and its effect is mainly on the endometrium and cervical mucus. Release of hormone (LNG progestogen) starts within 15 minutes of insertion, and the peak level reaches in a few hours. The hormone does not get absorbed into the systemic circulation, therefore side effects related to systemic adminstration are not seen.  

Advantages

• One-time insertion
• Effective for 5 years
• Good compliance rates
• Reduced menorhhagia (abnormally heavy or prolonged menstrual bleeding) and dysmenorrhoea ( painful menstrual cramps experienced by women during their menstrual periods)

Disadvantages  

• Failure rate is very low (0.5 per 100 woman-years)
• Teratogenic (interfering with developments of fetus, causing birth defects) if pregnancy occurs with Mirena in place
• Incidence of ectopic pregnancy 0.02%

Advantages 

• Independent to timing of sexual intercourse
• Not male partner dependent
• Cost effective: one-time insertion gives protection for a long period
• Highly effective as a contraceptive (recent IUCDs are as effective as oral contraceptives)
• No evidence that supports reduced fertility after its removal (about 75% conceive within 6 months of removal and 90% within on year)
• No systemic ill effects perceived  

Disadvantages  

• Trained medical/paramedical personnel is required to insert the device
• Complications such as menstrual irregularities, dysmenorrhoea (painful menstrual cramps), pelvic pain may make a woman remove it

Immediate  

• Difficulty in insertion
• Vasovagal attack
• Uterine cramps

Early

• Expulsion (2%-5%)
• Perforation (1%-2%)
• Spotting, menorrhagia (2%-10%)
• Dysmenorrhoea (2%-10%)
• Vaginal infection
• Actinomycosis

Late

• Pelvic Inflammatory Disease (2%-5%). IUCD does not prevent transmission of HIV
• Pregnancy (1-3 per 100 women-years (failure rate)
• Ectopic Pregnancy
• Perforation through uterine wall
• Menorrhagia (abnormally heavy or prolonged menstrual bleeding)
• Dysmenorrhea (painful menstrual cramps)