The FDA recently approved another copper-IUD. The device, called Miudella, is more flexible and uses less copper than the Copper-T which has been the only non-hormonal IUD on the market for many years.

An intrauterine device (IUD) is a small T-shaped device that is inserted into the uterus by a health care provider. It works by preventing sperm from reaching and fertilizing an egg.

Some IUDs contain hormones like those in birth control pills that can also prevent ovulation (so there is no egg to be fertilized) and thicken cervical mucus (to make it harder for the sperm to get into the uterus).

Types of IUDs

There are currently four brands of hormonal IUDs available in the United States. They all work the same way, but some last longer than others. Mirena and Liletta last for eight years, Kyleena lasts for five years, and Skyla last for three. Kyleena and Skyla were designed to be smaller for younger patients who often have smaller uteruses.

Copper IUDs do not contain any hormones. Instead, they rely on copper, which is toxic to sperm. The only copper IUD on the market in the United States for the last several decades has been Paragard, sometimes called the Copper-T. Paragard is made out of plastic and wrapped with copper wire. It works for 10 years.

Miudella is similar, but it is made from a material called nitinol which has been used in medical devices for decades. Nitinol is a flexible alloy that can hold its shape when bent. This should make insertion easier. In addition, Miudella comes already loaded into an inserter. While the person getting an IUD will likely not notice this, it can make the procedure easier for health care providers.

Like all other IUDs, Miudella must be inserted and removed by a healthcare provider. It comes with a string that hangs through the cervix into the vagina to make removal easy. Miudella lasts for three years.

FDA approval was based on three clinical trials that found that Miudella was safe and effective. IUDs are 99% effective. Fewer than one percent of people using an IUD will become pregnant. About 15% of women in the trial had their IUDs removed before the end of the three years which is similar to the rates with other IUDs.

Long-acting reversible contraception (LARC)—like IUDs and the implant—are popular in large part because you can “set them and forget them.” Once inserted, users are protected from pregnancy from multiple years without having to remember to take a pill or change a patch. These methods, however, do not protect against sexually transmitted infections.