“I’m having a lot of painful cramps. And this is my first period since my IUD was placed,” said one MyLupusTeam member. Some people with lupus choose to have an intrauterine device (IUD) inserted as contraception to prevent pregnancy. However, some are unprepared for the effects these contraceptive methods can have.

If you are considering an IUD or if you have one already, it’s important to understand what you can expect from your body. That way, side effects won’t surprise you because you’ll be ready and have a plan in place.

What Is an IUD?

An IUD is a type of birth control that your gynecologist places inside your uterus through your cervix. It provides long-term protection against pregnancy and can be taken out if you want to have a baby. An IUD is safe for both your cervix and uterus, and it’s a reliable and reversible option for birth control.

IUDs do not offer emergency contraception, and they do not prevent sexually transmitted infections. You can add additional contraceptive use, like a condom, to your IUD to prevent these.

IUDs have a few risks. They may increase your chance of developing certain types of cancer or pelvic inflammatory disease (PID). There’s a small risk that the IUD can go through the lining of your uterus (perforation). It’s also possible for bacteria to enter the area when the IUD is inserted, causing an infection soon after the device is placed. These things don’t happen often, but it’s important to know they are possible.

Does Lupus Affect Your Menstrual Cycle?

Inflammation associated with lupus can have an impact on the menstrual cycle in several ways. This inflammation can affect hormone production and absorption, which can lead to several menstrual issues such as long cycles, short cycles, heavy cycles, and painful cramping.

Conditions associated with lupus, such as lupus nephritis, can also affect the menstrual cycle. While this does not affect everyone the same way, menstrual problems are common.

Some people may find that their cycles stay the same, but they experience lupus flares at certain points in the cycle. This means that they would continually experience improvements and setbacks in their lupus symptoms as their hormones change. At least one member experienced this, saying, “About one week before every period, my joints swell up and I feel like I got hit by a truck.”

Lupus can make pregnancy less safe for both the mother and the baby, too. In one study looking at teenage women with lupus, both moms and babies had more problems than people without lupus. This doesn’t mean that those living with lupus cannot get pregnant, it just means that you should work closely with your health care provider if that’s your goal. They can help you carefully plan your pregnancy so that you and your baby have the best chance for a healthy birth.

Lupus Medications and Menstruation

Lupus medications can also cause complications with both the menstrual cycle and pregnancy. Some lupus medications have a high risk of causing birth defects. It’s crucial to discontinue these medications before attempting to conceive and take precautions to avoid pregnancy until they are stopped. Consult with your doctor about when and how to taper off these medications and when it’s safest to become pregnant after stopping them.

Anti-inflammatories, antidepressants, and immunosuppressants are often prescribed for people diagnosed with lupus — sometimes independently or together. These medications can all have different effects on the menstrual cycle. The effects can vary depending on which drugs you’re taking, their dosages, and which ones you’re taking together.

Are IUDs a Good Choice for People Living With Lupus?

IUDs can be a great choice for people living with lupus. There are many brands available and approved by the Food and Drug Administration (FDA) in the United States. Some of them have hormones, like Mirena, Liletta, Kyleena, and Skyla, which release levonorgestrel. Levonorgestrel is an artificial hormone found in contraceptives that helps prevent pregnancy by stopping ovulation and changing the uterine lining.

The Paragard IUD uses copper instead of hormones. Both types can be effective for people living with lupus. Make sure to discuss the benefits and potential side effects of each type with a health care professional to find the most suitable choice based on your needs.

IUDs are a great option because they offer long-term birth control. The versions using copper can be left in the uterus for up to 10 years, while those containing hormones are good for three to five years. This means that, once they’re inserted into the uterus you won’t have to worry about consistently taking a birth control pill every day.

The only caution for people with lupus regarding an IUD is an increased risk of infection. The exact risk of infection after IUD insertion is unknown, but people with lupus may be at higher risk than the general population. Because lupus can cause immune system problems, it makes sense to be cautious if your doctor thinks you might be more likely to experience an infection than someone without lupus.

What Can You Expect When You Have Your First Period After IUD Insertion?

The first few months after you have an IUD inserted can be difficult for some. Cramping is common during and after placement. The cramping can last up to two or three weeks, though the pain usually improves greatly within 24 hours.

For the first few months, you can expect more painful periods than you had before you got your IUD. You may also have irregular bleeding for up to six months. This bleeding may or may not be accompanied by pain and should not be heavy. If your bleeding is very heavy after the IUD is placed, call the doctor who inserted it right away, as this is not supposed to happen.

Even if your bleeding isn’t heavy, it’s a good idea to record any spotting. You should meet with your doctor again between four and six weeks after the insertion and mention any bleeding or bleeding patterns to them at that time, even if it is only light menstrual bleeding.

What Happens to Your Menstrual Cycle Over Time With an IUD?

Your experience with your IUD over time will change, but how it changes depends on what type of IUD you have.

If you choose a copper IUD, your period pain should go back to normal after two to three months. Note that this means whatever is normal for you. If you usually experience quite a bit of pain, you can expect that will continue. If you usually have easier periods, they should go back to that, too.

If you choose a ‌levonorgestrel-releasing IUD, it can take three to six months for your periods to settle into your new normal. Most people experience significantly less period pain once their body has gotten used to the IUD. Some find that, over six to 12 months, their periods become lighter and might even disappear. In fact, studies have shown that up to 50 percent of women who use hormonal IUDs for at least two years find their periods disappear entirely. If you have struggled with heavy or painful periods that seem to be connected to lupus, an IUD might help you find relief.

Talk to Your Doctor

If you are living with lupus and notice changes in your periods, want to avoid pregnancy, or think your lupus flares relate to your hormones, talk to your doctor as soon as possible. They can help you find the right IUD and birth control that best suits your needs.

Find Your Team

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you thinking about using an IUD? Share your experience in the comments below, or start a conversation by posting on your Activities page.