The INSIDER Summary:
- Mirena IUDs are approved to prevent pregnancy for 5 years, and ParaGard IUDs are approved for 10 years.
- But studies show that they can actually last up to 7 years and 12 years, respectively, depending on your age.
- INSIDER spoke with two gynecologists about extended IUD use — here’s what you need to know.
Two popular IUDs might last even longer than experts once thought.
Mirena is a hormonal IUD that’s FDA-approved for 5 years of contraception. ParaGard is a copper IUD that’s FDA-approved for 10 years of contraception. But several studies done in hundreds of real women show that they can be just as effective for 7 years and 12 years, respectively.
This isn’t new intel: Scientists were studying extended use of copper and hormonal IUDs back in 1990s.
So why haven’t you heard about it yet?
For one, the makers of IUDs aren’t exactly publicizing these findings. They don’t have much incentive to get women to use their products less frequently.
But there’s also a big, important caveat: Studies of extended IUD use have only been done in women who were age 25 or older and had at least one child when they got the device inserted.
These findings could also apply to women who haven’t had kids — we just don’t yet have the data to know for sure. And since younger women have higher odds of getting pregnant, they may not be able to use IUDs past their approved expiration dates, either.
Plus, the studies — while high in quality — have looked at a relatively small number of women. So it makes sense that some experts are wary of pushing the IUD’s lifespan.
“The data is limited but promising,” Dr. Salena Zanotti, MD, a gynecologist at the Cleveland Clinic, told INSIDER. “To ensure adequate contraception, we do recommend following the [FDA-approved] labeling until larger studies have been done.”
But if you got your Mirena or ParaGard when you were 25 or older, you might want to ask your doctor about delaying removal or replacement.
Gynecologist Dr. Jen Gunter, MD, told INSIDER that she always informs her IUD-using patients about the extended use data, provided they fall into the right age range.
Gunter does acknowledge that the studies are small, but she also acknowledges that their results are pretty impressive: She cited one recent study that followed 398 women using Mirena 2 years past the expiration date. Those women reported zero pregnancies between years 5 and 7, she said.
Still, using an IUD past its approved expiration date is considered using it off-label.
That’s a catchall term to denote when doctors prescribe meds for a different use than originally intended. (Here’s a more in-depth explainer.)
“We use things off label very commonly in medicine, and I explain that to people,” Gunter said. “And some people are totally comfortable with that.”
But some people aren’t — and that’s okay.
“If you have somebody who is incredibly anxious [about getting pregnant] and simply cannot accept the fact that we don’t have large studies with thousands of women designed specifically to look at this question, then they might want to have their IUD replaced [on time],” Gunter said.
But for others, extended use could be a huge boon. Take women whose IUDs aren’t covered by insurance, for example. “The average cost of a Mirena is $700,” Gunter said. “If you extend the lifespan for two more years, you’re going to $100 a year rather than $140 a year. For some individual people, that’s going to make a difference.”
The bottom line: If know you want to replace your IUD exactly at the FDA-approved time, go for it. But if you had your ParaGard or Mirena inserted at age 25 or older, and you’re okay with using the device off-label, it’s worth talking with your doctor about extended use. (This is especially true if you had ParaGard inserted at age 35 or older. Zanotti and Gunter both said that women in this particular situation could leave their IUD in place until menopause with only a small theoretical risk of getting pregnant.)
“I would let the patient make the choice,” Gunter said. “People should make a decision that’s best for them in a consultation with [a] personal doctor.”
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