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Hormonal IUDs increase stress response

For many woman, hormonal intrauterine contraception may lead to undesirable side effects. An Erasmus MC study has shown that women with a hormonal IUD have higher cortisol levels, a higher heart rate during exercise stress tests, and generally have higher hair cortisol levels than women who use other forms of contraception.

hormoonspiraaltjeProlonged chronic stress can lead to mental disorders such as depression and poor concentration. The study results have been published in the scientific journal Psychoneuroendocrinology.

The hormonal IUD is a widely used contraceptive method in the Netherlands. It is estimated that more than 12% of women aged between 18 and 45 use a hormonal IUD, and its use grows every year. A hormonal IUD is inserted into the uterus, and is popular because it works as a contraceptive for five years and because many women do not get their period while using it.  The popularity is enhanced by the idea that the hormone is only released locally in the uterus.

Stress test
Jurate Aleknaviciute, a researcher at Erasmus MC's department of Psychiatry, conducted a study on the effects of  hormonal IUDs, and, more specifically, on the physical response of  women to a stress test. She was supervised by Prof. Steven Kushner, Professor of Neurobiological Psychiatry. Her study showed that women who use hormonal IUDs had a significantly higher cortisol response during the stress test than women who use the pill or have a natural menstrual cycle. In addition, the women with hormonal IUDs had a significantly higher heart rate; on average more than 10 beats per minute higher than women who take the pill or do not use contraceptives.

Kushner: "The current guidelines for information on the hormonal IUDs need to be urgently reviewed. Women are now being told that the hormonal IUD only works locally in the uterus. This is partly based on the assumption that the amount of hormones reaching other parts of the body is negligible." Aleknaviciute: "Our study has shown that this assumption is incorrect. This is why women should be informed that the effects of hormonal IUDs are not only local and that the increased stress response is partly due to the effects of the hormonal IUD on the brain."


Date published: 3 July 2017.

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