Which type of intrauterine device is preferred for patients with severe cirrhosis?

The Copper T 380A (ParaGard) intrauterine device is particularly preferred for patients with severe cirrhosis due to its non-hormonal nature. In patients with liver disease, hormonal contraceptives, like the Levonorgestrel-releasing IUD (Mirena) or other hormonal contraceptives, can pose potential risks because the liver is involved in metabolizing these hormones. Patients with severe liver dysfunction may have impaired metabolism, which can lead to an increased risk of side effects and complications associated with systemic hormone therapy.

On the other hand, ParaGard works by releasing copper ions that create a toxic environment for sperm, effectively preventing fertilization without influencing hormone levels. This makes it a safer option for individuals with liver disease, ensuring that they can avoid unintended pregnancy while minimizing the risk of complications related to hormone exposure. Emergency contraceptive pills are also hormonal in nature and can similarly represent risks in this population, further emphasizing the preference for a non-hormonal method like Copper T 380A.