Which of the following is a nonhormonal contraception option?

• A. LNG IUS
• B. The implant
• C. Copper IUD
• D. Combined oral contraceptive pills

Answer: (C)

Nonhormonal contraception relies on mechanisms that do not alter hormone levels. The copper IUD achieves contraception by releasing copper ions in the uterus, which create a spermicidal environment and an inflammatory endometrium that impairs fertilization and implantation, all without any hormones being released. This stands in contrast to the other options, which rely on hormones: a levonorgestrel-releasing intrauterine system delivers progestin to thicken cervical mucus and thin the endometrium (and may suppress ovulation); the implant provides continuous progestin; and combined oral contraceptives use estrogen and progestin to suppress ovulation and alter cervical mucus and the endometrium. Copper IUD is also long-acting and can be used as emergency contraception if placed soon after unprotected sex. Side effects can include heavier, longer periods and cramping, especially in the early months.