IUD Options: Mirena vs. ParaGard - A Comprehensive Guide

Question
Hi, and thanks in advance for your time and help!

My husband and I are expecting our first child in July. Even though it was a long struggle through infertility (due to PCOS and recurrent miscarriages) to get here, we are young and we know we will not want any more children for at least several more years. After researching my options, I am interested in getting an IUD after the baby is born, but I am having trouble choosing between Mirena and ParaGard and was hoping you could help me decide.

The hormones are my main concern with Mirena. Before we started trying to conceive, I was on the pill. The hormones gave me headaches and made me bloated and irritable, so I decided to try the minipill. Bad idea -- I bled constantly for the three months I was on it and ended up anemic before going back on the combined pill. I am concerned that if I choose Mirena, I will have to have it removed for the same reason I stopped the minipill.

My main concern with ParaGard is related to my infertility issues. Because of the PCOS, I rarely menstruate without pharmaceutical assistance (usually once every 4-8 months). I know that the risk of endometrial cancer is increased when you cycle rarely, and I want to keep my reproductive system in working order in case we decide to have another child. Would it be an option to go with the ParaGard and take Provera or Prometrium every three months or so if I am not menstruating spontaneously?

Answer
I think either IUD might work well for you.  You may get some bleeding with either one.  With the Paragard it's usually more with periods (they're heavier), and with the Mirena it's more the first few months, although usually nothing like the constant bleeding you had with the mini pill.  And after a few months, many women have no bleeding at all with the Mirena.  Since you rarely menstruate on your own, the Mirena will prevent endometrial cancer, and you won't really need to ever have a period until it's taken out.  You could do the same thing with the Paragard taking progesterone every 2-3 months.  I think most women are happier with the Mirena because they bleed little, but I think probably either one would work for you.