Hormonal IUD

What is a hormonal intrauterine device (IUD)?

A hormonal IUD (intrauterine device) is a small, T-shaped device a healthcare provider inserts into your vagina to prevent pregnancy. It’s a highly effective method of birth control that works by releasing small amounts of the hormone progestin into your body. A healthcare provider must insert an IUD for you, but once it’s in, it gives you continuous pregnancy protection for between three and eight years. That doesn’t mean you have to keep it in that long — you can have your provider remove it at any time.

There are four types of hormonal IUDs available in the United States: Mirena®, Liletta®, Kyleena® and Skyla®. They all contain the same hormone (levonorgestrel), but they differ in how long you wear them. Other countries may have other hormonal IUD options available.

• Mirena: Mirena was the first hormonal IUD to become available. It provides up to eight years of pregnancy protection.
• Liletta: Liletta provides six to eight years of pregnancy protection.
• Kyleena: Kyleena offers five years of pregnancy protection.
• Skyla: Skyla offers three years of pregnancy protection.

How do hormonal IUDs work?

A hormonal IUD is a small piece of plastic shaped like a T. It has a short string on the end, which allows your provider to remove the IUD later. A hormonal IUD releases tiny amounts of progestin in your body. It prevents pregnancy in two ways:

• Stops ovulation. Ovulation is when your ovary releases an egg. It takes an egg and sperm to create a pregnancy. Without an egg, there can’t be a pregnancy.
• Thickens cervical mucus. Sperm like thin and stretchy cervical mucus because it’s easier for them to swim through to reach an egg. When your mucus is thick, sperm can’t reach an egg.

How effective are hormonal IUDS?

Hormonal IUDs are more than 99% effective. Outside of abstinence (not having sex), IUDs are significantly more effective than most forms of birth control. This is mainly because there’s little to no room for error. After your healthcare provider puts it in, it works completely on its own without you having to think about it.

How quickly do they work?

You can get an IUD at any point in your cycle. But if your provider inserts it more than seven days since the beginning of your last period, you should use a backup birth control (like a condom) for at least seven days. But, if it’s less than seven days since the beginning of your last period, you shouldn’t need a backup birth control at all.

What are common side effects of hormonal IUDs?

The most common side effects happen during or shortly after your provider inserts the IUD. These effects tend to go away on their own. In the weeks following IUD placement, some people experience:

• Discomfort.
• Spotting between periods or irregular bleeding.
• Heavier periods.
• Mood changes, breast tenderness and headaches.

These side effects should subside after about three to six months. Although some people report not getting a period at all after they get a hormonal IUD.

Talk to your healthcare provider if you experience these or other side effects. It may be that this type of birth control doesn’t work for you. Your provider can help you find one that works better for your body.

Does a hormonal IUD cause weight gain?

There’s been a lot of research on this topic, but most studies show hormonal IUDs don’t cause weight gain.

What are the pros and cons of hormonal IUDs?

There are many advantages to using hormonal IUDs for birth control. Some of those are:

• Easier periods: People who have painful period cramps or heavy periods tend to experience lighter, less painful periods. IUDs may also improve symptoms of endometriosis or fibroids.
• Effective: IUDs are 99% effective.
• Safe: IUDs are safe to use, even for people who are breastfeeding (chestfeeding).
• Long term: A healthcare provider places the IUD in a short, nonsurgical office procedure. After placement, the device works for many years without you having to do anything.
• Reversible: Pregnancy protection ends right after you remove your IUD. You can get pregnant right away after you take an IUD out.
• Discreet: No one knows what type of birth control you use. It also doesn’t disrupt sexual spontaneity.

While IUDs are safe for most people, they come with risks. Some possible complications are:

• The IUD falls out. Your healthcare provider needs to put a new one in if this happens to you. This is more common in people who just gave birth or who’ve given birth multiple times.
• The IUD perforates (pokes a hole in) your uterine wall. This is rare, but possible. It causes severe pelvic pain and bleeding.
• An infection develops. People who have undiagnosed sexually transmitted infections (STIs) are more likely to develop pelvic inflammatory disease after getting an IUD. IUDs don’t protect against STIs or HIV/AIDS.

Additionally, some people shouldn’t get an IUD. This includes people who have:

• A history of uterine or cervical cancer.
• Unexplained vaginal bleeding.
• STIs or other pelvic infections.

Can you get pregnant with a hormonal IUD?

Getting pregnant with an IUD is uncommon but possible. You should seek medical care if you have any reason to believe you may be pregnant when you have an IUD. Your healthcare provider will have you take a pregnancy test before placing your IUD.

A note from Cleveland Clinic

There are several different kinds of hormonal IUDs to choose from. All of them work in the same way, but some last longer than others. If you’re interested in this type of birth control, talk to your healthcare provider about the pros and cons of each type, how they work and the possible side effects. While IUDs are over 99% in preventing pregnancy, they don’t offer any protection against STIs.