Hormonal IUD

THE BASICS

What is it?

Hormonal IUDs are T-shaped plastic devices that contain the hormone progesterone. They are just over an inch wide and long. A doctor inserts the IUD into your uterus through the cervix. This takes just a few minutes.

Hormonal IUDs can prevent pregnancy for 3 to 8 years, depending on brand.

How well does it prevent pregnancy?

A very effective form of birth control — one of the lowest pregnancy rates of all birth control methods.

Less than 1 out of 100 women using hormonal IUDs get pregnant in a year of use.

HOW DOES IT WORK?

Progesterone thickens the mucus in your cervix. This stops sperm from entering the uterus. Sperm that do get in are less able to fertilize an egg. The lining of the uterus also becomes thinner. Prevents the monthly release an egg from the ovaries (ovulation) in some women.

WHAT ARE SOME PRODUCT NAMES?

Kyleena (5 years), Liletta (8 years), Mirena (8 years), and Skyla (3 years).

PROS

  • Very effective birth control.
  • Long lasting — 3 to 8 years, depending on type.
  • Safe if you can’t use birth control with estrogen because you:
    • Are a smoker over 35
    • Have high blood pressure
  • May be safe for some — but not all — women who:
    • Have an increased risk of blood clots or stroke
    • Have coronary artery disease
    • Have lupus
  • Safe if you are breastfeeding.
  • With higher dose hormonal IUDs (Liletta, Mirena), periods are likely to be much lighter or may stop.
  • Reversible. Can be removed by a doctor at any time if you want to try to get pregnant.
  • Sex can be spontaneous.
  • Mostly private. (Some partners do feel the IUD strings inside the vagina.)

CONS

  • Irregular bleeding and spotting are common for first three to six months.
  • A procedure is required for insertion and removal. Can be mildly painful.
  • No-go with some health issues:
    • Active pelvic inflammatory disease
    • History of breast cancer
    • If you or your partner has a sexually transmitted infection (STI), you'll need to delay getting an IUD until treatment is complete.

POSSIBLE CONCERNS

Possible problems include:

  • Some spotting and cramping right after IUD insertion. Tell your doctor if pain is severe or doesn’t go away.
  • A small risk that your uterus may expel a hormonal IUD. This happens to about 3 in 100 women in the first year. It’s less likely after that. If it happens, you could get pregnant.
  • A small risk of infection after insertion of an IUD.
  • Very rarely, insertion of an IUD punctures the uterus. This may require surgery.

Possible side effects include:

  • Irregular bleeding and spotting
  • Very light or no periods.

Other side effects that are possible, but not likely, include acne, headache, mood changes, and weight gain.

EXTRA BENEFITS

  • Can reduce heavy menstrual bleeding, painful periods, and anemia.
  • Even if you have normal periods, you may bleed less. About 70 out of 100 women have lighter periods after the first three to six months with Mirena. About 20 out of 100 women stop having periods.
  • Lowers risk for endometrial cancer.
Back to my options

Use with condom to avoid getting or spreading sexually transmitted diseases or infections, including HIV.

Lasts 3 to 8 years, depending on type.

Pregnancies with an IUD are rare. But those that occur are more likely to be ectopic (outside the uterus) than pregnancies that happen otherwise. Pregnancy with an IUD in place can be life-threatening. You’ll need to call your doctor right away if you miss your period, notice breast tenderness, nausea (“morning sickness”), or other signs of pregnancy.