Side-by-side comparison
Hormonal IUD vs copper IUD
Both are over 99% effective and last for years. The hormonal IUD often makes periods lighter or stops them; the copper IUD is hormone-free but can make periods heavier and more painful at first, and it can also be used as emergency contraception.
By the AltFTool health editorial teamLast reviewed Checked against WHO, CDC and NHS guidance
Key differences
| Feature | Hormonal IUD | Copper IUD |
|---|---|---|
| Typical-use effectiveness | Over 99% | Over 99% |
| Perfect-use effectiveness | Over 99% | Over 99% |
| Hormones | Progestogen | None |
| How long it lasts | 3 to 8 years, depending on the brand | 5 to 10 years depending on the type (US Paragard is licensed for 10 years) |
| Protects against STIs | No | No |
| Needs a clinician to start | Yes | Yes |
| Daily or every-time action | No | No |
| You can stop it yourself | No | No |
| Fertility after stopping | Quickly after removal | Quickly after removal |
| While breastfeeding | Yes | Yes |
| Effect on periods | Periods usually become lighter and less painful, and many people stop bleeding, though spotting is common in the first months. | Periods may become heavier, longer, or more painful, especially in the first 3 to 6 months. |
Read each guide
Hormonal IUD
People who want very effective, long-lasting contraception, especially those with heavy or painful periods or who cannot take estrogen.
Copper IUD
People who want very effective, long-lasting contraception without hormones, or who need emergency contraception and want ongoing protection afterward.
FAQ
Which is more effective, hormonal iud or copper iud?
Both are over 99% effective and last for years. The hormonal IUD often makes periods lighter or stops them; the copper IUD is hormone-free but can make periods heavier and more painful at first, and it can also be used as emergency contraception.
Does the hormonal iud or copper iud protect against STIs?
Neither does. Use condoms as well if you need protection from sexually transmitted infections.
Can I switch from the hormonal iud to the copper iud?
Usually yes. A clinician or pharmacist can tell you when to start the new method and whether you need extra protection (such as condoms) for a few days while switching.
More comparisons
Sources
Reviewed 1 November 2026. We link to the guidance itself so you can check it.