How it works
The device releases a small amount of levonorgestrel, a progestogen, directly into the uterus. This thickens cervical mucus so sperm cannot easily get through and thins the lining of the uterus. In some users it also stops ovulation.
People who want very effective, long-lasting contraception, especially those with heavy or painful periods or who cannot take estrogen.
How effective is it?
Typical use
Over 99%
In real life fewer than 1 in 100 people get pregnant in a year.
Perfect use
Over 99%
About 0.3 in 100 when used exactly as directed every time.
0.1 to 0.4 in 100 in the first year, depending on the device
See how it ranks against every method in the effectiveness chart.
How to use it
See a doctor, nurse, or sexual health or family planning clinic; you may have a check for infections before fitting.
A trained clinician places the device through the vagina and cervix into the uterus; fitting usually takes a few minutes and can be uncomfortable, so ask about pain relief options.
Depending on when in your cycle it is fitted, you may need condoms or another method for the first 7 days.
Two thin threads hang into the top of the vagina; you can learn to feel for them to check it is still in place.
Have it removed or replaced by a clinician when it is due (3 to 8 years depending on the brand), or any time you want to stop.
Pros and cons
Advantages
- One of the most effective reversible methods, with nothing to remember day to day.
- Lasts for several years from one fitting.
- Periods often become much lighter and less painful, and it is also used to treat heavy periods.
- Contains no estrogen, so it suits many people who cannot use combined methods.
- Can be used while breastfeeding.
- Fertility returns quickly after removal.
Disadvantages
- Does not protect against sexually transmitted infections (STIs); use condoms as well for that.
- Fitting needs a clinician and can be painful or uncomfortable for some people.
- Irregular bleeding and spotting are common in the first 3 to 6 months.
- Small risks at fitting, including infection in the first few weeks, the device coming out, and rarely a hole made in the uterus (perforation).
Effect on periods: Periods usually become lighter and less painful, and many people stop bleeding, though spotting is common in the first months.
Possible side effects
- Irregular bleeding or spotting, especially in the first few months
- Cramping or period-like pain after fitting
- Headaches
- Breast tenderness
- Acne
- Mood changes
Who it may not suit
A clinician checks your medical history before you start. This list is not complete.
May not be suitable if
- You have, or have had, breast cancer.
- You have a current pelvic infection or untreated STI.
- You have unexplained vaginal bleeding that has not been checked.
- You have certain conditions affecting the shape of the uterus or cervix.
- You have cancer of the cervix or uterus, or serious liver disease.
Get medical help if
- You cannot feel the threads, they feel longer or shorter, or you can feel the hard part of the device.
- You have severe pain in your lower tummy, fever, or unusual smelly discharge, especially in the first weeks after fitting.
- You think you might be pregnant; pregnancy with an IUD in place is rare but needs checking quickly, as there is a higher chance it is outside the uterus (ectopic).
- Sex becomes painful or you have unusual bleeding.
Frequently asked questions
How long does a hormonal IUD last?
It depends on the brand: the main types last 3, 5, or 8 years for contraception. Check which device you have and its replacement date with your clinic, as licensed durations can differ between countries.
Will a hormonal IUD stop my periods?
Many users find their periods get much lighter, and some stop bleeding altogether, especially with the higher-dose devices. Irregular spotting is common in the first few months before things settle.
Does getting a hormonal IUD fitted hurt?
Experiences vary from mild discomfort to significant cramping. You can ask about pain relief before the appointment, and cramps usually ease within a day or two.
Can a hormonal IUD fall out?
It can, but this is uncommon (around 1 in 20) and most likely in the first few months. Feeling for the threads helps you notice; use another method and see a clinician if you think it has moved.
What is the difference between a hormonal IUD and a copper IUD?
A hormonal IUD releases a progestogen and often makes periods lighter. A copper IUD has no hormones, lasts up to 10 years or more, and can make periods heavier, but can also be used as emergency contraception.
Sources
Reviewed 1 November 2026. We link to the guidance itself so you can check it.