The hormonal IUD is very effective because it doesn’t depend on you remembering to use it.

It’s over 99% effective. Fewer than 1 in 100 hormonal IUD users will get pregnant in a year.

If 100 people who could get pregnant don’t use any contraception, 80 to 90 will get pregnant in a year.

• It thickens the mucus in your cervix (entrance to the womb). This makes it difficult for sperm to move through it and reach an egg
• It makes your uterus (womb) lining thinner to help stop a fertilised egg implanting
• In some people, it stops the ovaries releasing an egg (ovulation). Most people who use a hormonal IUD will continue to ovulate
• A hormonal IUD doesn’t cause an abortion

You can get a hormonal IUD fitted for free at:

• a sexual health clinic or contraception clinic
• some GP surgeries
• some genitourinary medicine (GUM) clinics
• some young people’s services

An IUD can only be fitted by a trained healthcare professional.

Most people with a uterus (womb) can use a hormonal IUD. This includes young people, people who have never been pregnant, and people who have never been sexually active.

Your healthcare professional will ask about your medical history to check if the IUD is suitable. Do mention any illnesses or operations you’ve had. You may need specialist care when it’s fitted.

You may be advised not to use a hormonal IUD if you:

• think you might be pregnant
• have had a baby in the last 4 weeks (but an IUD can be fitted in the first 2 days after the birth). See I’ve just had a baby. Can I use a hormonal IUD?
• have symptoms of an untreated sexually transmitted infections or pelvic infection
• have breast cancer or have had it in the past
• have problems with your uterus (womb) or cervix (entrance to the womb)
• have serious liver disease
• have unexplained bleeding from your vagina (for example, between periods or after sex)
• have, or have had, arterial disease, serious heart disease, some heart rhythm problems or stroke

You may still be able to use a hormonal IUD even if you have any of the above. Your healthcare professional will discuss this with you.

Advantages

• Periods usually become much lighter and shorter and sometimes less painful. For some people, bleeding stops completely. This isn’t harmful
• Some types (Mirena, Levosert and Benilexa) can be used to treat heavy or painful periods
• You don’t have to remember to use it
• Works as contraception for 3 years (Jaydess), 5 years (Kyleena), 6 years (Levosert and Benilexa) or 8 years (Mirena)
• It’s not affected by other medicines
• Can be used if you’re breastfeeding
• Your fertility returns to normal as soon as the hormonal IUD is taken out
• It’s useful if you can’t use oestrogens, like those in the combined pill, the contraceptive patch and the contraceptive vaginal ring
• A Mirena, Levosert or Benilexa IUD can be used as the progestogen part of HRT to protect the lining of your uterus (womb)

Disadvantages

• Your bleeding pattern may change in a way that is not acceptable to you – see Will the IUD affect my periods?
• You may get side effects like spotty skin, breast tenderness, headaches or mood changes. These usually get better after the first few months
• You’ll need an internal examination. Your healthcare professional will gently feel your tummy and inside your vagina to check the position, size and shape of your uterus
• The hormonal IUD doesn’t protect you from sexually transmitted infections, so you may want to use condoms as well

• Research on the risk of breast cancer and hormonal contraception use is complicated and hasn’t given definite answers. The available research suggests that users of any hormonal contraception (including the hormonal IUD) may be slightly more likely to be diagnosed with breast cancer, but the risk is small
• There’s a very small chance of you getting an infection during the first few weeks after an IUD is put in. You may be advised to have a check for sexually transmitted infections before or when the IUD is fitted
• An IUD can be pushed out (expulsion) by your uterus (womb) or it can move (displacement). Your healthcare professional will teach you how to check the threads so you know the IUD is in place
• There’s a very small chance that when the IUD is put in, it may perforate (go through) the side of your uterus or cervix. This is not common. The risk is higher if you’ve recently given birth or are breastfeeding. If it does happen, it may cause pain, but often there are no symptoms. The IUD may have to be removed by surgery. The uterus or cervix will heal by itself.

A hormonal IUD can be put in at any time in your menstrual cycle if it’s certain you’re not pregnant.

• If it’s fitted in the first 7 days of your cycle, you’ll be protected from pregnancy straight away. If you have a very short cycle or a cycle that changes, ask your healthcare professional if condoms are advised for the first 7 days
• If it’s fitted at any other time, you’ll need to use condoms or avoid sex for the first 7 days

It’s put into your uterus through your vagina by a trained healthcare professional. They will feel your tummy and inside your vagina first to find the position and size of your uterus (womb).

Your appointment will last around 20 to 30 minutes. Inserting the IUD usually takes around 5 minutes.

It can be uncomfortable or painful for some people. Your healthcare professional should discuss pain relief options with you, including over the counter painkillers and local anaesthetic.

Tell your healthcare professional if it feels painful or uncomfortable when the IUD is being fitted. You can choose to pause or stop at any time.

You may get a period-type pain and some light bleeding for a few days after the IUD is fitted. You can take painkillers if you want to.

The IUD has 2 threads that hang down into the top of your vagina. Your healthcare professional will teach you to feel the threads to make sure the IUD is in place.

Check the threads in the first 4 to 6 weeks after the IUD is put in. After this, check once a month.

If you can’t feel the threads, or think you can feel the IUD itself, you may not be protected from pregnancy. See a healthcare professional straight away and use condoms if you have sex.

If you had sex recently, you may need emergency contraception.

If a partner can feel the threads during sex, ask your healthcare professional to check the threads.

If you feel unwell, with pain in your lower tummy and a high temperature or a smelly discharge from your vagina, you may have an infection. See a healthcare professional as soon as possible.

The IUD needs to be removed by a trained healthcare professional. They can take it out by gently pulling the threads. If you want to, you can get a new IUD at the same appointment.

It’s common for bleeding to change while using the hormonal IUD. Bleeding usually becomes lighter, shorter, less frequent and less painful. For many people, periods stop altogether.

In the first few months, bleeding may be unpredictable, more frequent, or last longer.

If you have any concerns about your bleeding, talk to your healthcare professional.

Yes. To help lower the chance of the IUD coming out, make sure the suction is released before removing a cup and try not to pull on the IUD threads when removing a tampon or a cup.

Yes. It can be fitted at the time of delivery or up to 48 hours afterwards. Otherwise, you’ll need to wait until 4 weeks after the birth.

Use other contraception from day 21 after the birth until the IUD is put in.

It’s safe to breastfeed while you’re using a hormonal IUD.

A hormonal IUD can be put in straight after a miscarriage or abortion. You’ll be protected from pregnancy straight away.

Ask your healthcare professional to take the hormonal IUD out.

Your periods and fertility will go back to normal as soon as the IUD is removed.

If you don’t want to get pregnant, avoid sex or use condoms or other contraception for the 7 days before the IUD is taken out. Then use other contraception from the day it’s removed.

If you want to try for a baby, start pre-pregnancy care – such as taking folic acid and vitamin D and stopping smoking – before you stop using the IUD. Ask your healthcare professional for advice.

You can try to get pregnant as soon as you stop using the hormonal IUD if you want to.

The hormonal IUD is very effective and it’s unlikely you’ll get pregnant. If you do, there’s a small increased risk of ectopic pregnancy. An ectopic pregnancy develops outside the uterus (womb), usually in a fallopian tube.

The chance of an ectopic pregnancy is less in hormonal IUD users than in people using no contraception at all.

If you have any signs of an ectopic pregnancy – such as a sudden or unusual pain low in your tummy – or think you might be pregnant, get medical advice as soon as possible.

If you do get pregnant, talk to a healthcare professional as soon as possible. If you’re in the first 12 weeks of pregnancy, it’s usually recommended to remove the IUD.

You won’t usually need a check-up after the IUD is fitted. Contact your healthcare professional if you have any problems or questions, if you want the IUD taken out or if you want to change to a different method of contraception.

If you think you may have a sexually transmitted infection, seek advice as soon as possible.

A hormonal IUD works for contraception for 3, 5, 6 or 8 years, depending on the type. It then needs taking out. If you want to keep using an IUD, a new one can be put in.

If you’re aged 45 or over when you have a Mirena, Levosert or Benilexa IUD fitted, it can stay in place as contraception until you’re aged 55. After this, contraception isn’t needed.

If the hormonal IUD is used for HRT, it needs changing every 5 years for as long as HRT is needed. Also see our guide to Menopause.