Long Acting Reversible Birth Control Method: Hormonal IUD

Choosing the right birth control method is an important decision, and the hormonal IUD provides a long-acting, reversible option for those seeking reliable contraception.

This small, T-shaped device is inserted into the uterus, where it releases hormones to prevent pregnancy for several years. Unlike daily pills or on-demand methods, the hormonal IUD offers continuous protection without requiring frequent maintenance, making it a convenient choice for individuals looking for a low-effort yet highly effective solution.

While not as widely discussed as other hormonal contraceptives, the hormonal IUD has been a trusted option for many people seeking long-term birth control. It provides benefits beyond pregnancy prevention, such as lighter periods and reduced menstrual cramps, making it an appealing choice for those who experience heavy or painful cycles.

With several brands available and a high success rate, the hormonal IUD is a practical and discreet option for individuals looking for dependable, long-lasting contraception.

What Is Hormonal IUD?

A hormonal IUD is a small, flexible T-shaped device made of plastic that is inserted into the uterus. It releases a steady amount of the hormone progestin (similar to the hormone progesterone) to prevent pregnancy.

The progestin works in several ways: it thickens cervical mucus to prevent sperm from entering the uterus, thins the uterine lining to reduce the likelihood of implantation, and in some cases, suppresses ovulation.

Hormonal IUD is effective for long periods of time, typically between 3 and 7 years, depending on the specific type and brand.

How Does Hormonal IUD Work?

The hormonal IUD works primarily by altering the environment inside the uterus, making it hostile to sperm.

Progestin is released slowly into the uterus, which thickens the cervical mucus, creating a barrier that sperm cannot penetrate.

In addition to this, the hormone also thins the lining of the uterus (endometrium), which makes it less likely for a fertilized egg to implant and grow.

In some cases, the hormonal IUD may also suppress ovulation, meaning that the ovaries do not release an egg every month, reducing the chances of fertilization.

Various Hormonal IUD Options

There are a few different brands of hormonal IUDs, each with slight variations in hormone dosage and duration of use. Some of the most commonly known options include:

Mirena: One of the most widely used hormonal IUDs, Mirena provides effective contraception for up to 8 years. It also has the added benefit of reducing menstrual bleeding and cramping over time for some users.
Skyla: This IUD is similar to Mirena but contains a lower dose of progestin, making it ideal for younger individuals or those who have not had children. Skyla is effective for up to 3 years.
Liletta: Liletta is an IUD used for birth control for up to 8 years and to treat heavy periods for up to 5 years. It is often seen as a cheaper option to Mirena.
Kyleena: This hormonal IUD is effective for up to 5 years and releases a lower dose of progestin than Mirena. It’s often used by those who prefer a smaller device and reduced hormone levels.

Each of these options is available by prescription, and a healthcare provider will help you choose the best one based on your individual health needs and preferences.

Where Can a User Obtain Hormonal IUD?

Hormonal IUDs are available by prescription and must be inserted by a healthcare provider, typically at a clinic, doctor’s office, or family planning center.

To obtain one, you will first need to schedule a consultation with a healthcare professional, who will assess your medical history and discuss any potential risks or side effects. If you and your provider decide that a hormonal IUD is the right choice for you, the insertion procedure will take place in their office.

In most cases, the procedure is quick and can be done with local anesthesia to minimize discomfort. After insertion, follow-up appointments may be scheduled to ensure the IUD is in place and functioning correctly.

How Much Does Hormonal IUD Cost?

The cost of a hormonal IUD can vary depending on several factors, such as location, healthcare provider, and whether you have insurance coverage. On average, the price of the device itself typically ranges from $500 to $1,000 in the United States. This cost may include the insertion procedure, but it’s important to check with your healthcare provider to understand the total cost, as fees for the insertion can be separate.

If you have health insurance, many plans cover the cost of an IUD, including both the device and the insertion, often with little to no out-of-pocket expense. For individuals without insurance or with insufficient coverage, the cost may be higher, but some clinics offer sliding-scale fees or payment plans. Some government-funded family planning programs also offer hormonal IUDs at a reduced cost or for free, depending on eligibility.

Many provincial healthcare systems in Canada cover the cost of the IUD and insertion for residents, especially in publicly funded clinics or through your family doctor or gynecologist.

While the initial cost may seem high, the hormonal IUD is a long-term contraceptive, effective for 3 to 8 years (depending on the brand), making it more cost-effective over time compared to methods that require ongoing payments, like birth control pills.

Benefits & Disadvantages

Benefits:

Highly Effective: With typical use, hormonal IUDs have a failure rate of less than 1%, making them one of the most reliable methods of contraception.

Long-Term Protection: Depending on the brand, hormonal IUDs provide protection from pregnancy for anywhere between 3 to 7 years.

Convenient: Once inserted, there’s nothing more you need to do, and you don’t have to remember to take a pill daily.

Reduced Menstrual Symptoms: Many users experience lighter periods, fewer cramps, or even no periods at all after several months of use.

Reversible: Fertility returns quickly once the IUD is removed, making it an ideal option for those who may want to conceive in the future.

Disadvantages:

Requires Doctor’s Visit and Insertion: A hormonal IUD must be inserted by a healthcare provider, which involves a medical appointment and potential follow-up.

Potential Side Effects: Some users may experience side effects such as spotting, headaches, nausea, breast tenderness, or changes in mood.

Initial Discomfort: The insertion process can cause discomfort, cramping, or spotting, and it may take a few weeks for the body to adjust

Possible Complications:In rare cases, the IUD can become dislodged, or there may be a risk of uterine perforation during insertion.

Not STI-Protective: Hormonal IUDs do not protect against sexually transmitted infections (STIs), so additional protection (like condoms) may be needed during sexual activity.

Success and Failure Rate for Birth Control When Using a Hormonal IUD

Hormonal IUDs are among the most effective forms of contraception available.

With typical use, the failure rate is less than 1%, meaning that fewer than 1 in 100 people will become pregnant during the first year of use. This makes the hormonal IUD one of the most reliable long-term birth control options.

The failure rate is so low because the device works continuously to prevent pregnancy without requiring user action after insertion.

However, as with all birth control methods, it’s important to remember that no method is 100% foolproof, and factors like improper insertion or expulsion can impact effectiveness.

Hormonal IUD vs Copper IUD

Hormonal and copper IUDs are both long-acting, reversible forms of birth control, but they work in different ways and have distinct effects on the body.

Hormonal IUDs (pictured above left), release a steady, low dose of progestin, which thickens cervical mucus to block sperm, thins the uterine lining, and may also prevent ovulation. These hormonal devices often lead to lighter periods, reduced cramping, and in some cases, the complete absence of menstruation over time.

In contrast, copper IUDs (pictured right), are hormone-free and use copper as a natural spermicide, creating an environment that is toxic to sperm and preventing fertilization. However, they can cause heavier menstrual bleeding and more intense cramps, particularly in the first few months after insertion.

While both types are highly effective and convenient, the choice between them often comes down to personal preferences around hormones, menstrual changes, and potential side effects.

Alternative Long-Acting Reversible Methods Of Birth Control?

There are several alternative long-acting reversible methods of birth control, each offering a different approach to contraception. These options are suitable for those who do not want to have children at the present date, but may so in the future. To learn more check out the page on other long-acting reversible methods of birth control.

As with any contraceptive, it's important to choose what aligns best with your lifestyle and needs, and consulting with a healthcare provider can help ensure you're selecting the most suitable option for your situation.

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