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Hormonal (Progestin) Intrauterine Devices

Patient Education
Published May 5, 2020
• Reviewed by a UI Health Care Provider
on Nov. 12, 2025

What is an intrauterine device (IUD)?

  • An IUD is a type of birth control.
  • It is a small, T-shaped device that your provider puts in your uterus by going through your vagina and cervix.
  • These are made of flexible plastic and have 2 thin plastic strings that hang out of your cervix.
  • They may be called LARC devices, a ‘long-acting reversible contraceptive’ method of birth control.
  • Many people who use progestin-releasing IUDs have lighter, less painful periods than they had before getting the IUD.
  • Some people stop getting periods. This is not harmful and does not need to be treated.
  • After the IUD is taken out, your normal periods come back, and your body can try to get pregnant again.

There are 3 hormonal IUDs (Liletta®, Mirena®, and Skyla® or Kyleena®).

Hormonal IUDs
NameLevonorgestrel amountLasts for
Liletta®52 mg8 years
Mirena®52 mg8 years
Skyla® or Kyleena®19.5 mg5 years

Your provider can help you choose the right IUD for you.  

  • Liletta® and Mirena® can be used longer for birth control. If you start having problems with irregular bleeding, it can be replaced before 6 to 7 years. Talk to your care team about your bleeding

A progestin IUD might be a good choice if you:

  • Have heavy, painful periods. Progestin IUDs can make your periods lighter and less painful.
  • Want birth control for at least 1 year. It will last up to 5 years.
  • IUDs are very safe and help prevent pregnancy. Less than 1% (1 in every 100) of people who use these devices get pregnant during the first year of using them.
  • You do not need to take a birth control pill each day.
  • They do not have many side effects. Most of the hormone stays in the uterus.
  • It does not have estrogen so there is less risk for blood clots.
  • You can take the IUD out when you want, like if you want to get pregnant.
  • If you use an IUD for many years, it can cost less over time than many other types of birth control.
    • There are no costs after you have it put in.
  • For people with heavy periods, bleeding may be lessened. Most people have 80% less bleeding as early as 3 months and 90% less at 6 months.
     
  • It is very rare for an IUD to come out by itself. This is called expulsion.
    • You will need a new IUD if this happens.
    • Call your provider if you are worried that it has come out.
  • The first cost (getting the IUD put is) is higher than the cost of other methods. Many IUDs are covered by insurance.
  • It does not prevent sexually transmitted infections (STIs).
    • Use condoms with new partners.
  • Only a provider can put in or take out an IUD.
  • IUDs do not prevent ovarian cysts. Ovarian cysts can go away on their own, but they can be painful.
  • Are or might be pregnant.
  • Have a pelvic infection called pelvic inflammatory disease (PID) or get infections easily.   
  • Have certain types of cancer, such as breast cancer, that are sensitive to progestin.
  • While very unlikely, you can get pregnant with IUDs.
  • If you miss any periods and feel like you may be pregnant, take a urine (pee) pregnancy test.
  • If you have a positive pregnancy test, call the clinic right away. We will need to see you right away. 
  • Some temporary pinching or period-like cramping
  • Bleeding:
    • Can last for a few days.
    • Can be irregular for a few weeks and may last up to 3 to 6 months.
  • Dizziness
  • Feeling sick to your stomach
  • Feeling faint, like you may pass out
  • People who have not had a baby often feel more discomfort than people who have had a baby, but each person is different.
  • Lighter periods (see below)
  • You have heavy period bleeding or severe belly pain.
  • You have a fever of 100.4° Fahrenheit (or 38.0° Celsius) or higher
  • Your IUD falls out.

What changes may happen to my period after my IUD is put in? 

In the first 1 to 3 months, you may have:

  • Irregular bleeding, anywhere from random spotting to bleeding like a period.
  • Cramping.
    • You may take ibuprofen (Advil®) 600 mg (milligrams) every 6 hours or acetaminophen (Tylenol®) 650 mg every 4 to 6 hours. You can take both at the same time.

Come to your follow-up visit about 6 weeks after your IUD is put in if your provider wants to see you.

In the first 3 to 6 months:

  • You may have frequent spotting or light bleeding that will get better.
  • Your period may be irregular.
  • Some people may find that their periods are heavier than normal. Call your care team if your period stays heavier than normal for a while.

Most side effects get better after 3 to 6 months. The longer your IUD in place, the more likely any side-effects will lessen or go away, such as spotting or irregular bleeding.

After your body has adjusted to your IUD:

  • Your period may be shorter and lighter than before.
  • Your period may stay irregular.
  • Your period may stop.

You may have these effects for as long as you have your IUD in place. Your period will go back to normal once your IUD is taken out. 

How do I check my strings?

  • Your care team may suggest checking your IUD strings. You can check your strings if you want to, but it is not needed.
  • If you do check your strings and are not able to feel them when you used to be able to feel them:
    • Use condoms for back-up.
    • Schedule a visit for an IUD string check.
    • Most of the time, they are there. They can be tucked up where you cannot find them. 

What is important to remember?

  • IUDs do not protect against sexually transmitted infections (STIs) or human immunodeficiency virus (HIV). You should use a condom with any new partner. Condoms are the only method to lessen the risk of spreading or getting an STI.
  • After the IUD is put in, it takes a few days for it to start working. Use a backup method of birth control for at least 7 days (such as a condom).