The Pros & Cons of the Hormonal IUD


Safe sex, whether with a long-term partner or a new encounter, necessitates a vital first step—understanding your options for contraceptives. Let's take a closer look at the pros and cons of the hormonal IUD.

Mirena IUD

Safe sex, whether with a long-term partner or a new encounter, necessitates a vital first step—understanding your options for contraceptives. Familiarizing yourself with the various methods available will help you find one that aligns with your unique body, personal needs, and lifestyle circumstances.

Here, we’re taking a closer look at the hormonal IUD, a small, flexible plastic device, shaped like a T, that is inserted by a healthcare professional through the vagina and up past the cervix into the uterus. The IUD is attached to a thread that hangs into your vaginal canal. 

What's the difference between hormonal and non-hormonal IUDs? You probably can guess––hormones! Hormonal IUDs release low levels of the hormone progestin (very similar to the hormone progesterone that our bodies make naturally) to prevent egg fertilization, unlike non-hormonal IUDs that have copper which transform the uterus into a hostile environment for sperm. 

Hormone-releasing IUDs should be removed and replaced every 3-10 years, depending on the brand. You should always consult your doctor to decide if an IUD is the right choice for you. 

Like every contraceptive, it offers both pros and cons.

The Pros of the Hormonal IUD

  • Using an IUD allows for spontaneous, uninterrupted sex.
  • It requires minimal effort — you get it inserted and then you can forget about it. 
  • Unlike some other forms of contraception, you don't have to remember to do or take anything every time you have sex.
  • It's more than 99% effective at preventing pregnancy. 
  • It can remain in place anywhere from 3 to 10 years. 
  • It can be removed at any time by a doctor and will not affect your fertility. 

The Cons of the Hormonal IUD

  • It requires a doctor to insert it and take it out. 
  • IUDs don't protect against STIs.
  • Rarely, the IUD can slip out of place.
  • It can cause side effects such as pain, cramping, spotting, chills, heavy bleeding or unusual discharge.
  • It can tamper with your period flow. For some women it makes their periods much lighter and for others it disappears all together.
  • If you do get pregnant with an IUD (the chances are 0.2% to 0.8% in the first year and less after that), your risk of ectopic pregnancy is higher. This refers to a fertilized egg implanting outside the uterus, which can cause life-threatening bleeding and needs medical care right away. 
  • There's a low risk of developing inflammatory disease (PID). PID occurs in just 1% of women within the first 20 days after insertion and in 0.5% in the first 3 to 6 months.
  • It's also possible to expel the IUD from your uterus. Women who have never been pregnant, have heavy or long periods, have the device inserted immediately after childbirth, or have previously expelled an IUD are at a higher risk of this. You might not feel the expulsion if it occurs. 
  • There's a 1 in 1000 chance that the IUD could go through the uterus wall and into the abdomen, which requires surgical removal. 
  • Migration can happen if the uterus is torn, usually by an instrument during IUD insertion. However, these uterine perforations only occur in 0.01% of cases.


If you're not looking to get pregnant, a contraceptive method is always better than none. It's just about finding the one that works for you, your lifestyle, and your body. Get informed about your contraceptive options and make the decision of what's best for you, based on your body, lifestyle, priorities, and choices.

Disclaimer: If you're thinking of starting hormonal contraception or are concerned about the impact it's having on your body, consult a gynecologist. 

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