Hormonal Intrauterine Device (IUD)

A hormonal IUD is a plastic object that is inserted into the uterus and contains progestogen hormone.
Hormonal Intrauterine Device (IUD)
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Street names IUD, Mirena, T
Medical names Hormonal IUD, Mirena® (brand)
Effectiveness 99.8% ?
It lasts It works for 5 years, unless you have it removed earlier
Fertility Fertility returns when it is removed
Who can use it? People with a vagina and uterus of any age from menarche to menopause
Hormones Contains progestogen
Visibility Very discreet
STIs No protection ?
Side effects Uterine bleeding, headaches, acne, mood changes. Allow 6 months to adjust to the hormone
Cost Between $6 and $220 depending if you have a Heath Care card, Medicare card or private script. Additional costs for the procedure.
Where to get it Visit a reproductive and sexual health clinic or your local doctor. You may need to visit a pharmacy to pick up a prescription

How does it work?

The hormonal IUD slowly releases progestogen hormone into the bloodstream. The hormone generally stops the ovaries from releasing eggs (ova). It also changes the mucus of the cervix making it harder for any sperm to enter the uterus. This prevents pregnancy.

The IUD contains 52mg of a progestogen hormone called levonorgestrel. It releases 0.02 progestogen every day, and works as a contraceptive for 5 years.

You will still need to consider the risk of Sexually Transmitted Infections (STIs) every time you have sex.

What’s it like to use?

The hormonal IUD is inserted by a reproductive and sexual health clinician through the cervix and into the uterus. The procedure involves a local or light anaesthetic to reduce the pain and discomfort you will feel during the procedure. The clinician does not make any cuts or use stitches so there is no scarring.

It is very discreet. You will not be able to feel it is there.

Menstrual periods will stop and instead you will experience a uterine bleeding period. It will feel similar to a menstrual period but the flow is usually lighter and bleeding patterns can be irregular.

A thin piece of nylon thread will be left at the end of the hormonal IUD, which can be felt at the top of the vagina. If you don’t want to be able to feel the thread at all, ask your clinician to tuck it alongside the cervix.

The hormonal IUD is very good at reducing blood loss during your period and can be used to treat heavy menstrual flow. It can take time for your body to adjust to the hormone, and in the first 3-6 months following insertion of the hormonal IUD, it is common to have irregular, prolonged or frequent bleeding. After 3-6 months uterine bleeding typically become shorter and lighter. Around 20% of people that use the hormonal IUD will have no monthly bleeding.

What if I forget about it?

The hormonal IUD can be left in the uterus longer than 5 years. After 5 years it will stop working as a contraceptive so you will need to consider another contraceptive method.

If you’d like to replace your hormonal IUD, it can be taken out and replaced with a new one all in the same procedure.

Who can use it?

People with a vagina and uterus of any age, from menarche to menopause.

The hormonal IUD is suitable for people who have never experienced pregnancy and for use as contraception after pregnancy.

If you experience polycystic ovarian syndrome (PCOS), the Combined Hormonal Contraceptive Pill is generally considered to be the best contraceptive option. However, the hormonal IUD is also a suitable option for people with PCOS. It is best to discuss your exact situation with a doctor.

The hormonal IUD is suitable for people with a family history of breast cancer. It is not suitable for people who have breast cancer or have experienced breast cancer in the past.

Side effects

You may experience some discomfort, similar to period pain, for 1-2 weeks. The pain is not usually from the IUD itself, it is because the organs take time to recover from the procedure. Plan to have 2-3 days of rest after the IUD has been inserted. Use a hot water bottle to reduce abdomen pain.

During the first 6 months your body may take time to adjust to the hormones. The most commonly reported side effect is altered uterine bleeding patterns. Of people who use the IUD, 95% will experience uterine bleeding lighter than usual menstrual bleeds or will experience amenorrhoea (no uterine bleeding at all). Other hormonal side effects such as headaches, acne, or mood changes are rare. Some people use one contraceptive choice to manage menstrual bleeding and the other to prevent pregnancy. Learn more about your reproductive organs and sexual health and hormonal contraceptives.

If you have a Sexually Transmitted Infection (STI), an IUD will increase the risk of Pelvic Inflammatory Disease (PID). The IUD can allow the infection to travel more quickly from the vagina to the uterus, fallopian tubes, and/or ovaries. PID symptoms can include fevers, lower abdominal pain, and vaginal discharge. PID needs to be treated as soon as possible. If left untreated PID can affect long term fertility. A health assessment prior to an IUD insertion should always include a STI test. If you are experiencing PID or a STI, this will need to be addressed before the IUD can be inserted.

In rare cases an IUD can perforate (make a small hole inside) the uterus. This happens in about 2 in 1,000 insertions. In these cases the IUD is removed and an alternative contraceptive method can be used. Occasionally an IUD can be expelled, which is when it exits via the uterus into the vagina. This happens about 5 times per 100 insertions. In these cases the IUD can be replaced, or an alternative contraceptive method can be used.

If at any point you feel that this contraceptive method is making you feel uncomfortable or unwell, get advice from a doctor or medical professional. If it is an emergency, call an ambulance on 000.

How and where to get it

A reproductive and sexual health clinician can do a health assessment, provide the IUD, and do an insertion. It may require more than 1 appointment. Some reproductive and sexual health clinics do not have IUDs in stock, so you may need to get a prescription and pick it up from the pharmacy.

A hormonal IUD will cost between $6 and $220 depending on whether you have a Health Care Card, Medicare card or a private script. There may also be consultation fees. You can ask for a quote when you book an appointment.

What if you change your mind

Any time you want to have it removed visit a reproductive and sexual health clinic to have it removed. It does not need to be the same clinician who did the insertion. While in the removal appointment ask about other contraceptive options because fertility will return shortly after the IUD is removed.