Hormonal vs copper IUD: what's the difference?

Bottom lineBoth IUDs are over 99% effective but differ: the hormonal IUD releases progestin, lasts 3 to 8 years, and usually makes periods lighter (good for heavy or painful periods) though it may cause early spotting, while the copper IUD is hormone-free, lasts up to 10 years, can make periods heavier, and works as emergency contraception within 5 days. Both are reversible with quick return of fertility and offer no STI protection.

Both IUDs are small devices placed in the uterus and are over 99% effective, but they work differently and affect your periods in opposite ways.

Hormonal IUD

• Releases progestin locally
• Works by thickening cervical mucus, thinning the lining, and sometimes suppressing ovulation
• Lasts 3 to 8 years (brand dependent)
• Periods usually get lighter; some people stop bleeding; can ease cramps and heavy periods
• May cause irregular spotting in the first few months

Copper IUD

• Hormone-free - copper makes the uterus and tube environment hostile to sperm
• Lasts up to 10 years
• Periods can get heavier and crampier, especially at first
• Can be used as emergency contraception if fitted within 5 days of unprotected sex
• A good option for those who prefer or need to avoid hormones

Choosing between them

• Want lighter periods or have heavy/painful periods? Hormonal may suit you
• Want no hormones or longest duration? Copper may suit you

Shared features

• Over 99% effective, reversible, fertility returns quickly after removal
• Insertion can be uncomfortable
• No STI protection

A clinician helps you choose based on your periods, health, and preferences.

See how effective is the IUD.

Femora helps you track how your bleeding changes with either IUD.