There are two types of Intrauterine devices, the copper IUD (regular) and the hormonal IUD. What is the difference between them? Is the IUD better than oral contraceptives?


What is the hormonal IUD?

The hormonal IUD is similar to the copper IUD but is supplied with the hormone progesterone; it is a T-shaped plastic device that is placed inside the uterus, providing the body with a fixed and low dose of the hormone progesterone. The hormonal IUD is used as a contraceptive, and it has other therapeutic benefits as well. (1)


The efficiency of the hormonal IUD in preventing pregnancy reaches more than 99%, and its effect lasts for a period of up to 5 years, and some types may last longer. (1)



How is it different from the copper IUD?

The hormonal IUD is distinguished from the copper IUD in several ways, including: (2)(3)


  • It is used for therapeutic purposes. The hormonal IUD is useful in reducing heavy menstrual bleeding, menstrual pain, or treating endometriosis, fibroids, etc., while the copper IUD is useful in preventing pregnancy only.
  • It helps prevent pregnancy in more than one way, by making the cervical mucus thicker to prevent the entry of sperm, preventing ovulation, and changing the uterine environment to become unsuitable for receiving the fetus.
  • It can cause the menstrual cycle to stop for a temporary period, but this does not negatively affect health and fertility in any way.
  • If the woman does not have any problems, the copper IUD may be sufficient, but the hormonal IUD may offer better advantages in terms of preventing pregnancy in more than one way.


Benefits of the hormonal IUD


The hormonal IUD has many benefits and advantages compared to oral contraceptives and other contraceptives, including: (4)(5)


  • Both safe and effective method to prevent pregnancy, with an effectiveness of more than 99%, and some types such as Mirena IUD may be 99.9% effective, while Kyleena IUD may be 99.7% effective.
  • Fewer side effects than oral contraceptives; because the effect of hormones is local in the uterus only, and does not affect the body.
  • It can be removed at any time, and the ability to conceive is restored without any problems.
  • Lower cost than using daily oral contraceptives.
  • It helps relieve menstrual pain and bleeding, as most women reported an improvement of 80% after 3 months of using the hormonal IUD, and 90% after only 6 months.
  • It can be installed while breastfeeding.



The effect of the hormonal IUD lasts for about five years and saves you from having to remember to take a pill every day; Instead of taking 1825 oral contraceptive pills over five years, you can insert the IUD just once!


The hormonal IUD does not cause weight gain, and if weight gain occurs, it is minor and is due to fluid retention only!


Disadvantages and side effects


The hormonal IUD is not without some disadvantages, including: (5)(6)


  • Some women find the experience of inserting the IUD uncomfortable and sometimes painful.
  • It needs to be inserted in a clinic or family planning center only, and a woman cannot insert it herself at home.
  • Some women may experience mild side effects, such as: vaginal bleeding, bloating, headaches, acne, mood swings, or breast pain. These effects last for a short period and are rare because the dose of hormones used is small and localized in the uterus.
  • The IUD may occasionally move from its place and needs to be installed again, and this is more common in the first 3 months of use.
  • There is a small chance of infection at the time of insertion of the IUD.
  • It does not protect against sexually transmitted diseases.
  • The hormonal IUD is not suitable for all women, as it is not recommended for use in these cases: (3)

o Currently or previously had breast cancer.

o Uterine or cervical cancer.

o Liver disease.

o Pelvic inflammatory disease.

o Suffering from unexplained vaginal bleeding.


It is normal to notice changes in the nature of your menstrual cycle during the first 3-6 months of using the hormonal IUD; there may be intermittent vaginal bleeding; menstrual bleeding is often lighter or even the cycle may stop during this period. (6)


How to install the hormonal IUD

The IUD is installed inside the uterus through the vagina by a qualified doctor, either in the clinic or in family planning clinics, and the process takes only a quarter of an hour. (6)


There will be a thread hanging from the hormonal IUD, which cannot be seen, but you can feel it at the top of the vagina from the inside, and it is best to check the thread at least once a month and inform the doctor if it becomes shorter or longer than usual to ensure that the IUD is in place. (6)




Put your trust in our doctors at Al-Ahli Hospital who are distinguished in installing the hormonal IUD in the easiest possible way and providing you with a comfortable and safe experience. If you have any inquiries or questions about the hormonal IUD, contact our Obstetrics and Gynecology Department at Al-Ahli Hospital.



Important information while using the hormonal IUD

  • Book an appointment for the IUD installation and remember the date of its removal because it should not remain for a longer period than recommended. (7)
  • Feel inside the vagina with your finger to make sure the thread is there every month to make sure the IUD is in its place. (7)
  • If you have any unusual symptoms including unusual vaginal discharge, vaginal bleeding, or pain in the lower abdomen or during intercourse, see your doctor immediately. (7)
  • See your doctor if you suspect that you are pregnant. (7)



References