Hormonal IUD vs Non-Hormonal IUD: Let’s Compare Benefits, Side Effects, and Costs
What are the differences between hormonal and non-hormonal intrauterine devices? What benefits and side effects does each birth control option present? And what about the costs? In this article, you’ll learn more about the different types of IUDs to help you decide which option is better for you.
If you’ve ever considered contraception, whether for birth control or health reasons, you’ve probably come across two options: hormonal and non-hormonal contraception. There are many hormonal contraception options, from combination pills to vaginal rings and hormonal IUDs. Non-hormonal options are scarcer. If you don’t want contraception affecting your hormones, you’re basically left to choose between barrier methods and copper IUDs. In this article, we’ll compare hormonal and non-hormonal IUDs.
You’ll learn about:
- How hormonal and non-hormonal IUDs work
- What their efficacy is
- How long each IUD lasts
- How much do they cost and how the insertion procedures work
What are IUDs?
Both hormonal and non-hormonal intrauterine devices (IUDs) are small, T-shaped birth control devices, inserted into the uterus by a healthcare provider. Their shape is designed to fit into the uterus and release hormones or copper ions to prevent pregnancy.
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There are two types of intrauterine devices:
- Copper IUD
- Hormonal IUD
Both options are great at preventing pregnancy and they have one of the highest efficacy rates compared to other birth control methods.
IUDs are the third most popular birth control option among married and unmarried women. Only female sterilization and condoms surpass IUDs.
Hormonal IUD
Hormonal IUDs work by using a hormone called levonorgestrel (a type of progestin) that mimics the natural female sex hormone, progesterone. The IUD releases minuscule amounts of this hormone into the uterus. It thickens cervical mucus, making it difficult for sperm to travel through the cervix to reach eggs. It also thins the uterine lining (endometrium), which can reduce menstrual flow and make egg implantation less likely.
Even though it’s a hormonal contraceptive, hormonal IUDs release hormones locally, unlike other birth control options like combination pills, patches, or injections.
Some of the most popular hormonal IUD brands are:
- Mirena: It’s most widely used across the world. It contains 52 mg of levonorgestrel and can last up to 7 years. Due to its hormone levels, Mirena is commonly used to treat heavy periods alongside its contraceptive effects.
- Kyleena: It’s another popular option. Kyleena contains less levonorgestrel, 19.5 mg. This IUD lasts up to 5 years and is more popular among women who haven't had children but may wish to have them in the future.
- Skyla/Jaydess: It contains one of the lowest amounts of levonorgestrel, only 13.5 mg. Skyla lasts up to 3 years and is recommended for younger people or those with smaller uteruses.
How effective are hormonal IUDs?
IUDs are one of the most effective contraception methods, with an efficacy of over 99%. This is because there’s very little room for human error. You can’t forget to take it and don’t need to insert it yourself, so it stays inside the uterus until you decide to schedule a removal appointment.
How long can you use a hormonal IUD?
Most hormonal IUDs are effective for 3 to 8 years, depending on the brand. Make sure to talk to your doctor during the insertion and mark the expiration date on your calendar if you don't plan on getting pregnant.
What are the benefits of a hormonal IUD?
Hormonal IUDs are one of the safest birth control methods, with over 99% effectiveness.
More benefits:
- Reduces heavy menstrual bleeding, usually within 3 months of using the IUD, either periods become very light or they stop altogether.
- Less or no menstrual cramps and pain
- Helps manage endometriosis symptoms
- Can reduce pain associated with pelvic inflammatory disease
- May reduce the risk of pelvic infection
- Helps with anemia by reducing menstrual blood loss
- Can help manage perimenopause symptoms
- Long-term but reversible
- No daily medication to remember
- Minimal systemic hormone exposure compared to pills
- Cost-effective over time compared to monthly birth control
What are the side effects of hormonal IUDs?
Hormonal IUDs tend to have broader side effects compared to non-hormonal IUDs but have fewer than other hormonal options like the pill. The most common side effect is period-like cramping and spotting during the first few days after insertion. Spotting might last for 3 months but sometimes can extend up to 6 months after getting the IUD inserted. Your periods are also likely to disappear or become so light that a panty liner is enough. Other side effects include breast tenderness, headaches, acne, mood changes, and bloating.
More rare but serious side effects are:
- IUD coming out partially or completely
- Uterine perforation when a hole or tear develops in the wall of the uterus
- Pelvic inflammatory disease
How much does a hormonal IUD cost?
The price of hormonal IUDs differs based on the IUD brand, your location, and insurance coverage. You need to pay not only for the IUD itself but also for the insertion procedure. In the US, it typically costs anywhere between $0 and $1,300, depending on your medical insurance.
In many European countries like the UK, Germany, and France, the IUD with insertion costs around 120-200 euros.
Non-hormonal IUD
The only non-hormonal IUD option is the copper IUD. Non-hormonal intrauterine devices are made of copper, which works by inactivating sperm cells.
The copper ions released by the IUD create an environment that is toxic to sperm. They kill or disable sperm cells before they can reach the egg. The copper also triggers an inflammatory response in the uterus that prevents fertilized eggs from implanting.
How effective is a copper IUD?
Just like the hormonal option, copper IUDs are over 99% effective at preventing pregnancy because of the lack of human error. It may be more effective than the hormonal option within the first weeks after insertion because it starts working right away. Because of this, copper IUDs are also considered an emergency contraception method.
How long can you use a copper IUD?
Copper IUDs are also one of the longest-lasting reversible contraception methods. Most brands can last for up to 10 years. Again, make sure to track your IUD's insertion date to schedule a timely visit to your doctor to remove or replace it.
What are the benefits of a copper IUD?
Copper IUDs are highly effective at preventing pregnancy for years. However, the main benefit of the copper IUD over the hormonal options is that it doesn’t release synthetic hormones into your body. Many people are sensitive to synthetic hormones and experience uncomfortable symptoms. A copper IUD is highly effective and has less impact on your overall health.
Because of the unique characteristics of copper, non-hormonal IUDs can be used as emergency contraception if inserted within 5 days of unprotected sex.
They can also be used as a reliable contraception method while breastfeeding, as they don’t release hormones. And you can get pregnant right away after removing the device.
Side effects of non-hormonal IUDs
Copper IUDs present fewer side effects related to overall health, but they might have more noticeable effects related to the menstrual period. After inserting the copper IUD, your periods are likely to remain the same or become heavier. You might also experience more cramping, especially in the first few months. Therefore, they aren’t recommended for people with heavy periods, copper allergies, or Wilson's disease.
How much does a copper IUD cost?
Again, the price includes the device and insertion. Like hormonal IUDs, copper IUDs in the US cost around $1,000 or more. In some European countries, they cost between 130 and 450 euros for the device and placement.
The insertion procedure and preparation
The insertion process is pretty simple, but it can be painful. Many clinics recommend taking a painkiller like ibuprofen an hour before the appointment. However, you might request local anesthesia. The pain from the insertion occurs because, to insert the IUD, the doctor needs to open the cervix.
The cervix tries to contract, causing period-like cramps. However, many people experience much more intense pain; some even faint or feel nauseated. So make sure to advocate for yourself and discuss the best pain-management options with your doctor. The good news is that the pain lasts only a few moments and should completely subside after a couple of days.
The IUD insertion process is done in a healthcare provider's office and takes about 10-15 minutes. Before the procedure, your doctor will need to confirm you aren’t pregnant. It's best to schedule the insertion during your period when the cervix is naturally more open to reduce the pain.
During insertion, you'll lie on an exam table with your feet in stirrups. Your doctor will perform a pelvic exam and insert a speculum to see the cervix. The cervix and vagina are cleansed with antiseptic and measured with a thin rod. The IUD is inserted through the cervix into the uterus using a special applicator. The strings are trimmed, leaving about 1-2 inches.
ecovery is pretty simple. You’ll be able to get back to work or school the same day after the insertion. Your doctor might recommend taking OTC painkillers and using a heating pad to reduce cramping. For at least 24 hours after the insertion, don’t have vaginal sex or insert a tampon or menstrual cup. On the first day, it’s also recommended to avoid baths and saunas.
What to keep an eye on after getting an IUD?
It’s completely normal to feel some discomfort and cramping after the IUD insertion for a few days. However, you should seek medical attention if you develop a fever, severe pain, unusual discharge, abnormal bleeding beyond expected spotting, or severe cramping that doesn't improve with pain medication.
Having an IUD makes things simpler, but requires regular monitoring. Check IUD strings monthly, especially after periods. You or your partner shouldn’t feel the strings. If you do feel them, schedule an appointment with your doctor to trim them.
Note any significant changes in bleeding patterns. Be aware of signs of pregnancy, even though the pregnancy on IUD is very rare. Contact your healthcare provider if you can't feel the strings with your fingers, if they feel longer or shorter, or if you can feel the plastic part of the IUD.
Choose birth control right for you
Many birth control options are available for most people in the Western world. However, it’s no secret that it takes time to find the method that works for you. Hormonal IUDs are better at managing period pains and heavy bleeding, while copper IUDs might have fewer side effects. Before deciding to get an IUD, do your research and consult with your doctor about potential side effects and benefits. The most important thing is to take control of your health and fertility.
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