Hormonal IUD Procedure
Overview
The hormonal intrauterine device (IUD) is a small, T-shaped device that a healthcare provider places in the uterus to help prevent pregnancy. It belongs to a group of intrauterine systems that release progestin over time.
This hormone thickens cervical mucus, making it difficult for sperm to reach an egg, and thins the lining of the uterus. It can also reduce ovulation in some users. There are several types of intrauterine devices available, including:
| Type | Contains Hormones? | How Long It Lasts |
|---|---|---|
| Hormonal | Yes (progestin) | Up to 8 years |
| Copper | No | Up to 10 years |
Hormonal IUDs are popular because they are highly effective and offer long-term birth control.
Reasons for Choosing This Option
People choose this method for both practical and medical reasons. It provides reliable pregnancy prevention, with over 99% effectiveness. Unlike pills or condoms, the hormonal IUD offers continuous protection without daily action or use before sex, making it especially useful for those seeking a long-term solution.
Key Advantages
Long-Lasting Support: Remains effective for up to eight years but can be removed earlier.
No Partner Involvement Needed: Users maintain protection without interrupting intimacy or depending on their partner.
Rapid Return to Fertility: Fertility returns quickly after removal, offering flexibility for future family planning.
Breastfeeding Compatibility: New mothers can use Mirena during breastfeeding.
Common Non-contraceptive Benefits
| Health Issue | How Mirena May Help |
|---|---|
| Heavy periods | Less bleeding over time; may stop periods altogether. |
| Menstrual cramps | Decreases pain and discomfort during cycles. |
| Endometriosis | Reduces pain linked to tissue growth outside the uterus. |
| Endometrial hyperplasia | Helps slow or prevent abnormal tissue growth. |
| Adenomyosis | Can ease symptoms related to tissue growth in the uterus. |
| Anemia | May lower heavy bleeding, helping prevent low iron. |
| Noncancerous uterine growths | Offers symptom relief for some with fibroids. |
Emergency Use: May be used for emergency contraception if inserted within five days of unprotected sex.
Lower Health Risks
- May lower the risk of endometrial cancer.
- Decreases the risk of pelvic infections.
Who May Not Be Suitable
People with specific health issues may not be candidates. This includes those with certain cancers, unexplained vaginal bleeding, or a history of infections. It’s important to discuss all health conditions and medications with a healthcare provider.
Possible Concerns
Using a hormonal IUD such as this involves several risks and side effects. Most people do not become pregnant with this device; less than 1% of those who use it correctly experience pregnancy within a year.
If pregnancy occurs, there’s a greater chance it may develop outside the uterus, known as an ectopic pregnancy, which usually affects the fallopian tube and can be dangerous. This IUD releases levonorgestrel, a type of progestin hormone. Some people experience common side effects such as:
- Headaches
- Acne
- Breast tenderness
- Changes to vaginal bleeding patterns
- Mood changes
- Cramping or pelvic pain
These symptoms often lessen after the first three months. Irregular bleeding is usually temporary, but may continue in some cases.
Rare but serious complications can occur. Inserting the device very rarely causes uterine perforation—when it creates a small tear in the wall of the uterus. The chance of this happening increases if insertion occurs soon after childbirth.
| Complication | Possible Risk Factors |
|---|---|
| Uterine perforation | Insertion soon after giving birth |
| IUD falling out | Young age, not having children, heavy periods |
| Pelvic infection | STIs, recent childbirth, infection risk |
| Ectopic pregnancy | Device failure (very rare) |
Serious side effects may also include high blood pressure, severe migraines, and increased risk for certain cancers such as endometrial or cervical cancer. People with liver disease, breast cancer, or unexplained vaginal bleeding should discuss these risks with their provider.
This IUD does not contain estrogen or protect against sexually transmitted infections. Report symptoms like severe pain, unusual bleeding, or signs of infection to a medical professional.
Getting Ready
Before placing the IUD, a healthcare provider reviews the patient’s health and typically performs a pelvic exam. Screening for sexually transmitted infections may also be part of the visit.
Preparation Steps
- The provider may perform a pregnancy test if needed.
- The IUD can be inserted during menstruation, right after a pregnancy ends, or after childbirth.
- If placed more than seven days after a period starts, additional birth control is needed for one week.
Tip: Taking ibuprofen or a similar pain reliever 1–2 hours before the appointment may help with cramping during the procedure.
Breastfeeding women can ask about timing and possible effects on cervical mucus and ovulation.
What You Can Expect
A healthcare provider usually inserts the IUD in a clinic. The patient lies down, and a speculum is used to open the vagina. The provider cleans the cervix and vagina with an antiseptic solution. They check the size and depth of the uterine cavity and may use tools to steady the cervix.
The IUD’s arms are folded and loaded into an applicator tube, which is gently inserted through the cervical canal. Once in place, the device is released, and the applicator is removed. Strings are trimmed so they stay inside the vagina but are not too long.
Patients may be asked to check for these strings regularly. Insertion may cause mild to moderate cramps, brief dizziness, or a slow heart rate. Some may feel faint, but these symptoms usually pass quickly.
What Happens Right After Insertion
A follow-up exam is often scheduled about a month later to confirm placement and check for signs of infection or displacement. Patients may be advised to feel for the IUD strings each month.
Menstrual changes such as irregular bleeding, lighter periods, or even missed cycles are common in the early months of use. Call a healthcare provider if any of the following occur:
| Symptoms to Watch For |
|---|
| New or sudden heavy bleeding |
| Persistent pelvic or sexual pain |
| Fever or unusual vaginal discharge |
| Headaches that are severe |
| Yellowing skin or eyes |
| Trouble finding the IUD strings |
| Feeling the IUD itself, not just strings |
| Belief that the IUD has moved |
Though rare, infections and device displacement can occur. Contact a healthcare provider if you have any concerning symptoms.
Taking Out the Device
This IUD can stay in the uterus for up to eight years but can be removed earlier if needed. A healthcare provider removes it in a clinic. Using gloved fingers or a tool, the provider gently pulls the strings, and the device’s arms fold as it slides out.
You may feel mild cramping or light bleeding during and after removal. Difficult removals are rare, but can happen if the device is not easy to reach. If desired, a new device can usually be inserted during the same visit.
