Copper and hormonal intrauterine contraception
An intrauterine device is placed inside the womb for contraception. Copper and hormonal options differ in their effects on bleeding, duration and suitability. Choice should reflect your history and preferences, rather than a product name alone.
Copper and hormonal options
A copper device contains no hormones and can make periods heavier or more crampy. A hormonal intrauterine system releases a progestogen and may reduce bleeding over time, although irregular spotting can occur initially.
Both are highly effective, but duration depends on the product. Keep a written record of its name, insertion date and replacement date.
Assessing suitability
Not having given birth is not, by itself, a reason to exclude an intrauterine method. Assessment considers pregnancy, unexplained bleeding, current pelvic infection and conditions affecting the uterine cavity. Tests are selected from the history and examination.
Mention heavy or painful periods, breast disease and current medicines. Breastfeeding and the time since childbirth can also influence insertion planning.
Insertion and pain relief
A speculum provides access to the cervix and the device is placed after appropriate assessment of the cavity. Cramping and pain can occur; a pain-free experience cannot be promised. Discuss pain relief, possible local anaesthesia and the option to stop beforehand.
Excluding pregnancy and the start of contraceptive protection depend on the method and cycle timing. Ask specifically whether additional contraception is needed.
Side effects and when to seek help
A device can be expelled, move or rarely perforate the uterine wall. Infection symptoms, new or worsening pain and unusual bleeding need assessment. If threads cannot be felt, do not try to reposition the device yourself; ask about checking it and additional protection.
Pregnancy is uncommon with an intrauterine method, but if it occurs an ectopic pregnancy must be considered. Severe one-sided pain, faintness or pain with a positive pregnancy test needs prompt assessment.
Removal, replacement and other uses
Removal is performed by a trained healthcare professional and fertility can return promptly. Mention recent unprotected sex before removal; considering only the days after removal can overlook pregnancy risk.
Certain hormonal systems are also used for heavy periods or protection of the uterine lining during menopausal hormone therapy. Their replacement schedule for those purposes should not be assumed to match contraceptive duration. Intrauterine methods do not protect against sexually transmitted infections.
Frequently asked questions
Will a hormonal system stop periods?
Bleeding may become lighter or stop, but responses differ. Irregular bleeding can occur in the early months.
Can I use one if I have not given birth?
That alone does not exclude use; individual suitability needs assessment.
How many years does it last?
Different copper and hormonal products have different durations. Confirm the replacement date for your particular device.
What if I cannot feel the threads?
Arrange assessment and ask about additional contraception and pregnancy risk. Do not pull or push the device yourself.
Can I conceive after removal?
Yes. Fertility can return promptly, so discuss pregnancy planning or replacement contraception in advance.
Does it protect against infections?
No. Prevention of sexually transmitted infections requires separate consideration.
Sources and updates
Sources checked: 19 October 2026. Screening and service arrangements can differ between countries; your individual plan follows clinical assessment.