Key Facts about Hormonal IUDs

There are two main types of IUDs – hormonal and non-hormonal. This page provides information on the hormonal IUD. For information on non-hormonal IUDs, click here.

The hormonal IUD is a small, T-shaped plastic device which contains the hormone progestogen. It is put into the uterus (womb).  There are two funded hormonal IUDs in New Zealand, Mirena and Jaydess.

• It is a Fit & Forget contraception – Jaydess lasts up to 3 years and Mirena lasts up to 5 years.
• It is small – Jaydess is only 3cm long, 2.8cm wide and Mirena is only 3.2cm long, 3.2cm wide.
• It is suitable for most women, including those who are young and those who have not had children.
• Works immediately once fitted.
• The hormonal IUD has a very small amount of hormones and most people have no side effects from this.
• It does not protect you from STIs.

How it works

The hormonal IUD is placed in the uterus. It works in three ways to prevent the egg being fertilised by sperm. 

Pros & cons

• Hormonal IUDs are at least 99% effective. Only 1 in 100 people will get pregnant each year.
• Your periods may be lighter, shorter, or they may stop completely.
• It may cause irregular bleeding at first.
• It protects you from pregnancy immediately.
• It is reversible – you can get it taken out when you like.
• Once your hormonal IUD is removed, you can get pregnant right away. This is because hormonal IUDs don’t completely stop ovulation.
• It does not protect you from STIs.
• You will need to see a nurse, midwife or doctor to have the hormonal IUD fitted.

Where to get it

The hormonal IUD needs to be fitted by a doctor, midwife or nurse who has been specially trained. Your nurse, midwife or doctor will provide more information on Jaydess and Mirena for you to decide which one is right for you. It is available FREE* from a range of services. Click here to find your nearest service.

*See Terms & Conditions.

The hormonal IUD contains a progestogen called levonorgestrel that it releases slowly into the womb.

The hormonal IUD works in three ways to prevent the egg being fertilised by sperm. A hormonal IUD interrupts this process by:

• It prevents fertilisation of the egg by damaging or killing the sperm.
• It also affects the lining of the uterus, making it unsuitable for a fertilised egg to implant and grow.
• It partially stops ovulation (when ovaries release an egg), although most women continue to ovulate.
• It can stay in place and prevent pregnancy for between 3 and 5 years, depending on the type, or until you have it taken out.

An IUD can be put in at any time you choose. The IUD is fitted in the uterus by a trained nurse, midwife or doctor.

Many women wonder where the IUD is fitted in their body. This image from Bedsider.org show the position of an IUD in the uterus. You will notice from the image that the strings from the IUD will not be visible.

Pros

There are loads of things about hormonal IUDs that are good for your body as well as your sex life.

• You can really Fit & Forget it! No more worrying about missing a pill, injection, etc. 
• It does not interrupt sex.
• Hormonal IUDs are at least 99% effective. Only 1 in 100 people will get pregnant each year.
• Once you have had it fitted, it prevents pregnancy for between 3 and 5 years.
• It protects you from pregnancy immediately.
• It is reversible – you can get it taken out when you like.
• Your fertility will return to normal after the hormonal IUD has been removed. This is because hormonal IUDs don’t completely stop ovulation.
• Your periods may be lighter, shorter, or they may stop completely.
• There is no evidence that the hormonal IUD causes additional weight gain.
• It can be taken by some women who cannot use contraception that contains oestrogen, such as the combined pill, contraceptive patch and the contraceptive vaginal ring.
• The IUD is not affected by vomiting, diarrhoea or other medicines like other methods of contraception.
• The hormonal IUD does not affect breastfeeding and can be fitted after the birth of your child.

Cons

Everyone worries about negative side effects, but for many people, they’re not a problem. Most people adjust to having a hormonal IUD pretty quickly, but give yourself time. It could take a few months.

• Does not protect against sexually transmitted infections (STIs).
• It may cause irregular bleeding at first.
• It can cause temporary side effects such as skin problems, headaches or breast tenderness.
• It can cause small fluid-filled cysts on your ovaries – these usually disappear without treatment and often there are no symptoms.
• There is a small risk of getting an infection after the IUD is inserted.
• There is a small risk of the IUD becoming pushed out or the IUD becoming displaced.
• There is a very small risk of perforation of the uterus.
• If you do become pregnant while you are using the IUD there is a small risk of ectopic pregnancy. 
• You will need to see a nurse, midwife or doctor to have the hormonal IUD fitted.

Where to get the hormonal IUD?

A hormonal IUD needs to be fitted by a nurse, midwife or doctor who has been specially trained. It is available FREE* from a range of services.

Who can get a hormonal IUD?

Most people can use an IUD, including those who are young and those who have not had children. Your nurse, midwife or doctor will advise you of the best option for you to choose. 

What happens at an appointment?

An appointment will typically include:

• A few questions about your medical and family history, to work out what method would suit you best.
• Before the IUD is fitted, you will need to have a vaginal examination. The doctor, midwife or nurse will pass a small instrument into your womb (uterus) to check its size and position.
• They will also check for any signs of infection, sometimes you may also be given antibiotics.
• Some services may be able to fit it at the same appointment, or you may need a second appointment.

Fitting the IUD (shouldn’t take longer than 5 minutes):

• You’ll be asked to lay on the bed.
• Remove the lower half of your clothing (e.g. trousers/skirt and underwear).
• Open your legs and bend your knees so the nurse, midwife or doctor can use a speculum to slightly widen your vagina to help insert the IUD into your uterus.
• The IUD is fitted using a small plastic insertion device. The arms on the IUD are flexible and fold inside the insertion device.
• The nurse, midwife or doctor may discuss painkiller tablets/using local anaesthetic to make the fitting more comfortable.

What happens after the hormonal IUD is fitted?

You may get some period-type pain and possibly some light bleeding for a few days afterwards.

The IUD has two threads which hang through the opening at the entrance of your uterus (cervix). You should check the threads a few times during the first month and then at least once a month.

Once the IUD is fitted, you will need to go back to the doctor, midwife or nurse after three to six weeks for a check up.

It is very unlikely that the IUD will come out but if you are worried and can feel the IUD itself, or cannot feel the threads you should see a nurse or doctor straight away.

You will then only need to go back when the IUD needs to be replaced (3 to 5 years depending on the type).

You should go back to the nurse, midwife or doctor if you notice any of the below symptoms:

• Severe or prolonged stomach pains, especially if you feel unwell, hot and clammy
• Heavy vaginal bleeding with or without clots.

When can I have the hormonal IUD fitted and when will I be protected?

The hormonal IUD can be fitted at any time in your cycle if it is certain that you are not pregnant. 

As soon as the hormonal IUD is fitted then you will be protected immediately. You will be asked to take a pregnancy test before the IUD is fitted and another three weeks later if there is a pregnancy risk.

How is the hormonal IUD removed? Can I remove it myself?

The hormonal IUD must be removed by a trained nurse, midwife or doctor, the procedure should be less painful and quicker than having the IUD fitted. Your nurse or doctor can take out your IUD by putting a speculum into your vagina and gently pulling on the IUD strings.

If you are not going to have another IUD you will need to use additional contraception, such as condoms, for the seven days before the IUD is taken out if you do not want to become pregnant.

Your fertility should return to normal as soon as the hormonal IUD is removed.

Can I use tampons with a hormonal IUD?

While using the IUD you can use tampons and/or towels.

Can I feel or can my partner feel my hormonal IUD?

No neither you or your partner should feel your IUD. An IUD is positioned in the uterus. You will be able to feel the strings in your vagina and your partner may notice the strings during sex.  The strings of the IUD usually get softer over time, but if they’re really a problem, talk to your doctor, midwife or nurse about adjusting them or cutting them shorter.