Australians can choose between two kinds of intrauterine device, copper and hormonal, and the Better Health Channel points out a practical difference: the hormonal IUD prescription is covered by the Pharmaceutical Benefits Scheme, while the copper IUD is not. Both are more than 99% effective at preventing pregnancy.
Whether an IUD is right for you depends on your health, your periods and your plans. Below are the types, benefits, risks and what to expect, drawn from Australian health sources.
Quick answer: An IUD may suit you if you want highly effective contraception that lasts for years and can be taken out whenever you choose. Copper IUDs last 5 to 10 years and hormonal ones up to 8 years, depending on the device. A current pelvic infection or an unusually shaped uterus can rule one out.
What is an IUD, and how does each type work?
An IUD is a small device placed inside your uterus to prevent pregnancy, and it is one of the long-acting reversible contraceptives. According to healthdirect, the two types work differently:
- Hormonal IUD: made of plastic and releases the progestogen levonorgestrel, which thickens cervical mucus, makes it harder for sperm to reach an egg, thins the uterine lining and may stop ovulation in some people.
- Copper IUD: made of copper and plastic with no hormones; it makes it harder for sperm to fertilise an egg and changes the lining so a fertilised egg cannot implant.
What are the benefits of an IUD?
An IUD is very effective, lasts for years and is easy to reverse. Fewer than 1 in 100 people using one become pregnant, says healthdirect, and your cycle and fertility return quickly after removal. Other benefits:
- A copper IUD can act as emergency contraception if inserted within 5 days of unprotected sex.
- After the first few months, most hormonal IUD users have no bleeding at all or a light regular period, says the Better Health Channel.
- RANZCOG's 2024 contraception guideline notes that the 52 mg hormonal IUD has potential extra benefits, including managing heavy menstrual bleeding and period pain.
What are the risks and side effects of an IUD?
Side effects are usually manageable and serious complications are rare. The Better Health Channel estimates that in about 1 in 500 people, a small hole is made in the wall of the uterus during insertion, and that around 1 in 300 get an infection when the IUD is first inserted, which can be treated with antibiotics. An IUD can also come out, most often in the first 3 months.
healthdirect lists possible hormonal IUD side effects such as ovarian cysts, headaches, mood changes, breast tenderness, acne and irregular bleeding or spotting. Copper IUDs can make periods heavier and longer and can cause spotting.
Who shouldn't have an IUD?
An IUD isn't for everyone, so talk to your doctor or a family planning clinic first. The Better Health Channel says an IUD may not suit people with a uterus that isn't the usual shape or a current pelvic infection. A hormonal IUD may not suit those treated for breast cancer or with severe liver disease, and a copper IUD may not suit those with heavy periods, low iron levels or endometriosis.
What should I expect when my IUD is inserted?
Insertion is similar to a cervical screening test: you lie on your back and a speculum is placed in your vagina. healthdirect says local anaesthetic can reduce the discomfort, and you may have cramps and bleeding for a few days. For a couple of days afterwards, avoid tampons, menstrual cups, sex, baths and swimming. You will be shown how to check the string, which healthdirect suggests doing about once a month.
Planning to use a period cup? Read our article on using a menstrual cup with an IUD first.
When to see a doctor
healthdirect suggests seeing your doctor if you're worried about side effects or if cramps and bleeding last more than a few days. See a doctor straight away for:
- unusual vaginal discharge;
- lower tummy pain;
- pain during sex.
The Better Health Channel adds that if you become pregnant with an IUD in place, you should see a doctor or nurse as soon as possible.
Frequently asked questions
Does IUD insertion hurt?
It can cause pain or discomfort, healthdirect says, and local anaesthetic can help reduce it. Afterwards, cramps and some bleeding for a few days are common. If they last longer than that, see your doctor. Ask the doctor or nurse inserting the IUD what pain relief options they offer before your appointment.
How quickly does fertility return after IUD removal?
Quickly. The Better Health Channel says your chance of getting pregnant goes back to normal as soon as a copper or hormonal IUD is taken out. healthdirect describes removal as quick: a doctor or nurse gently pulls the string, and the IUD's arms fold so it slips out. A new one can go in at the same visit.
Can I get an IUD after having a baby?
Yes. The Better Health Channel says an IUD can be inserted within 2 days after giving birth. If it isn't inserted straight after the birth, you need to wait at least 4 weeks. RANZCOG notes that expulsion rates are higher when an IUD is inserted within 48 hours of childbirth than at 4 to 8 weeks.
Rethinking your period products along with your contraception? The Lunette period cup is made of 100% medical-grade silicone and lasts up to 10 years with proper care. If a copper IUD brings heavier periods, Size 2 is the one Lunette recommends for a heavier flow; compare both in the period cup size guide.
This article is general information, not medical advice. For advice about your own contraception, see your GP, a nurse or a family planning clinic.
