This interactive tool can be used to review relevant research and practice tips with residents and other learners who will be counseling patients on contraceptive options. PDF versions also available for download in English and Spanish. For general information on Long-Acting Contraception, see RHEDI’s Long-Acting Contraceptive Information sheet.

Copper IUD
Progestin IUD
Progestin Implant
Brand names
Paragard®
Mirena®, Kyleena®, Skyla®, Liletta®, and others
Nexplanon®
How do I start using it?
After putting a speculum in your vagina, a health care provider inserts the IUD into your uterus. Many providers give medicine like ibuprofen first.
After putting a speculum in your vagina, a health care provider inserts the IUD into your uterus. Many providers give medicine like ibuprofen first.
After numbing your skin with a topical medicine, a health care provider inserts the implant under the skin of your upper arm.
When does my contraceptive start working?

The copper IUD starts working right awayCDC US SPR recommends “No additional contraceptive protection is needed after Cu-IUD insertion.” See: US Selected Practice Recommendations (US SPR) for Contraceptive Use, 2016.

The progestin IUD starts working 7 days after it is inserted.
The implant starts working 7 days after it is inserted.
How longThe ranges used here represent the FDA-approved duration to the evidence-based duration. can I use it?

Paragard® works for 10–12The Paragard® is labeled for 10 years of use, but evidence supports continued effectiveness up to 12 years. See: Wu J and Pickle S. Extended use of the intrauterine device: a literature review and recommendations for clinical practice. Contraception, Vol. 89, Issue 6, 495-503. years. Your health care provider can remove your IUD at any time. You may also be able to remove it yourself.See: Greene D et al. Interest in and experience with IUD self-removal. Contraception, Vol. 90, Issue 1, 54–59.

Mirena® works for 6–7 years,Mirena® is FDA labeled for 6 years of use but evidence supports continued effectiveness up to 7 years. (Note that these studies were done largely with women over the age of 25 at the time of insertion.) See: Rowe P et al. Safety and efficacy in parous women of a 52-mg levonorgestrel-medicated intrauterine device: a 7-year randomized comparative study with the TCu380A. Contraception, Vol. 93, Issue 6, 498-506. Seeber B et al. Quantitative levonorgestrel plasma level measurements in patients with regular and prolonged use of the levonorgestrel-releasing intrauterine system. Contraception, Vol. 86, Issue 4, 345-349. McNicholas C. et al. Prolonged use of the etonogestrel implant and levonorgestrel intrauterine device: 2 years beyond Food and Drug Administration-approved duration. Am J Obstet Gynecol. 2017;216(6):586.e1-586.e6. Mirena package insert Kyleena® works for 5 years, Liletta® works for 5-6 yearsLiletta® is currently FDA approved for 5 years, with evidence for effectiveness through 6 years and plans to study effectiveness up to 7 years. See: Westhoff CL et al. Six-year contraceptive efficacy and continued safety of a levonorgestrel 52 mg intrauterine system. Contraception, article in press. See: Creinin M et al. Levonorgestrel release rates over 5 years with the Liletta® 52-mg intrauterine system. Contraception, Vol. 94, Issue 4, 353-356., and Skyla® works for 3 years. Your health care provider can remove your IUD at any time. You may also be able to remove it yourself.

The implant works for 3–5 years.Nexplanon® is labeled for 3 years of use but evidence supports continued effectiveness for up to 5 years. See: Ali M et al. Extended use up to 5 years of the etonogestrel-releasing subdermal contraceptive implant: comparison to levonorgestrel-releasing subdermal implant. Human Reproduction, Vol. 31, Issue 11, 21 November 2016, 2491–2498. Your health care provider can remove your implant at any time.

Does it contain hormones?
No.
Yes. There is a low dose of progestin but no estrogen.
Yes. There is a low dose of progestin but no estrogen.

Side effects*

*These may be bothersome but are not unsafe

There may be cramping during or immediately after the procedure, heavier or longer periods, or stronger cramps with your period.
There may be cramping during or immediately after the procedure, spotting, lighter periods, or no periods after a few months.
There may be changes to your period (lighter or heavier) or spotting. Less commonly, there may be bloating, nausea, headaches, or breast pain.
Benefits
Can be used as emergency contraception: Prevents pregnancy when inserted up to 5 days after unprotected sex.
Can decrease heavy periods, cramps, PMS.
Does not require a vaginal exam. Mostly invisible to others, although it can be felt under the skin.