An intrauterine device (IUD) is a highly effective, long lasting form of birth control. However, it can cause you to experience a heavier-than-typical period.

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IUDs are generally safe to use, but like other forms of birth control, you may experience some unwanted side effects.

Keep reading to learn more about how an IUD can cause heavy periods, what other side effects may occur, and more.

An IUD is a T-shaped device that a doctor inserts into your uterus via your vagina. There are two types of IUDs:

  • Copper (ParaGard) IUDs: These are plastic devices wrapped in coiled copper. They only need to be replaced every 10 years and have a failure rate of about 0.8%.
  • Hormonal IUDs: These include Mirena, Skyla, Kyleena, and Liletta. They contain the hormone progestin and must be replaced every 3 to 8 years. They have a failure rate of about 0.1-0.4%.

Copper IUDs release a small number of copper ions into the tissue of your uterus, which creates an inflammatory response.

This response makes the environment less welcoming to the egg and sperm. Copper is also toxic to sperm, so if any do reach the egg, they will likely be unable to fertilize successfully.

Hormonal IUDs work similarly, but they use progesterone to prevent fertilization. While they can cause abnormal bleeding for about 3-6 months following implantation, you will likely experience lighter periods after this transition period.

IUDs do not protect against sexually transmitted infections (STIs). You may still want to use condoms with new sexual partners and get regular testing for STIs to help prevent infections.

Learn more about choosing the right IUD.

The cost of an IUD can vary from $0 dollars out of pocket to around $1,000, according to the National Women’s Law Center (NWLC).

If you have health insurance, the Affordable Care Act requires the insurance company to cover the full cost. They cannot charge you copays or other expenses related to birth control as long as you go through an in-network provider.

The NWLC warns, however, that while they need to cover both copper and hormone IUDs, they do not need to cover every type. While you may be able to use any option available with no issues, you may run into an issue if a doctor recommends you use a type your insurance does not cover.

If your insurance does not cover the specific type of IUD you need, or you do not have insurance, a local health clinic may be able to provide a lower-cost option.

You may experience heavy bleeding after IUD insertion or irregular bleeding in the first 3 to 6 months. Other possible side effects can include the following:

  • discomfort during or shortly following placement
  • expulsion of the IUD
  • cramping
  • heavier or longer than typical periods
  • passing blood clots with an IUD

More specific side effects vary depending on the type of IUD.

Copper IUDs often cause heavy bleeding. They can also cause an increase in cramping and backaches during monthly periods in some people. These side effects are not unusual or necessarily a reason for concern.

In a 2018 study, researchers noted that heavy bleeding within the first year following implantation represented a primary cause of discontinuation of the device. They also found in their study that heavy menstrual bleeding before insertion puts a person at a higher risk of discontinuation within a year.

Your period with IUD after 1 year may return to typical levels. But you may continue to experience heavy or irregular bleeding after a year with a copper IUD.

Hormonal IUDs typically have the opposite effect. Periods often become lighter and less painful or may go away entirely.

A heavy period, also called menorrhagia, may have other causes. If your heavy bleeding started shortly after the insertion of your IUD, ask your doctor about possible complications, especially if it’s copper.

You may also want to consider the following medical reasons for your bleeding:

Hormone Imbalances

Hormone imbalances in the amount of estrogen and progesterone in the body can occur. When these two hormones are not balanced, it can affect the uterine lining, making it thicker. When your period comes, this thick lining sheds and results in a heavy period.

Anovulation can also result from a hormone imbalance. Anovulation happens when your body doesn’t release an egg. This can result in very low progesterone levels. Over time, this can lead to a thickened uterine lining and heavy menstrual bleeding. Left untreated, it can lead to fertility issues.

Tumors or Growths

Fibroids are mostly benign tumors that can form in the walls of your uterus. They are most common in people between the ages of 30 and 40, and they can cause heavy bleeding and other symptoms.

Polyps are smaller noncancerous growths that can form in the uterine lining. They can also cause abnormal or heavy bleeding and indicate high hormone levels.


In some cases, heavy bleeding may signify pelvic inflammatory disease (PID). The risk is highest in the first few weeks following the insertion of the IUD.

This serious infection can lead to infertility, sterility, and chronic pain.

The symptoms of PID include:

  • abdominal pain
  • pain after vaginal intercourse
  • abnormal bleeding or discharge
  • a fever

If you experience any of these symptoms and have had your IUD placed recently, contact a doctor immediately. Other common causes include STI infections, such as gonorrhea, or using vaginal douches.

Other Causes

Adenomyosisis more common in people in their 30s and 40s and those who have given birth. Tissue from the endometrium can end up in the uterus muscle and cause pain and excess bleeding.

Pregnancy may cause bleeding that may be mistaken for a late period. If you suspect you may be pregnant, see your doctor. Heavy bleeding can also be a symptom of miscarriage or ectopic pregnancy.

Cancer or bleeding disorders can cause abnormal or heavy periods.

Certain medications and other medical conditions may cause excessive bleeding as well. You should consider speaking with a doctor if you are taking anything to prevent blood clotting. You should also mention if you have or suspect you may have:

  • PID
  • thyroid issues
  • endometriosis
  • liver disease
  • kidney disease

Certain risk factors may increase your chances of excessive menstrual bleeding. Since they may make menstrual symptoms worse, a doctor may not recommend copper IUDs for people with the following conditions:

  • heavy or irregular menstrual bleeding
  • severe cramps
  • anemia
  • heart valve disorders
  • a copper allergy
  • blood clotting issues

Both hormonal and copper IUDs are not recommended for anyone with the following:

  • a medical history of pelvic inflammatory disease
  • an abnormal Pap smear
  • an abnormal cervix, uterus, fallopian tubes, or ovaries
  • medical conditions, such as leukemia or AIDS
  • a history of substance misuse

People who experience pain or heavy bleeding have a higher chance of wanting early removal of the IUD.

IUD expulsion is another possible risk. If your device moves out of place, you may experience extreme pain, feel plastic sticking out of your cervix, or notice that your strings feel different.

If you experience any of these symptoms, contact a doctor or healthcare professional as soon as possible to have your device repositioned or replaced. If your device has shifted, you may not be protected against accidental pregnancy.

If you have a copper IUD and are experiencing heavy bleeding more than a few months after placement, you may want to mention it to a doctor. You may want to speak with a doctor sooner if it is interfering with daily activities or if you have other concerns.

Menorrhagia is a well-known side effect of nonhormonal IUDs. Treating the bleeding may require the removal of the device from your uterus and choosing another birth control method.

If left untreated, excessive bleeding can lead to complications like iron-deficiency anemia. With this condition, your blood has trouble carrying oxygen to the different tissues in your body.

Mild symptoms include fatigue and overall feelings of weakness.

Moderate to severe symptoms of anemia include:

  • shortness of breath
  • an elevated heart rate
  • headaches
  • lightheadedness

If you are not currently using an IUD and experiencing heavy bleeding, you may try a hormonal IUD to avoid these symptoms. Over time, many women experience significantly lighter to non-existent periods.

You may experience heavier than typical bleeding for the first several months following IUD placement. When using a hormonal IUD, you will likely notice significantly lighter periods after the adjustment period. A copper IUD may cause bleeding or clotting for several months to a year.

Removal typically clears up the issue if there’s no other underlying medical cause.

IUDs don’t protect against STDs. Use a backup method, such as condoms, if you have several sexual problems or do not know the sexual history of your partner.