Intrauterine devices (IUDs) are an extremely effective method of birth control. An IUD is a small, T-shaped device that’s placed in your uterus. It must be prescribed by a doctor, who will place it in your uterus during an outpatient procedure.

Five brands of IUDs approved by the Food and Drug Administration (FDA) are available today. Mirena, Skyla, Liletta, and Kyleena release hormones to prevent pregnancy. Paragard contains copper and doesn’t release hormones.

Which one could be right for you? Let’s compare Mirena, Skyla, Liletta, Kyleena, and Paragard to explore how these IUDs are similar and different.

Learn about what it feels like to have an IUD.

IUDs are long-term birth control. They can stay implanted in your uterus for several years. However, they can be easily removed if you want to become pregnant.

IUDs are made of a plastic called polyethylene. They’re T-shaped, with a string attached to the bottom of the T. The string makes it easier for a doctor to remove the IUD. The string also helps you know that it’s still in place when you check it each month.

An IUD is a form of birth control. It’s about the size of a quarter and is inserted into the uterus, where it stays for several years to prevent pregnancy. There are hormonal and nonhormonal options available.

Inserting an IUD is done by a doctor, and the process only takes a few minutes. The procedure can be painful or uncomfortable. Side effects may include cramping, backaches, dizziness, and discomfort. Some people experience these side effects for a couple of days after insertion, while others experience them for weeks or months.

The IUD can be removed quickly by a doctor if you want to become pregnant or if it expires and needs to be replaced.

Most IUDs start working immediately after insertion, though some take around 7 days to become effective.

You can still have sex and use tampons with an IUD. You may also continue to menstruate, though some people experience a lighter or heavier flow. Some people experience no period at all with an IUD.

There are five options to choose from: Mirena, Skyla, Liletta, Kyleena, and Paragard. They can be divided into two main types: hormonal and copper (nonhormonal).

Hormonal IUDs

Hormonal IUDs work by releasing the hormone progestin. This prevents pregnancy in two ways:

  1. The mucus in the cervix thickens, which prevents sperm from reaching and fertilizing an egg.
  2. The lining of the uterus becomes thinner, which partially suppresses ovulation.

Hormonal IUDs don’t last as long as nonhormonal options. The time varies, but a hormonal IUD can last for up to 7 years.

The primary function of a hormonal IUD is contraception, but they have noncontraceptive benefits, such as reducing menstrual pain and menstrual frequency. Hormonal IUDs are often prescribed for those who experience endometriosis, severe menstrual pain or bleeding, anemia, and other conditions. A hormonal IUD may also reduce the risk of endometrial cancer.

There are four hormonal IUDs: Mirena, Skyla, Liletta, and Kyleena. Their main differences include size, duration, and amount of hormones released. It may take up to 7 days for hormonal IUDs to become effective depending on the time they’re inserted in relation to your menstrual cycle.

Mirena and Skyla slowly release hormones into your body each day. These hormones can have three different effects to help prevent pregnancy:

  1. They may make you ovulate less often.
  2. They thicken cervical mucus, which makes it harder for sperm to pass into your uterus.
  3. They help prevent sperm from binding to an egg and attaching in your uterus.

Skyla releases the progestin hormone levonorgestrel (LNG). It should be replaced after 3 years.

Mirena also releases LNG. It should be replaced every 7 years.

Liletta and Kyleena are two other IUDs that slowly release low doses of LNG into your body. They last for 6 and 5 years, respectively. Liletta and Kyleena are the newest IUDs, so they haven’t been included in as many studies as the other IUDs. Liletta was approved by the FDA in February 2015, while Kyleena was approved in September 2016.

Copper (nonhormonal) IUDs

A copper IUD has copper wrapped around the plastic device, hence the name. There’s currently only one nonhormonal IUD option available: Paraguard.

Unlike the other options, Paragard doesn’t work by releasing hormones. Instead, it has copper coiled around the vertical stem of the T-shape and around each side of the horizontal arm.

The copper produces an inflammatory reaction within your uterus. It creates a harmful environment for sperm. This environment helps prevent the sperm from fertilizing an egg and may prevent an egg from attaching in your uterus.

Paragard IUDs can last for up to 10 years, but they can be removed at any time.

Copper IUDs are effective immediately after insertion. They can also be used as a form of emergency contraception after having unprotected sex if inserted with 5 days.

Nonhormonal IUDs are a great option for those who prefer hormone-free contraception. They’re also considered more effective than hormonal IUDs.

Skyla

Mirena

Paragard

Liletta

Kyleena

Size

28 mm x 30 mm

32 mm x 32 mm

32 mm x 36 mm

32 mm x 32 mm

28 mm x 30 mm

Type

progestin hormone

progestin hormone

copper

progestin hormone

progestin hormone

Effective for up to

3 years

7 years

10 years

6 years

5 years

Notable side effect

may cause changes in your period

may cause changes in your period

may cause bleeding and discomfort

may cause painful or irregular periods

may cause irregular periods and bleeding

Of the different forms of contraception, an IUD is among the least common. The Centers for Disease Control and Prevention (CDC) estimates that 10.4 percent of women ages 15 through 49 rely on IUDs or implants, compared with 14 percent who use the pill and 18.1 percent who rely on female sterilization.

However, the IUD has its perks that can’t be overlooked.

The IUD is highly effective. It’s more than 99 percent effective. While it’s still possible to become pregnant with an IUD, the chances are less likely than other forms of birth control.

It also lasts for several years. Aside from sterilization and male condoms, oral contraception is the most popular option among women. However, the pill must be taken daily. An IUD is a one-time procedure that lasts for up to 10 years, depending on the type.

Hormonal IUDs have benefits related to female reproductive health aside from contraception. They’re often prescribed to women with endometriosis, chronic pelvic pain, and heavy periods.

Many women also opt for hormonal IUDs since they may lessen period pain, reduce period frequency, or get rid of your period altogether.

Once you’ve decided to use an IUD as your primary form of birth control, you have five options to choose from: Mirena, Skyla, Liletta, Kyleena, and Paragard.

Deciding whether you want a hormonal or nonhormonal IUD can help you narrow down your choices. There are benefits and risks of both. If you decide to go the hormone-free route, your choice is simple, as there’s only one option: Paragard. If you prefer hormonal IUDs, your choices include Mirena, Skyla, Liletta, and Kyleena.

The duration of effectiveness is a point of consideration for many. Copper IUDs last the longest. Paragard can last for up to 10 years before needing to be replaced or removed, while hormonal IUDs last between 3 and 6 years. Of the hormonal options, Skyla lasts the shortest (3 years) and Mirena lasts the longest (7 years). Liletta lasts for 6 years and Kyleena lasts for 5 years.

There may be a cost associated with getting an IUD. There are ways to get free or low cost IUDs, but the procedure and office visit may increase those costs. Without insurance, IUDs cost between $500 and $1,300 out of pocket. Liletta is the least expensive and Paragard is the most expensive, though the price differences aren’t significant.

Copper IUDs can be used as emergency contraception, but hormonal IUDs can’t. If you have unprotected sex, you can choose to use the Paragard IUD as a form of emergency contraception if it’s inserted with 5 days.

Mirena, Skyla, Liletta, and Kyleena have similar side effects. You may have changes in your period, such as increased menstrual bleeding, discomfort, or no period at all. You may also have:

With Paragard, you may have an allergic reaction to the copper. Other side effects include:

All five devices can also fall out or shift position. This can increase your risk of pregnancy. They could also tear your uterus. In addition, all five can cause pelvic inflammatory disease (PID), but this is rare. If you have multiple sexual partners, this method of pregnancy prevention may not be your best choice.

Learn 11 tips to conquer your IUD side effects.

Results from a 2015 study have shown that these three IUDs have similar effectiveness. Both the copper and hormonal IUDs are more effective at preventing pregnancies than other forms of birth control, besides sterilization.

Overall, IUDs are more than 99 percent effective at preventing pregnancy. This means that fewer than 1 in 100 women who use an IUD gets pregnant each year.

If you do get pregnant while using an IUD, there’s a slight risk you could experience an ectopic pregnancy. However, the risk of ectopic pregnancy when not using an IUD is higher.

There’s also a small risk that the IUD may shift position or fall out. This can increase the risk of unwanted pregnancy. Learn what to do if your IUD falls out.

Certain health conditions can cause issues if you use a hormonal IUD or copper IUD. Don’t use any IUD if you have liver disease or if you have or have had the following conditions:

Both hormonal and copper IUDs are effective methods of birth control. The key differences between Mirena, Skyla, Liletta, Kyleena, and Paragard are what they’re made of, how they work, how long they last, and possible side effects.

For instance, Mirena, Skyla, Liletta, and Kyleena release hormones into your body. If you prefer to avoid hormones, you might choose Paragard.

However, the hormones in Mirena, Skyla, Liletta, and Kyleena are only released in one part of your body. They don’t have the same kind of broad effect as the hormones in birth control pills, which are delivered through your bloodstream.

On the other hand, if you already have heavy bleeding and cramping during your period, you may not want to use Paragard, which could worsen your bleeding.

To find out more about IUDs, talk with a doctor. They can give you more information about these devices and point you toward an IUD that may work well for you. Be sure to ask a doctor any questions you might have, such as:

  • Are there any benefits to the hormonal IUDs Liletta or Kyleena versus Mirena or Skyla?
  • Is there any reason why I should avoid using an IUD that has hormones?
  • What other long-term birth control options would you suggest for me?

It’s important to remember that IUDs don’t protect against sexually transmitted infections (STIs). Also, because they’re foreign objects, they can increase the risk of an infection. Barrier methods such as condoms can reduce the risk of STIs and prevent an unwanted pregnancy.