The IUD currently appeals to 17% of French women, but many are still hesitant due to a lack of clear information. Copper or hormonal IUD? Mirena, Kyleena, or Mona Lisa? Does insertion really hurt? Can you get pregnant with an IUD? Between persistent preconceived ideas ("it's reserved for women who have already had children"), contradictory testimonies, and sometimes vague advice, it's difficult to see clearly.
The IUD, or intrauterine device (IUD), is one of the most effective contraceptives available, with a 99% success rate.Whether it's copper-based (hormone-free) or hormonal (Mirena, Kyleena, Jaydess), each type has its own advantages and disadvantages. This article provides a comprehensive overview of everything you need to know before making your choice.
The main thing to remember
- The IUD is effective at 99% and lasts 3 to 10 years according to the models
- 2 large families : Copper IUD (hormone-free) and Hormonal IUD (Mirena, Kyleena, Jaydess)
- The IUD suitable for all women, even those who have never had children (“short” models available)
- The pose lasts 5 to 15 minutes and can be painful (anesthesia options available)
- Copper IUD: heavier periods, no hormones, effective immediately
- Hormonal IUD: decreased or absent periods, effective after 7 days
- Price : €30 (copper) to €120 (hormonal), reimbursed 100% for those under 26
What is an IUD? Definition and Principles
The term "IUD" is actually a misleading and outdated name. This device does not make you sterile at all. This is why healthcare professionals today prefer the terms IUD (Intrauterine Device) or IUS (Intrauterine System).
Technical definition
The IUD is a small, T-shaped plastic device that measures approximately 3 to 3,5 cm in length. It is inserted directly into the uterine cavity by a healthcare professional (gynecologist, midwife, or trained general practitioner).
At the tip of the IUD, two nylon strings, about 1 to 3 cm long, protrude from the cervix and hang into the vagina. These strings help check that the IUD is in place and make it easier to remove when the time comes.
How Does an IUD Work?
The mechanism of action depends on the type of IUD, but both work to prevent fertilization and/or implantation of an embryo.
The 2 Main Families of IUDs: Copper vs. Hormonal
Choosing between a copper IUD and a hormonal IUD is the first important decision to make. Each has radically different characteristics.
The Copper IUD (Non-Hormonal IUD)
This is the “hormone-free” option preferred by women who want natural contraception or who have had a bad experience with hormonal contraception.
✅ Benefits of the copper IUD
- No hormones : no effect on libido, mood or weight
- Immediate effectiveness from the moment of installation
- Natural cycles preserved, ovulation maintained
- Long duration : 5 to 10 years depending on the model
- Emergency contraception : can be placed up to 5 days after unsafe intercourse
- Price : around €30, refunded
❌ Disadvantages of the copper IUD
- Heavier periods : 20 to 50% increase in menstrual flow
- Longer periods : 7 to 9 days instead of 5
- Menstrual pain increased in the first months
- Risk of anemia : 20% of users develop iron deficiency
- SPM sometimes amplified (frequent testimonies, little scientifically studied)
Copper IUD: The Real Dangers to Your Health?
Increased bleeding, cramps, acne, fatigue... What should you watch out for and when should you seek medical help?
Everything you need to know about the effects of the copper IUD →Hormonal IUD (Mirena, Kyleena, Jaydess)
The hormonal IUD releases levonorgestrel (progestin) locally into the uterus. It is a very low-dose hormonal contraceptive, much lower in dosage than a pill.
✅ Benefits of the hormonal IUD
- Decreased or absent periods : 30 to 50% of women no longer have periods after 1 year
- Less pain menstrual
- Treatment of endometriosis and hemorrhagic periods
- Local hormones : very low doses compared to the pill
- Maximum efficiency : 99,8%
❌ Disadvantages of the hormonal IUD
- Possible hormonal effects : acne, decreased libido, weight gain (water retention), mood
- Irregular bleeding the first 3 to 6 months
- Functional ovarian cysts (benign but frequent)
- Effectiveness time : 7 days after installation if installed outside of the rules
- Price : 100 to 120€ depending on the model (reimbursed)
Hormonal IUD: Our Unfiltered Opinion
Lighter, irregular, or absent periods... Weigh the pros and cons of the hormonal IUD
Read the full article on hormonal effects →The Different Brands of IUDs: Comparison
There are several brands of IUDs, each with specific characteristics. The choice depends on your body type, your medical history, and your preferences.
Hormonal IUDs: Mirena, Kyleena, Jaydess
How to choose between Mirena, Kyleena and Jaydess?
- Mirena : The highest dose, recommended if you have very heavy periods or endometriosis. More amenorrhea (absence of periods) than the others
- kyleena : Intermediate dosage, good compromise between effectiveness on periods and limitation of hormonal effects
- Jaydess : The lowest dose, for those who want the minimum of hormones. Shorter duration (3 years)
Copper IUDs: Mona Lisa, UT, Flexi-T
💡 Good to know : The larger the copper surface area (380 mm²), the greater the contraceptive effectiveness. The “Short” or “Mini” models are suitable for nulliparous women or those with a small uterus. taille.
Who is it for? Is the IUD suitable for all women?
Contrary to popular belief, the IUD is not only for women who have already had children. This outdated belief is still very much alive, but it is false.
The Myth of the “IUD for Mothers Only”
The IUD is suitable for all women of childbearing age, whether or not they have had children. Teenage girls can also wear them.
This misconception stems from a time when IUDs were larger and doctors mistakenly believed they increased the risk of pelvic infections and infertility. Current scientific evidence has dispelled these fears.
Today, there are "short" or "mini" models (28 mm instead of 32 mm) specially adapted to the smaller uteri of nulliparous women.
Contraindications of the IUD
Although the IUD is suitable for the majority of women, certain medical conditions constitute contraindications.
Common contraindications (copper AND hormonal)
- Current or suspected pregnancy
- Current genital infection (STI, pelvic infection)
- Unexplained vaginal bleeding
- Significant uterine malformation (bicornate, septate uterus)
- Cervical or endometrial cancer
- Wilson's disease (for copper IUD only, copper metabolism disease)
Specific contraindications to the hormonal IUD
- Current or recent history of breast cancer
- Severe liver disease
- Deep vein thrombosis in progress
- Hypersensitivity to levonorgestrel
Special Situations
- Severe anemia : The copper IUD can worsen anemia due to heavier periods. Prefer the hormonal IUD
- Endometriosis or very painful periods : The hormonal IUD (Mirena) is often recommended as treatment
- Uterine fibroids : Possible depending on the taille and the location of the fibroids. To be discussed with the gynecologist
- feeding : Both types of IUDs can be inserted while breastfeeding (wait 4 to 6 weeks postpartum)
IUD Insertion: Procedure and Pain
Inserting the IUD is the most stressful process. Between those who say "I didn't feel a thing" and those who describe it as "the worst pain of their lives," it's hard to know what to expect.
Procedure for the installation (5 to 15 minutes)
- Gynecological examination : The practitioner checks the position and the taille of your uterus
- Speculum placement : As in a smear test
- Disinfection of the cervix : With an antiseptic solution
- Hysterometry : Measurement of the depth of the uterus with a thin graduated rod (may cause cramps)
- Insertion of the IUD : Through the cervix to the bottom of the uterine cavity (most painful moment for some)
- Cutting the wires : The practitioner cuts the threads 2-3 cm from the cervix
Pain: Reality and Anesthesia Options
Pain perception varies greatly from woman to woman. A 2013 study found that 50% of women experienced severe pain during the procedure, while 2,5% felt nothing at all.
Factors that increase pain
- Nulliparity (never given birth vaginally)
- Young age
- Retroverted uterus
- Narrow neck
- Significant anxiety before installation
Fortunately, there are several options for reducing pain. New medical recommendations (CDC 2024) encourage the use of local anesthesia.
IUD Insertion: What to Expect in Practice?
Duration, pain, possible anesthesia... find out how an IUD insertion really works.
Read the article on IUD insertion →IUD Effectiveness: Can You Get Pregnant?
The IUD is one of the most reliable forms of contraception. But like all contraception, it is not 100% effective.
Actual Failure Rates
The Risk of Ectopic Pregnancy
If a pregnancy occurs despite the IUD (rare), it is more likely to be ectopic than a normal pregnancy. Approximately 15 to 50% of IUD pregnancies are ectopic, compared to 2% in the general population.
⚠️ Warning signs
If you have an IUD and experience these symptoms, seek emergency medical care:
- Late period + positive pregnancy test
- Severe pelvic pain on one side
- Abnormal bleeding + pain
- Malaise, dizziness, fainting
Pregnancy with an IUD: Symptoms, Risks & What to Do?
Even with an IUD, there is a risk of pregnancy. Learn how to identify the symptoms...
Read the article on the risk of pregnancy →Side Effects & Possible Complications
Every medical device has potential side effects. The IUD is no exception, although it remains generally very well tolerated.
Common Side Effects (Mild)
Copper IUD
- Heavier and longer periods (50-55% increase in flow)
- Increased menstrual cramps
- Spotting between periods in the first few months
- Risk of iron deficiency and anemia (20% of users)
Hormonal IUD
- Irregular bleeding and spotting for the first 3-6 months
- Headaches, acne, breast tenderness
- Functional (benign) ovarian cysts
- Moderate weight gain (water retention)
- Possible decrease in libido
Rare but Serious Complications
- Expulsion of the IUD : 8-10% over 3 years, especially the first few months
- Uterine perforation : 1 case in 1000 insertions, generally during installation
- Pelvic infection : Rare, especially the first month after insertion if STI not detected
- Pregnancy : 0,2 to 0,8% depending on the type of IUD
Removal of the IUD
Removing the IUD is much simpler and less painful than inserting it.
When to Remove Your IUD?
- End of validity : 3, 5, 6 or 10 years depending on the model
- Desire for pregnancy : Immediate return of fertility after withdrawal
- Unbearable side effects : No obligation to keep it if you can't stand it
- Change of contraception : You can change your mind at any time
- Menopause : Wait 1 year after your last period if you are over 50 years old
How does the withdrawal work?
Removal takes less than 5 minutes. The practitioner grasps the threads with forceps and gently pulls. Most women experience only mild cramping, if any at all.
IUD: When & How to Remove It?
Pain, duration, feelings after removal, discover the steps and testimonials...
Everything you need to know about removing the IUD →Price and Reimbursement of the IUD
The IUD is one of the most economical contraceptives in the long term.
💰 Free for those under 26
Since 2022, contraception has been free for all women under 26. This free service includes:
- The IUD itself (100% reimbursed)
- The installation consultation
- The withdrawal consultation
Beyond the age of 26, the IUD is reimbursed at 65% by Health Insurance, the remainder being generally covered by mutual insurance.
Frequently Asked Questions About the IUD
The IUD: An Effective and Liberating Contraception
The IUD remains one of the most reliable and cost-effective long-term contraceptives. Whether copper or hormonal, each type has specific advantages depending on your situation, medical history, and personal preferences. The copper IUD appeals to those who want to avoid hormones and maintain natural cycles, despite sometimes heavier periods. The hormonal IUD is particularly suitable for women suffering from painful periods or endometriosis, with the possible bonus of completely eliminating periods.
The insertion process can be a bit apprehensive, but it only takes a few minutes, and anesthesia options are now available. Once in place, the IUD can be forgotten for years. If you're still unsure, don't hesitate to consult a professional to discuss the best model for your situation. And remember: you can always change your mind and have it removed if you can't stand it. Your comfort and well-being come first.
Sources & Scientific References
This article is based on scientific studies published on PubMed and official recommendations.
Efficacy and mechanisms of action
- Rivera R, et al. (2012). The Mechanism of Action of Hormonal Contraceptives and Intrauterine Contraceptive Devices. American Journal of Obstetrics and Gynecology. DOI: 10.1016/S0002-9378(99)70662-4
- Madden T, et al. (2014). Association of age and parity with intrauterine device expulsion. Obstetrics & Gynecology. PMC4172535
Secondary effects and complications
- Goh TH, Hariharan M. (1980). A longitudinal study of serum iron indices and haemoglobin concentration following copper-IUD insertion. Contraception. PMID: 7449387
- Hubacher D, et al. (2009). Side effects from the copper IUD: do they decrease over time? Contraception. PMC2702765
- Rowlands D, et al. (2016). Intrauterine devices and risk of uterine perforation: current perspectives. Open Access Journal of Contraception. PMC5683155
Official recommendations
- Centers for Disease Control and Prevention. (2024). US Selected Practice Recommendations for Contraceptive Use. MMWR. DOI: 10.15585/mmwr.rr7303a1
- American College of Obstetricians and Gynecologists. (2023). Long-Acting Reversible Contraception: Intrauterine Devices. ACOG
- Ameli (Health Insurance). Contraception by IUD or intrauterine device (IUD). Ameli Link
Medical Warning: This article is for informational purposes only and is not a substitute for professional medical advice. To choose the best IUD for your situation, consult a gynecologist, midwife, or your primary care physician.
