The hormonal IUD, also sometimes called the hormonal IUS or LNG IUS, is a long-acting, highly effective reversible women’s health product indicated for use both as a contraceptive and as a treatment option for heavy menstrual bleeding.

The hormonal IUD is a white plastic device that is just over 3cm tall, or about the size of two stacked dice. It is extremely lightweight, less than 5g. The hormonal IUD is T-shaped, with two flexible arms that collapse flat as the IUD is being inserted or removed. If available, providers should allow their clients to see or hold a hormonal IUD model (not the product that will be inserted) during counseling.

Hormonal IUDs are made out of a material called polyethylene. Polyethylene is a plastic that is widely used for surgical implants and other medical applications due to its high “biocompatibility” or ability to be placed in the body safely, without becoming damaged or unstable. Extensive evaluation of the material has found it to be non-toxic. Hormonal IUDs also contain a very small quantity of silicone, a polymer also found to be biocompatible and widely used for breast implants, contact lenses, artificial cardiac valves, and other medical applications. The hormonal IUD’s materials are considered extremely safe, and the product is manufactured in quality-assured facilities inspected by the WHO.

Hormonal IUDs contain the progestin, or synthetic hormone, levonorgestrel. Levonorgestrel was first created in the 1960s and is now used in reproductive health products, including emergency contraception and implants, around the world. Synthetic hormones are generally derived from natural substances. In levonorgestrel’s case, it’s derived from yam or soybeans. They mimic the natural systems and hormonal processes in the body. Every body reacts differently to hormones, either natural or synthetic, and clients can talk to their provider about any negative side effects they experience.

The hormonal IUD slowly releases the hormone levonorgestrel directly into the uterine and cervical tissue, causing an effect that is predominantly localized in the reproductive system. The method has three main effects: thickening of the cervical mucus to prevent sperm from entering the uterus, a mild inflammatory effect within the uterus that inhibits sperm movement and survival, and inhibition of uterine lining growth over the course of the menstrual cycle. These effects work together to provide contraceptive protection and reduction of menstrual bleeding. Unlike many hormonal methods, the hormonal IUD does not meaningfully inhibit ovulation as part of its contraceptive effect. Most users will continue to ovulate (and have cyclical hormonal fluctuation) during their use of the method.

No, the hormonal IUD is not considered an abortifacient because its primary contraceptive effects prevent sperm from reaching and fertilizing the egg. Embryo loss does not occur significantly more frequently in hormonal IUD users than it does for people not using any contraceptive.

Both the hormonal IUD and the copper IUD are highly effective, long-acting reversible contraceptives. The copper IUD has a longer approved duration (up to 12 years), is approved for use as emergency contraception, and is often associated with heavier, less predictable bleeding and increased abdominal pain during use. The hormonal IUD has a shorter approved duration (up to 8 years), is not yet approved for use as emergency contraception, and is often associated with lighter or paused menstrual bleeding and pain over time. The hormonal IUD is indicated for treatment of heavy menstrual bleeding. As the copper IUD is often associated with heavier bleeding, it does not have this indication.

Both the hormonal IUD and implants are highly effective, long-acting reversible contraceptives. Implants have shorter durations (3-5 years) and while many people experience reduction in menstrual bleeding during their use of the implant, that effect is less consistent and universal than it is for hormonal IUDs. Implants may also lead to ongoing unpredictable bleeding for their full duration of use. Hormonal IUDs have a longer approved duration (up to 8 years) and cause lighter or paused menstrual bleeding and pain in almost all users over time. The hormonal IUD is indicated for treatment of heavy menstrual bleeding. Implants do not have this indication. Implant insertion and removal can be more technically complex than IUD insertion as it is considered a minor surgical procedure, though both require specialized training to ensure patient safety and product efficacy. The two methods also may contain different hormones; while all hormonal IUDs only contain levonorgestrel (as of 2026), many single-rod implants contain etonogestrel.