Yes, the hormonal IUD is indicated for treatment of heavy menstrual bleeding in users also willing to experience its contraceptive effect. In some countries, the hormonal IUD Mirena is also indicated for use as part of hormone replacement therapy in women experiencing perimenopause or menopause, as it protects against endometrial hypoplasia, reduces the risk of endometrial cancer associated with estrogen supplementation, and can help maintain bone density.

The hormonal IUD is not yet approved for use as an emergency contraceptive and evidence supporting this use is limited. As of 2026, a large clinical trial is underway in the United States to assess whether the hormonal IUD may be a viable emergency contraceptive when used in “real world” clinical settings.

While the hormonal IUD can reduce bleeding and pain associated with fibroids, it cannot shrink or remove the uterine myomas or cure clients of the condition. Clients should be made aware of this distinction by their providers during method counseling. The hormonal IUD is an effective first-line treatment for adenomyosis and endometriosis, as it limits uterine volume and endometrial thickness and is associated with reduced menstrual bleeding and pain.

The hormonal IUD can limit menstrual blood loss, which is associated with increased or restored hemoglobin levels and iron stores in women with anemia, particularly those who typically experience heavy menstrual bleeding. This retention of hemoglobin and iron can improve the symptoms of iron-deficient anemia. A study is underway in Kenya to determine how effective the hormonal IUD is in treating the symptoms of iron-deficient anemia.

Based on large population studies, hormonal IUD use is believed to be associated with lower risk of endometrial cancer and ovarian cancer and potentially associated with lower risk of cervical cancer. This effect is largely due to the method’s inhibition of endometrial over-growth. Extensive clinical evaluation of the method has determined that it is an effective treatment option for early-stage endometrial cancer and atypical hyperplasia, either alone or when combined with oral progestins, GnRH agonists, or hysteroscopic resection. The method can also be used alongside tamoxifen therapy in women being treated for breast cancer to reduce the risk of tamoxifen’s common side effects, endometrial polyps and hyperplasia.