The hormonal IUD is not new, globally. It was first developed in Finland by the Population Council (an international, non-governmental research organization) and the University of Helsinki in the mid-1970s and the product received its first regulatory approval in 1990. It has been available throughout Europe, the United States, and Australia for more than 30 years, and it is the most commonly used LARC in these contexts.

There are two WHO pre-qualified hormonal IUD products available in the global market: Mirena, supplied by Bayer, and Avibela, supplied by Medicines360. Both contain 52mg of the hormone levonorgestrel. There is a third quality-assured 52mg hormonal IUD available non-commercially, called the LNG-IUS. This unbranded IUD is donated by the International Contraceptive Access Foundation. There are also a number of hormonal IUD products that either have not received regulatory approval from a WHO Listed Authority or are not available globally. These products may be sold in the private sector, and include Eloira, a 52mg IUD supplied by Pregna, and Kyleena or Skyla, low-dose IUDs supplied by Bayer.

Given the hormonal IUD’s long history, it has been extensively and comprehensively studied around the world. Large-scale clinical trials to assess efficacy, safety, and user experiences have been conducted since the 1970s in the United States, Europe, and China. Smaller-scale clinical and sociobehavioral evaluation has also been conducted in these settings, and in Latin America, Africa, and South Asia. See the Hormonal IUD Scientific Communications materials for a full review of the method’s evidence.

In addition to high-income settings, where the method has been available for more than 30 years, the hormonal IUD has now been introduced in the public sector in 17 countries: Many more countries are preparing to introduce the method in the public sector. The hormonal IUD is widely available, at varying cost, in private health systems around the world.

For governments procuring the hormonal IUD for introduction in the public sector through UNFPA, the method costs about 10 USD/unit. As of 2026, UNFPA assists national governments with hormonal IUD procurement by covering some or all of the commodity cost for eligible countries through a targeted fund. For clients receiving the hormonal IUD through public sector clinics, out of pocket cost will vary by country and setting. In some settings, they may be asked to pay a service fee or pay for the cost of single-use tools. In the private sector, cost to clients will vary widely depending on country, clinic setting, and hormonal IUD product. Costs ranging from 15 USD to 200 USD+ have been documented.