Hormonal vs. Copper IUDs: How They Change Your Cycle

If you’re considering an intrauterine device (IUD) for birth control, one of the biggest questions you probably have is: What happens to my period?

Since there are two main types of IUDs—hormonal and copper—the answer depends on which one you choose. Some people stop bleeding altogether, while others notice heavier or longer periods in the first few months.

Let’s break down how each type of IUD impacts ovulation, menstrual cycles, and symptoms, so you can make the choice that feels right for your body.

What Is an IUD?

An IUD is a small, T-shaped device placed into the uterus by a healthcare provider. Once inserted, it provides long-lasting, highly effective birth control with little day-to-day maintenance.

There are two types of IUDs:

• Hormonal IUDs: Release a steady, low dose of progestin (a synthetic form of progesterone)

• Copper IUDs: Release copper ions, which act as a natural spermicide, but contain no hormones

Both types are more than 99% effective at preventing pregnancy, but they influence your menstrual cycle in very different ways.

Hormonal IUDs and Your Cycle

Brands like Mirena, Kyleena, Liletta, and Skyla fall into this category. These devices release progestin, which works mainly by thickening cervical mucus (blocking sperm) and thinning the uterine lining (making implantation unlikely).

Do you still ovulate?

• With higher-dose IUDs (Mirena, Liletta), ovulation is suppressed in about 85% of cycles during the first year

• With lower-dose IUDs (Kyleena, Skyla), ovulation usually continues

• Unlike the pill, which stops ovulation more consistently, many women with a hormonal IUD still release eggs

What happens to your period?

• Because the uterine lining stays thin, many women experience lighter bleeding or no period at all

• Not bleeding doesn’t always mean you’ve stopped ovulating—it simply means there isn’t enough tissue to shed

• About 20% of Mirena users stop getting their periods completely after one year

Will you still have PMS?

Yes, possibly. Since your ovaries often continue producing estrogen and progesterone, you may still experience mood shifts, breast tenderness, or bloating. However, many women report milder symptoms than before.

Fertility after removal

Your fertility usually returns quickly, sometimes even within the first month after removal.

Copper IUDs and Your Cycle

The copper IUD (brand name Paragard) works differently. Instead of using hormones, it releases copper ions, which create an environment toxic to sperm. This prevents fertilization but does not interfere with ovulation or your natural hormones.

Do you still ovulate?

Yes, every month. Since there are no hormones at play, your ovaries continues their normal rhythm of follicle growth, ovulation, and hormone secretion.

What happens to your period?

• Your period almost always continues with a copper IUD

• For many women, bleeding becomes heavier, periods last longer, and cramping increases, especially during the first 3–6 months

• These changes are due to the inflammatory reaction in the uterus caused by copper and the foreign device, which increases blood flow and uterine contractions

  
  

Will you still have PMS?

Yes, but in contrast to cramps and bleeding , PMS usually does not worsen.

Fertility after removal

Fertility after copper IUD removal returns rapidly and reliably, with most conceiving within a few cycles.

Science Snapshot: Hormonal vs. Copper IUDs

Feature	Hormonal IUD	Copper IUD
Primary action	Progestin thickens cervical mucus, thins uterine lining, may suppress ovulation	Copper ions create sperm-hostile environment
Ovulation	Sometimes suppressed (depends on dose and brand)	Always continues
Periods	Often lighter, sometimes stop	Usually heavier and longer (especially first 3–6 months)
PMS symptoms	May continue but often reduced	Continue as before (since hormones aren’t altered)
Longevity	3–8 years depending on brand	Up to 10 years
Fertility return	Rapid after removal	Rapid after removal

Interested in other methods of contraception? Learn more here.

Which One Is Right for You?

• If you’re tired of heavy, painful periods and prefer lighter or no bleeding, a hormonal IUD may be ideal

• If you want completely hormone-free contraception and don’t mind a potentially heavier flow, the copper IUD might be your best match

Both options are safe, effective, and reversible. What matters most is how they align with your body, lifestyle, and comfort with side effects.

Summary

IUDs are among the most reliable forms of birth control available today, and both hormonal and copper versions let you step away from the daily hassle of remembering pills. But they don’t affect your cycle in the same way. With a hormonal IUD, your periods may lighten or stop completely, while with a copper IUD, your natural cycle continues, sometimes with heavier flow at first.

Understanding these differences means you can choose an IUD not just for pregnancy prevention, but also for how it aligns with your experience of your monthly cycle.

Sources

• Differential Effects of the Hormonal and Copper Intrauterine Device on the Endometrial Transcriptome

• Contraception with levonorgestrel-releasing intrauterine system versus copper intrauterine device: a meta-analysis of randomized controlled trials

• Contraception: hormonal and copper coil only show minor differences