Both IUDs are over 99% effective and last for years. The hormonal IUD usually makes periods lighter; the copper IUD is hormone-free but can make periods heavier. Here is how to choose.
The short answer
Both are small T-shaped devices placed in the uterus, and both prevent more than 99% of pregnancies. A hormonal IUD releases a small amount of levonorgestrel; it usually makes periods lighter and less painful, and some people stop bleeding. A copper IUD has no hormones; it can make periods heavier and crampier, especially in the first months, and it also works as the most effective emergency contraception.
Side by side
| Hormonal IUD | Copper IUD | |
|---|---|---|
| Brands in Canada | Mirena, Kyleena, Jaydess | Several copper models |
| Hormones | Low-dose levonorgestrel, mostly local | None |
| Effectiveness | Over 99% | Over 99% |
| Lasts | 3–8 years by brand | 3–10 years by model |
| Periods | Lighter, less painful; may stop | May be heavier and crampier, especially early |
| Emergency contraception | Not the standard option | Yes, within 7 days in Canada (5 days in most guidance) |
| Good for | Heavy or painful periods | Wanting no hormones |
The short version
What insertion is like
Insertion takes a few minutes in a clinic. Cramping during and after is common; ask about pain relief options beforehand. Spotting and irregular bleeding are common for the first 3 to 6 months with either type.
Risks
Serious problems are uncommon: the IUD can come out (about 1 in 20), rarely it can perforate the uterus at insertion, and there is a small infection risk in the first weeks. IUDs do not protect against STIs.
Cost in BC
Since April 2023, BC has covered many prescription contraceptives, including IUDs, at no cost to residents.
Frequently asked questions
Which IUD is better, hormonal or copper?
Both are equally effective. Choose hormonal if you want lighter periods, copper if you want no hormones.
Does the copper IUD make periods heavier?
Often, especially in the first 3 to 6 months. It can also increase cramps.
Can an IUD be used as emergency contraception?
Yes. A copper IUD inserted soon after unprotected sex is the most effective emergency contraception.
Is the IUD free in BC?
Yes. BC covers many prescription contraceptives, including IUDs, for residents.