Choosing a long-term contraception option can feel overwhelming. There are more choices today than ever before. This guide compares the four most common long-acting options, explains who each one suits, and answers the questions women actually ask us. For a focused look at the most popular IUD, see our existing blog on 3 benefits of using a Mirena.
What is an IUD?
IUD stands for Intrauterine Device. It is a small, T-shaped device that sits inside the uterus. Once in place, it prevents pregnancy without needing to think about it every day. Modern IUDs are safe, highly effective, and much more popular than older generations of IUD.
There are two main types: hormonal IUDs (Mirena and Kyleena) and the non-hormonal copper IUD. Implanon is a different device, placed in the arm, not the uterus, but it belongs to the same long-acting group.
The main options compared
Mirena (hormonal IUD)
Mirena releases a small amount of progesterone directly into the uterus. It is approved for up to 8 years of contraception in Australia. It is the most popular IUD in the country.
Who it suits best: women who want long-lasting contraception, women with heavy or painful periods, women with endometriosis, women needing progesterone as part of HRT, women who want very light periods or no periods at all.
Common effects: periods often become much lighter and shorter, and about 1 in 5 women have no periods at all after a year. There can be irregular spotting in the first few months.
Kyleena (hormonal IUD, smaller)
Kyleena works the same way as Mirena but is smaller and releases less hormone. It is approved for up to 5 years in Australia.
Who it suits best: younger women who have not had a baby and are keen on a slimmer device, women who want effective contraception but prefer a lower hormone dose, women who want to keep some monthly bleeding.
Common effects: periods usually become lighter but women are more likely than with Mirena to still have monthly bleeding.
Copper IUD (non-hormonal)
The copper IUD contains no hormones at all. It works by causing inflammation making the inside of the uterus unfriendly to sperm. It is approved for up to 10 years in Australia and starts working immediately after insertion.
Who it suits best: women who prefer no hormones, women who have had side effects from hormonal methods, women who want the longest-lasting option, women needing emergency contraception.
Common effects: periods usually become heavier and more painful, especially in the first few months. For some women this settles over time. The copper IUD is usually not chosen if you already have heavy periods.
Implanon (hormonal arm implant)
Implanon is a small rod placed just under the skin of your upper arm. It releases a small amount of progesterone and lasts for 3 years. It is not an IUD but it fits in the same long-acting group.
Who it suits best: women who do not want anything inside the uterus, women who want an easy swap-out every 3 years, women who travel often or forget to take daily pills.
Common effects: periods become unpredictable. Some women stop having periods, some have light frequent bleeding, some have no change. It is harder to predict than an IUD.
How do I know which is right for me?
The best choice depends on more than contraception. Here is how we usually think about it:
If you have heavy or painful periods, the Mirena is usually the first choice. See our heavy and painful periods page.
If you have endometriosis, the Mirena is also often recommended because the progesterone helps settle endometriosis pain.
If you have PCOS and irregular periods, hormonal options can help regulate your cycle and protect the lining of the uterus.
If you are in perimenopause or menopause and need progesterone with HRT, Mirena is one of the most convenient options.
If you want absolutely no hormones, the copper IUD is the main option.
If you are concerned about having something in your uterus, Implanon in the arm may suit you better.
What is IUD insertion like?
An IUD insertion is a short appointment, usually around 20 to 30 minutes. The IUD is placed through the cervix into the uterus. Most women describe the experience as a strong cramp for a few seconds, followed by some lower belly discomfort for the rest of the day.
We offer several options to make insertion more comfortable:
1. Pain relief medication before and after the procedure.
2. Green whistle or Penthrox inhalation for women who find it very uncomfortable.
3. Light sedation or a general anaesthetic at a day hospital if you have had a difficult experience before or feel very anxious.
4. Combining the insertion with another gynaecology procedure if you are having surgery anyway.
Your specialist will discuss which option is right for you. See our contraception page for more details.
Side effects and what to expect in the first 3 months
Any new contraception needs a few months to settle. With hormonal IUDs, light irregular spotting is very common for a variable period which is unpredictable. With a copper IUD, periods may be heavier at first. With Implanon, bleeding is again for a variable period which is unpredictable.
If you have severe pain, heavy bleeding, fever, or unusual discharge, see your specialist. These are not normal and should be checked.
Mirena with HRT: a special note for women 45 and older
Mirena is often used as the progesterone part of HRT in women who still have a uterus. In this situation, oestrogen is given through a patch, gel, or tablet, and the Mirena protects the lining of the uterus. This combination has fewer side effects than taking tablet progesterone for many women. If you are approaching menopause and still want contraception, Mirena can do both jobs at once.
Cost and Medicare
The device itself is subsidised by the PBS, so the cost of the Mirena, Kyleena, or Implanon is around a standard script fee. The insertion appointment has a specialist consultation fee, and you can claim a Medicare rebate on that if you have a GP referral. Our team will give you a full quote before you commit.
About Northside Gynaecology and contraception care
Northside Gynaecology is a specialist gynaecology practice in Brisbane. Our team, led by Dr Archna Saraswat, FRANZCOG, has been performing IUD insertions since 2011. Many of our patients come to us for IUDs after a difficult experience elsewhere. We consult from Kedron, North Lakes, and Caboolture Private Hospital.
Frequently asked questions
Which IUD is best for heavy periods?
All hormonal LARC will reduce bleeding and what is best would depend on your circumstances and expectations. The Mirena IUD is usually the best IUD for heavy periods. It releases progesterone directly into the uterus and reduces period bleeding for most women. The copper IUD does not reduce bleeding and can make periods heavier for some, so it is usually not chosen for heavy periods.
Does IUD insertion hurt?
IUD insertion can feel like a strong cramp for a short time. We can offer options to make it more comfortable, including local anaesthetic, sedation at a day hospital, or combining it with another procedure. A specialist appointment lets you discuss what will suit you best.
How long does a Mirena last?
A Mirena is approved for up to 8 years of contraception in Australia. For heavy period treatment it is usually effective for about 5 years. Your specialist can advise when yours should be removed or replaced.
Can I use a Mirena as part of HRT?
Yes. The Mirena is a very common choice as the progesterone part of HRT in women who still have a uterus. It protects the lining of the uterus while you take oestrogen through a patch, gel, or tablet.
Can I get an IUD if I have not had a baby?
Yes. All IUD types are safe and effective for women who have not been pregnant, including teenagers. Modern IUDs are small and the insertion is well tolerated with the right preparation.
Can I get pregnant right after removing a Mirena or Implanon?
Yes. Fertility returns very quickly after removal. If pregnancy is not wanted, start another form of contraception immediately.
What is the difference between Mirena and Kyleena?
Kyleena is smaller and releases less hormone than Mirena. Kyleena lasts up to 5 years, Mirena up to 8 years. Kyleena is a popular choice for younger women who have not had a baby as it is slimmer with less hormonal content. Mirena is a stronger option for heavy periods, endometriosis, and HRT support.
Book an IUD consultation in Brisbane
Choosing contraception is personal. There is no single right answer. The best choice is the one that fits your body, your symptoms, and your life.
You can book at Kedron, North Lakes, or Caboolture. Call 07 3054 4687 or use our contact page. Ask your GP for a referral so you can claim your Medicare rebate. Our specialist team will help you choose and insert the right option for you.