Hormonal IUD and menstruation: effects on the cycle and menstrual flow

The hormonal IUD is a contraceptive method used by many women to avoid getting pregnant or to regulate their menstrual flow. What are the impacts of this contraception on menstruation?

What is a hormonal IUD?

The hormonal IUD, also known as an IUD, is placed in the woman's uterus. It is a small, very flexible piece of plastic that looks like the letter T and contains a dose ofsynthetic hormones that will be released for 5 years and have a contraceptive effectiveness of nearly 99.9%. The hormones released will be progestogens similar to those found in certain pills. This contraceptive will therefore have an impact on the production of the uterine mucous membrane and on the secretions of the uterus in order to prevent pregnancy through the implantation of an embryo. Levonorgestrel makes the uterine lining very thin. This makes implantation impossible. The IUD and menstruation are linked because of the impact on the uterine tissue.

This means of contraception is inserted by a health professional. He or she will insert the IUD using a speculum. Insertion is usually painless. Removal of the IUD is done by a health care provider, using the thread.

The hormonal IUD is an internal contraceptive, as are the copper IUD, the diaphragm, and the female condom.

Is there a difference between IUD designs?

The hormonal IUD is very different from the copper one. Many women refer to the hormonal version as the period-free IUD. But what are the differences between all IUDs on the market and their effects and impacts?

There are four major brands of hormonal IUDs on the market. Your gynecologist or midwife will suggest an IUD based on your health, weight, menstruation, and history.

Most devices on the market all release a progestin called levonorgestrel. Here is a chart summarizing each IUD model and its properties.








52 mg




13.5 mg




19.5 mg




52 mg

What are the effects of the hormonal IUD on menstruation?

This method of contraception has a direct impact on the various menstrual phases. In fact, by releasing hormones, it will affect the creation of the endometrium, which lines the cervix and thickens during the month to accommodate a pregnancy. Like the contraceptive pill, it will potentially have an impact on menstrual bleeding. While the copper IUD will increase the volume of menstrual bleeding, the hormonal IUD will significantly reduce it.

Few or no periods

When a hormonal IUD is inserted, women tend to experience the following menstrual symptoms:

  • Amenorrhea, an absence of menstruation
  • Very lightmenstrual flow
  • Blood loss outside the menstrual period, also called spotting

The reason is that this contraceptive does not preventovulation but acts on thethickness of the uterine lining by making it very thin. This prevents an embryo from taking hold. Since the uterine tissue is thinner, there will be less blood loss during menstruation because there is less tissue to evacuate.

Bleeding after insertion

After the IUD is inserted, you are likely to experience some spotting as a result of the doctor's insertion.

  • Spotting may occur for the first few months while the uterine lining builds up a new consistency. 20% of women do not bleed at all after a few months of use.
  • The other menstruating people will have very light blood loss of light colors (because the blood will be diluted with the thicker cervical mucus), brown because the blood in small quantity will take more time to eliminate and will have time to oxidize.

You may also experience cramps and pain after the procedure.

Other effects: a greater risk of acne

When taking hormonal contraception, especially when it contains progestin, it is possible to have acne outbreaks. In fact, the IUD is not recommended for anyone with a history of severe acne.

The hormonal IUD can also have side effects such as

  • chest pain and breast swelling
  • nausea and migraines,
  • decreased libido.

In some menstruating women, it is possible to experience dizziness, chronic fatigue and a change in irritability.

When is it not advisable to wear a hormonal IUD?

As you will have understood, the hormonal IUD has a significant impact on the menstrual cycle and on menstruation. It also has an impact on the entire endocrine and hormonal system. It is therefore important to discuss with your gynecologist or midwife all the contraindications associated with the use of a hormonal IUD.
It is contraindicated in cases of

  • abnormal vaginal discharge: very heavy periods, or spotting, for example
  • In case of diseases such as thrombosis, pulmonary embolism, phlebitis, cancer of the uterus, neurological migraines.
  • It cannot be used in cases ofuntreated STIs orSTIs that have been treated for less than three months
  • All women who have had an infection after childbirth, abortion, vacuum aspiration or curettage will not be able to wear an IUD for three months.
  • It will never be inserted before six weeks after delivery.
  • Finally, all women who have anoverly largecervix

What are the advantages of a hormonal IUD compared to a copper device?

The benefits of a hormonal IUD compared to a copper IUD should be discussed with your midwife, physician, or gynecologist. Each woman is unique and will have different needs. The main advantages of both forms are ease of use and 99.9% protection against unwanted pregnancy.

  • The hormonal IUD will have an impact on menstruation by reducing or eliminating it completely. People who suffer from heavy periods, endometriosis or adenomyosis will have fewer symptoms.
  • The main advantage of the copper IUD is that it does not contain any hormones, so it does not increase the risk of arterial or thromboembolic diseases. It will have an action on spermatozoa. It is also suitable for women who are breastfeeding.

FAQ about the hormonal IUD and menstruation

Why do I get my period with a hormonal IUD?

It is possible to have a period with a hormonal IUD. If your uterine l ining tends to thin out, you may continue to produce it. When your period comes, your uterus will shed it.

What are the side effects of the hormonal IUD on menstruation?

One of the side effects of the hormonal IUD on menstruation isamenorrhea. The absence of menstruation at the time of menstruation is completely normal.

Is it normal to have bleeding with a hormonal IUD?

It is completely normal and possible to have light blood loss when you have an intrauterine device. The menstruation or spotting will be light, very light, black or brown in color.

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