09/10/2026
As a midwife, the IUD question I get most is "which one," and the honest answer is that it mostly comes down to what you want your period to do.
Hormonal IUDs release a small amount of progestin locally. Mirena and Liletta go up to 8 years, Kyleena up to 5, Skyla up to 3. Most people see lighter periods over time and some stop bleeding altogether. For some patients that's the whole appeal. For others it's genuinely unsettling not to bleed, and that reaction deserves more respect than it usually gets.
Paragard is the copper option and lasts up to 10 years, no hormones involved. Your cycle generally keeps its normal schedule, though for the first several months periods often run heavier and crampier before settling.
Neither one is the better IUD. They answer different questions. This is a real decision with real tradeoffs, not a default someone else should be picking for you π
https://metroarea.org/blog/which-iud-is-right-hormonal-vs-copper