The copper IUD is hormone-free and lasts up to 10 years; hormonal IUDs release progestin, last 3 to 8 years, and usually lighten or stop periods.
Effectiveness is excellent for both: 0.1 to 0.4% typical-use failure for hormonal IUDs and 0.8% for copper. The lived differences are hormonal exposure and your period. Copper changes no hormones anywhere in your body, but periods often get heavier and crampier, particularly in the first months. Hormonal IUDs use a small local dose of progestin, and most users end up with light periods or none at all. Copper has two unique strengths: it is the most effective emergency contraception available when placed within 5 days of unprotected sex, and it is the only top-tier method for people avoiding hormones. Pick copper if hormone-free is the point or you want the full decade. Pick hormonal if period relief matters and progestin is acceptable. Both are placed and removed by a clinician, both are immediately reversible, and neither protects against STIs.
What to do
Common questions
Copper IUD vs hormonal IUD?
Both IUDs sit in the top tier of birth control, but they work completely differently. The copper IUD contains no hormones at all: copper ions create an environment sperm cannot survive. The hormonal IUD releases a small daily dose of progestin that thickens cervical mucus and thins the uterine lining. On effectiveness, the hormonal version edges ahead: 0.1 to 0.4% typical-use failure versus 0.8% for copper, though both beat the pill several-fold. Duration favors copper: up to 10 years, versus 3 to 8 years for hormonal IUDs depending on the device. Periods are the biggest day-to-day difference. Hormonal IUDs usually make periods much lighter and often stop them after the first year. The copper IUD tends to make periods heavier and cramps worse, especially early on, which is the main reason people have it removed. Two copper-IUD bonuses: it works as emergency contraception if placed within 5 days of unprotected sex, and it suits anyone who cannot or does not want to use hormones. Choose copper if you want hormone-free, long, and also-value the EC option. Choose hormonal if lighter or absent periods sound like a feature and you are fine with progestin.