Hormonal implants and intrauterine devices (IUDs) are both safe and dependable methods of birth control.
They’re called long-acting reversible contraceptives (LARCs). These “fit-and-forget” methods last years. Once they go in, you don’t have to do anything else to prevent pregnancy.
When you compare IUDs vs. implants, there are key similarities and differences.
IUD vs. Implant Similarities
Both IUDs and implants are very effective — your chance of getting pregnant is less than 1 in 100 during the first year of use. By comparison, nearly 10 in 100 birth control pill users get pregnant in the first year.
Implants and IUDs are alike in other ways too. A doctor or nurse has to insert and remove them — you can’t do it yourself. Both are reversible. You can get pregnant as soon as they’re removed. They’re more expensive at first than other kinds of birth control, but that cost evens out over time.
Neither method prevents sexually transmitted diseases (STDs), but you can use them with a condom to reduce your risk for STDs.
How Do Implants and IUDs Work?
An IUD is a tiny T-shaped device that goes inside your uterus. There are two types: hormonal and copper.
The hormonal IUD releases the hormone progestin into your body. It prevents pregnancy by:
- Making the mucus in your cervical canal too thick for sperm to get through
- Stopping your ovaries from releasing eggs
- Preventing a fertilized egg from attaching to the lining of your uterus
The copper IUD is wrapped in thin copper wire that’s toxic to sperm. It also keeps a fertilized egg from implanting in the uterus. After birth control pills, IUDs are the second most popular form of reversible contraception. In the U.S., about 15% of people choose IUDs for long-term birth control.
A hormonal implant is a tiny tube about the size of a matchstick that goes under the skin of your upper arm. It releases a small amount of progestin to stop your ovaries from releasing eggs and make the mucus in the cervix too thick for sperm to get through. You'll need to review all your medications with your doctor beforehand. Some drugs can make implants less effective.
How long do IUDs and implants last?
A hormonal IUD works for 3–8 years, depending on the brand. A copper IUD works for up to 10 years.
According to the FDA, these are the expected lifespans for different brands of IUDs:
- Paragard: 10 years
- Mirena: Eight years
- Liletta: Up to eight years
- Kyleena: Five years
- Skyla: Three years
Your doctor may decide you can use safely use the device longer.
An implant works for up to three years.
How soon do IUDs and implants start working?
Copper IUDs start to work as soon as they’re inserted. The hormonal kind will work right away if you put it in during the first seven days of your period. Otherwise, it may take up to seven days to prevent pregnancy.
An implant works right away if you get it within the first five days of your period. If you get it after that time, you’ll need to use condoms for at least seven days to avoid getting pregnant .
IUD vs. Implant Insertion Procedure
Before you get an IUD, your health care provider will test you for STDs. Putting one in when you have an STD could cause pelvic inflammatory disease (PID), a serious infection. Your provider also may test you to make sure you’re not pregnant.
The nurse or doctor will use a special tool to put the IUD through the opening in your cervix and into your uterus. It usually takes just a few minutes. The IUD has strings attached that your provider can use to remove the device later.
You might have cramps during the insertion. Experts say that most patients do well with IUD insertion. However, recently people have begun to call for more information about the pain associated with the procedure. As a result, the CDC has issued new guidelines.
Doctors are encouraged to discuss any concerns you have about your pain ahead of time. If you're worried, you can ask for medication that will numb the area and make you more comfortable.
To insert an implant into your arm, your provider will first give you a shot to numb the area. Then, they use a special device to place the implant under your skin. It takes only a few minutes, and no stitches are needed. They will tell you how to care for the skin in that area in the days after you get the implant.
Usually, you can’t see the implant under your skin, but you’ll be able to feel it with your fingers. The spot may be sore for a few days, and you may have a bruise.
IUD vs. Implant Side Effects
After you get a hormonal IUD, your menstrual cramps may hurt less and your period may be lighter. Side effects such as irregular periods and spotting between periods can happen but usually go away in three to six months. Copper IUDs can cause heavy bleeding, cramps, and bleeding between periods.
The strings attached to your IUD may feel stiff at first, something your partner might notice during sex. They usually soften over time.
Implants can make your period very light or go away, and ease cramps and pain. The most common side effect is spotting in the first 6-12 months. Other side effects such as headaches, weight gain, tender breasts, acne, and mood changes can happen but aren’t very common.
Heavy bleeding isn’t normal with an implant. If that happens, keep track of how many pads or tampons you use, and call your doctor right away.
IUD vs. Implant Safety Considerations
Almost everyone can safely use IUDs and implants, including teens and those who haven’t had a baby. However, some conditions make IUDs and implants unsafe for you to use.
Don’t use either kind of IUD if you:
- Have vaginal bleeding when you’re not on your period
- Have cancer of the cervix or uterus
- Have AIDS
- Are pregnant or want to get pregnant
- Have breast cancer
- Have liver tumors
- Have liver disease
- Have an increased risk for STD/PID
- Have abnormal uterine anatomy
Don’t use a hormonal implant if you:
- Are pregnant
- Have liver disease
- Have had breast cancer
- Have vaginal bleeding that’s not your period
IUD vs. Implant Complications
Although long-acting reversible contraception is generally safe, complications can happen.
IUD complications
These events are rare but can be serious.
IUD expulsion. Your IUD can come out by itself, and you may not feel it happen. Get in touch with your doctor if you:
- Can’t feel the IUD strings
- Can feel the IUD in your cervix
- Have fluid or odor coming from your vagina
- Have persistent pain
IUD moving through the uterine wall. The device could push through the wall of your uterus. If it happens when your doctor is putting it in, they can fix it right away. If it isn’t fixed right away, the IUD could damage nearby organs, so it will have to be taken out.
Ectopic pregnancy. In rare cases, you might get pregnant while using an IUD. There’s a higher chance that you could have an ectopic pregnancy, when the baby develops outside the uterus. This is a medical emergency. Call your doctor right away if you feel sharp or cramping pain in your lower stomach that lasts more than a few minutes.
Infection. When your IUD is placed in your body, there's a possibility that bacteria may enter, which could lead to infection. This problem is most likely to happen in the first 20 days after insertion. Your doctor should clean your cervix before placing your IUD, which will help protect against infection.
Birth control implant complications
Implant removal. Your implant might move or start to come out. This is more likely to happen the first month after you get it. As time goes on, the tissue around the implant should thicken, which will help keep it in place. If you notice your implant coming out, start using another birth control method right away and see your doctor as soon as possible.
Implant damage. If you've had an accident that caused trauma to your arm, your implant might shift, bend, or even break. If you think this might have happened, call your doctor.
Scarring. You might have a scar at the spot where the doctor made the incision in your arm to insert the implant.
Ectopic pregnancy. The risk of getting pregnant while you have the implant is very low. But if you do conceive, the risk that the pregnancy will be ectopic is higher.
IUD vs. Implant Removal
You may have your IUD or implant removed if you want to become pregnant, switch to a different form of birth control, or if the device is at the end of its use.
When you're ready to have your IUD removed, make an appointment with your doctor. They'll use an instrument to grab the strings and pull the IUD out. It usually takes less time to remove an IUD than it does to place one. If you want a new IUD, you can get it during the same visit.
To remove an implant, your doctor will first numb that area of your arm. They'll make a small cut and remove the implant. It takes only a few minutes. If you want a new implant, your doctor can insert it during the same procedure.
Cost Comparison
You may not have to pay for either one of them. Family planning clinics usually will provide an implant, IUD, or some other form of safe birth control at little or no cost to you.
Your insurance company may pay for some or all of your birth control, though this might or might not include implant or IUD options. Call your insurance to be sure.
If you pay yourself, expect around $1,000 for the implant plus a few hundred dollars to place it. Once in, it can last up to three years. There might also be a charge of a few hundred dollars to remove the implant.
An IUD may cost as much as $1,300, depending on the type. Because both types can last for many years, the cost is similar to methods that you take or change more frequently, such as the pill or the ring.
IUD vs. Implant: Which One Should You Choose?
Which method you choose is a personal decision. Your doctor can answer questions and guide you. Some points to keep in mind:
- Most IUDs last longer than implants.
- Do you want your periods to be lighter or stop?
- Are you looking for relief from painful periods?
- You'll need a pelvic exam when you get your IUD.
Takeaways
Both IUDs and hormonal implants are long-lasting birth control methods that are simple to reverse. They're popular because they're very effective at preventing pregnancy. Whether you choose an IUD or implant, your health care provider will have to place it. Some people have side effects, including cramps and spotting. Possible complications include infection and ectopic pregnancy, but those are rare. When you're ready to remove the device, it will take only a few minutes for your doctor to take it out.
IUD vs. Implant FAQs
What are the main differences between implants and IUDs?
Both are forms of long-acting birth control. An implant is inserted in your arm through a small incision. An IUD is placed inside your body during a pelvic exam.
IUD vs. implant: Which one hurts most?
When your doctor places an implant, your arm is numbed before your skin is cut. The site might be tender and sore for a few days. Most people have some cramping — from mild to intense — when they get an IUD. The CDC has recently issued new guidelines designed to address complaints about painful IUD insertions. You can ask your doctor for numbing medicine before the procedure if you're concerned.
Where can you get IUDs and birth control implants?
If you have a gynecologist you see regularly, they can advise you and place either device. You also can get IUDs and implants at low-cost family planning clinics.
Do you gain weight on arm birth control?
Studies show that weight gain is not a direct side effect of hormonal birth control implants. However, some implant users say they feel bloated or have gained weight.
