IUD Duration of Use
The copper IUD (TCu380A) can remain in place for 10 years per FDA approval but is effective for at least 12 years, while levonorgestrel IUDs are FDA-approved for 3-5 years depending on the specific product but the 52 mg LNG-IUD (Mirena) is effective for up to 7 years. 1, 2
Copper IUD Duration
The copper T380A IUD is FDA-approved for 10 years of continuous use but clinical evidence demonstrates effectiveness extending to at least 12 years with a failure rate remaining below 1% throughout this extended period. 1
- For women aged 25 years or older at insertion, extended use of the TCu380A for 12 years is well-supported by evidence. 3
- Women who are at least 35 years old at the time of TCu380A insertion can continue use until menopause with negligible pregnancy risk. 3
- The contraceptive failure rate remains remarkably low at less than 1% throughout the entire duration of use. 1
Levonorgestrel IUD Duration
The duration varies by specific product and dose:
- The 52 mg levonorgestrel IUD (Mirena) is FDA-approved for 5 years but is effective for up to 7 years. 2
- The cumulative failure rate during years 6-8 of Mirena use is only 0.68%. 2
- The 13.5 mg levonorgestrel IUD (Skyla) is approved for 3 years, with no data supporting extended use beyond this timeframe. 2, 3
- The 52 mg levonorgestrel IUD (Liletta) is approved for 3 years. 2
Important Clinical Considerations
Extended use beyond FDA-approved duration is supported for parous women aged 25 years or older at insertion, but data are lacking for nulliparous women and those under 25 years old. 3
- Women should be counseled that device removal is available at any time if bleeding patterns or other side effects become unacceptable. 2
- The copper IUD also functions as emergency contraception when inserted within 5 days of unprotected intercourse. 1
- Both IUD types have pregnancy rates of less than 1% per year during their approved duration. 1, 2
Common Pitfalls to Avoid
- Do not automatically remove an IUD at the FDA-approved timeframe in parous women over 25 without considering extended use data, as this may unnecessarily expose patients to reinsertion risks and costs. 3
- Avoid extending use of the 13.5 mg LNG-IUD (Skyla) beyond 3 years, as no efficacy data exist for this device. 3
- For women under 35 years old with copper IUDs, replacement at 10-12 years is recommended rather than continuing until menopause. 3