What is the duration of effectiveness for an Intrauterine Device (IUD)?

IUD Duration of Effectiveness

The copper IUD (Paragard) is FDA-approved for 10 years but remains effective for at least 12 years, while the levonorgestrel IUD (Mirena) is FDA-approved for 5 years but demonstrates effectiveness extending to 7-8 years. 1, 2

Copper IUD Duration

• The copper T380A IUD provides contraceptive protection for a minimum of 10 years as per FDA approval, with clinical evidence supporting effectiveness extending to at least 12 years 1, 2
• The contraceptive failure rate remains remarkably low at less than 1% throughout the entire duration of use, including the extended period beyond 10 years 1, 2
• Research data from continuous use studies show that women who continued using the same copper IUD beyond 10 years experienced no pregnancies through 15 years, with some women continuing through 20 years without pregnancy 3
• The copper IUD works continuously without requiring any user action and is hormone-free 2

Levonorgestrel IUD Duration

• Multiple levonorgestrel IUD products exist with varying approved durations: the 52 mg devices (Mirena, Liletta) are approved for 3-5 years but effective for up to 7-8 years, while the 13.5 mg device (Skyla) is approved for 3 years 2, 4
• Mirena specifically is FDA-approved for 5 years but demonstrates effectiveness extending to 7 years, with a cumulative failure rate during years 6-8 of use of only 0.68% 2, 4
• The levonorgestrel IUD releases 20 micrograms per 24 hours and maintains a failure rate of less than 1% throughout its approved duration 5, 2

Clinical Considerations for Extended Use

• Both IUD types maintain failure rates of less than 1% throughout their approved duration, making them among the most effective contraceptive methods available—comparable to female sterilization 2, 6, 7
• The levonorgestrel IUD offers the additional therapeutic benefit of lightening or eliminating menstrual bleeding, while copper IUDs often increase menstrual bleeding 2, 4, 8
• Use of copper IUDs beyond 10 years was not associated with intensification of side effects nor with an increase in the relative frequency of those effects, except for perimenopausal symptoms 3

Additional Clinical Applications

• The copper IUD also serves as highly effective emergency contraception when inserted within 5 days of unprotected intercourse, with a failure rate of less than 1% 1, 2
• Both IUD types are suitable for parous women (Category 1—no restrictions) and acceptable for nulliparous women (Category 2—advantages generally outweigh risks) 5, 4

Common Pitfalls to Avoid

• Do not remove a copper IUD at 10 years if the patient desires continued contraception and has no complications—clinical evidence supports extended use to 12 years 1, 2
• Do not assume contraceptive failure if bleeding patterns change with the levonorgestrel IUD—bleeding changes do not correlate with contraceptive failure 4
• Counsel patients that device removal is available at any time if they find bleeding patterns or other side effects unacceptable 4