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IUD vs. Implant: What’s the Best Option for Long-Acting Birth Control?

Mandy Armitage, MDSophie Vergnaud, MD
Updated on March 12, 2025

Key takeaways:

  • Intrauterine devices (IUDs) and hormonal implants are both similarly effective methods of birth control. An unplanned pregnancy occurs in fewer than 1 in 100 women with typical use.

  • There are two types of IUDs: hormonal and nonhormonal. These are small, T-shaped birth control devices that are placed in the uterus. They can last for up to 10 years, depending on the brand.

  • Contraceptive implants are a small plastic rod inserted into your upper arm. They can last for up to 3 years.

  • There’s no “best” option. What’s right for you depends on your situation and your preferences.

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Close-up of IUD (Intrauterine Device) Birth Control being held inbetween fingers on bluish white background.
Lalocracio/iStock via Getty Images

There are many reasons you might be looking into long-acting birth control methods like intrauterine devices (IUDs) and hormonal implants. They have many upsides: They’re highly effective and well tolerated. And they require only a one-time placement that can provide effective coverage for years. This means you don’t have to remember to take a daily pill

But is one better than the other? What are the differences? Here’s what you need to know about IUDs and implants.

IUDs and implants: What are the options?

IUDs are small, T-shaped devices inserted into the uterus. There are two types to choose from: hormonal IUDs and nonhormonal IUDs.

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An implant, on the other hand, is always hormonal. It slowly releases hormones into the tissues under the skin to prevent pregnancy.

Hormonal IUDs

This type of IUD releases a synthetic version of the naturally occurring sex hormone progesterone (progestin is the lab-made version). This hormone prevents pregnancy in a few different ways: 

  • It prevents ovulation (egg release).

  • It thickens cervical mucus to prevent sperm reaching the uterus. 

  • And it thins the lining of the uterus so an embryo can’t attach.

There are four IUDs in this category. Each is approved by the FDA for a different length of time:

Nonhormonal (copper) IUD

Nonhormonal IUDs are copper IUDs. They work by releasing copper ions, which create a toxic environment for sperm. They can cause heavier or longer menstrual bleeding than hormonal IUDs, although this usually improves with time.

GoodRx icon
  • Birth control pill alternatives: Long-acting methods like intrauterine devices (IUDs), implants, and more offer reliable protection without the hassle of remembering to take medication. 

  • Everything you need to know about “the pill”: Read our full guide to understand your different options, based on side effects, effectiveness, risk factors, cost, and more.

  • Are IUDs safe for teens? Yes, and in fact, IUDs are recommended by experts as one of the safest and most effective forms of birth control. Find out why.

There are two types of copper IUD:

  • Paragard: Paragard was approved by the FDA more than 40 years ago. And for decades, it was the only nonhormonal IUD available. It’s made of plastic, wrapped in copper wire. It’s FDA approved for up to 10 years of use.

  • Miudella: Miudella is a newer copper IUD. It’s made of a highly flexible metal alloy that contains half the amount of copper as Paragard. It comes preloaded in an inserter, which may make it easier for trained healthcare professionals to insert it. Miudella was FDA approved in February 2025 for up to 3 years of use.

Implants

An implant is a small, plastic rod (like a matchstick) that gets inserted under the skin in your arm. There’s only one type: the etonogestrel implant known under the brand name Nexplanon.

The Nexplanon implant slowly releases etonogestrel, a type of progestin. This helps prevent pregnancy in a similar way as a hormonal IUD.

It can stay in place for up to 3 years. Unpredictable vaginal bleeding and spotting is more common with Nexplanon than hormonal IUDs.

IUDs vs. implants: Key similarities

IUDs and implants have many similarities. For example, they:

  • Are very effective (over 99%) at preventing pregnancy 

  • Don’t require maintenance (“set it and forget it”)

  • Don’t affect your ability to get pregnant in the future

  • Are good options for people of all ages, even teens

  • Reduce periods and period cramps (except copper IUDs)

  • Require placement and removal by a healthcare professional, both of which can cause discomfort

It’s important to note that neither IUDs or implants can protect you against sexually transmitted infections (STIs). That means you’ll still have to use preventive measures, like condoms, vaccines, and testing.

IUDs vs. implants: Key differences

IUDs and implants have more similarities than differences. But these are the key differences:

  • Location: An IUD is placed in the uterus, and the implant goes in your arm.

  • Duration: Depending on the type, an IUD can last from up to 8 years (hormonal IUDs) to up to 10 years (nonhormonal IUDs). On the other hand, implants last up to 3 years.

  • Side effects: Because hormonal IUDs and implants both contain hormones, they have unique and similar side effects, including headaches and breast tenderness. The copper IUD has different side effects that include painful or heavy periods, pain during sex, and more.

  • Risk profile: There may be an increased risk in young people (younger than age 25) for an IUD to work its way out of the uterus. This could result in complications or unwanted pregnancy if the person is unaware that the IUD has moved. On the other hand, migration of a hormonal implant is very rare.

  • How long they take to start working: Hormonal IUDs and implants aren’t effective right away. You’ll need to use another form of birth control for the first 5 to 7 days, depending on the type. But a copper IUD is effective immediately.

Implants vs. hormonal IUDs vs. copper IUDs

Implant Hormonal IUDs Copper IUDs
Insertion By a trained healthcare professional By a trained healthcare professional By a trained healthcare professional
Location Upper arm Uterus Uterus
Time to start working 5-7 days 5-7 days Immediately
Duration 3 years 3-8 years 10 years
Side effects
  • Headache
  • Breast tenderness
  • Mood changes
  • Acne
  • Headache
  • Breast tenderness
  • Mood changes
  • Painful menstruation
  • Pain with sex
  • Anemia
Effects to menstruation Unpredictable spotting and bleeding Lighter or no period Heavier or longer period

Frequently asked questions

Do you gain weight on the IUD or the implant?

Any hormonal birth control has the potential for weight gain due to water retention. The risk is usually pretty low. But people respond differently to hormonal birth control methods. That makes it hard to predict who might gain weight and who won’t. Types of birth control without hormones — like a copper IUD — usually don’t cause weight gain.

What should I know about blood clots and IUDs or implants?

You may have heard that hormonal birth control can increase the risk of blood clots. IUDs and implants have a lower risk of this than pills, patches, and shots. But if you have a history of blood clots or clotting disorder, your risk may be different. It’s important to discuss your medical history with your primary care provider or reproductive care team before starting a new method of birth control.

Who shouldn’t get a birth control implant?

Anyone with the following medical conditions or health history shouldn’t get an implant:

  • Ongoing or history of breast cancer

  • History of blood clots or clotting disorder

  • Liver disease

  • Previous reaction to the implant

The bottom line

IUDs and hormonal implants are both highly effective methods of long-acting birth control. There are a few key differences though. These are mainly related to where they’re placed, how long they last, and their side effects. There’s no “best” option overall. But if you’re still not sure, your primary care provider or reproductive care team can help you decide which option is right for you.

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Why trust our experts?

Mandy Armitage, MD
Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.
Sophie Vergnaud, MD
Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.
Christina Aungst, PharmD
Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

References

American College of Obstetrics and Gynecology. (2024). Long-acting reversible contraception (LARC): Intrauterine device (IUD) and implant.

American Sexual Health Association. (2025). There’s a new non-hormonal IUD on the market.

View All References (4)
GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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