Contraceptive Pearl: IUD Duration

How long do IUDs remain effective? After the FDA approved the progestin (Mirena) and copper (Paragard) IUDs further studies supported two extra years of use for each device.

The FDA approved the 52-mg progestin IUD (Mirena) for five years of use. In a study conducted at five sites, the progestin IUD remained highly effective up to seven years after insertion. This study monitored 897 women using the progestin IUD. 172 women continued use past year five. No pregnancies occurred in year six or seven.

The FDA approved the copper IUD (Paragard) for 10 years of use. According to a 1997 study, the copper IUD remains highly effective up to 12 years after insertion. This multicenter trial enrolled a total of 4,673 women using the copper IUD. The culmulative 12-year failure rate was 2.1-2.8%.

If your patient wants to keep their Mirena or copper IUD beyond the FDA-approved limit, evidence supports continuing use for two extra years.

Liletta, a new IUD, also contains 52-mg of progestin. While it is FDA approved to protect against pregnancy for three years, it makes sense biologically that it will be effective as long as Mirena. A recent study confirmed it is effective up to five years.  We have every reason to believe that Liletta will have efficacy for seven years and await further studies for confirmation.

The 13.5-mg progestin IUD (Skyla) is FDA approved to protect against pregnancy for three years. At this time, no studies have researched efficacy beyond this duration.


Helpful Resources

IUD Fact Sheet

Copper IUD User Guide 

Progestin IUD User Guide

Patient Assistance Program for Mirena/ Skyla IUD

Patient Assistance Program for Paragard IUD

Patient Savings Program for Liletta 


Coutinho E, Sivin I, Stern J Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 mcg/day (LNg 20) and the Copper T380 Ag IUDs. Contraception. 1991; 44(5): 473-480. 

Hatcher RA, Zieman et al. A Pocket Guide to Managing Contraception. Tiger, Georgia: Bridging the Gap Foundation, 2016.

Long-term reversible contraception. Twelve years of experience with the TCu380A and TCu220C. Contraception. 1997; 56(6): 341-52. 

Pickle S, Wu J. Extended use of the intrauterine device: a literature review and recommendations for clinical practice. Contraception. 2014; 89(6): 495-503.

Creinin, M, Jansen R et al. Levonorgestrel release rates over 5 years with the Liletta 52-mg intrauterine system.  Contraception. 2016


The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.