What is the Levonorgestrel Intrauterine System (IUS)?

ByTarin Hussain
Updated: 17 Jun 2025, 10:03 am

Levonorgestrel-releasing intrauterine system (LNG IUS) is a hormonal contraceptive that slowly releases levonorgestrel into the uterus to prevent pregnancy. It's mainly used for long-term birth control, emergency contraception, reducing heavy menstrual bleeding, and managing certain uterine conditions. Remember to inform your doctor about all your medical conditions before choosing this hormonal IUS.

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Levonorgestrel-releasing intrauterine system (LNG IUS) is used for long-term birth control and to manage heavy menstrual bleeding. It’s a small, T-shaped plastic device placed in the uterus by a healthcare professional. It releases a hormone called levonorgestrel, a type of progestin, to prevent pregnancy and manage certain health conditions.

In this article:


Choosing this device often means fewer worries about unexpected pregnancies and a more spontaneous lifestyle. Still, it’s important to consider personal health when deciding on any birth control method.


How the Levonorgestrel Intrauterine System (IUS) Works

This device functions by slowly releasing levonorgestrel into the uterus, creating an environment that prevents pregnancy. Take a look at how it works:

  • Thickens cervical mucus: This creates a barrier that stops sperm from reaching or fertilising an egg.
  • Affects sperm function: The hormone makes it harder for sperm to survive or move effectively in the uterus.
  • Thins the uterine lining: This reduces the chance of a fertilised egg implanting.
  • Prevents ovulation: LNG IUS partially stops the release of eggs from the ovaries in some users.


Uses of Levonorgestrel Intrauterine System

This hormonal IUS primarily serves as a contraceptive, but it also helps with specific health conditions. Its key uses include:

  • Long-term birth control: Prevents pregnancy for up to eight years. It is ideal for those seeking a reliable, non-surgical option.
  • Heavy menstrual bleeding: Reduces heavy periods for up to five years, often prescribed for those with excessive bleeding.
  • Management of uterine conditions: Helps with issues like endometriosis (where uterine tissue grows outside the uterus), endometrial hyperplasia (abnormal uterine lining growth), adenomyosis (uterine lining growing into the uterine muscle), and fibroids (non-cancerous uterine growths).
  • Pain relief: Eases severe menstrual cramps and pain associated with conditions like endometriosis.
  • Anaemia treatment: Supports those with anaemia caused by heavy menstrual bleeding by reducing blood loss.
LNG IUS is suitable for individuals assigned female at birth (including teenagers) who haven’t reached menopause. It can also be used while breastfeeding, though there’s a higher risk of uterine tearing during its insertion in breastfeeding individuals.


Benefits of Levonorgestrel Intrauterine System

LNG IUS is more than just a birth control option. Some of its main benefits are:

  • Long-lasting: Stays effective for up to eight years without needing replacement.
  • Non-invasive: A non-surgical method that doesn’t require daily attention or interruption during sexual activity.
  • Independent birth control: Offers autonomy in birth control as it doesn’t rely on a partner’s involvement.
  • Reversible: Can be removed at any time, with fertility returning soon after.
  • Reduces health risks: Lowers the risk of pelvic infections and endometrial cancer.
  • Improves menstrual symptoms: Many users experience lighter periods after three to six months, with about 20 per cent stopping periods entirely after a year.


Who Should Not Use the Levonorgestrel Intrauterine System

LNG IUS isn’t suitable for everyone. You should avoid it if you have certain conditions or circumstances:

  • Pregnancy: Not safe if you’re pregnant or planning to conceive.
  • Cancer: Contraindicated if you have or have had breast, uterine, or cervical cancer, as these may be hormone-sensitive.
  • Infections: Not advised if you have active pelvic inflammatory disease (PID), recent uterine infections post-pregnancy or abortion, or a high risk of sexually transmitted infections (STIs).
  • Uterine abnormalities: Conditions like fibroids or structural issues that affect IUS placement make LNG IUS unsuitable.
  • Unexplained vaginal bleeding: Should be investigated before using this IUS device.
  • Liver issues: Avoid if you have liver disease or tumours.
  • Existing IUS: Another IUS must be removed before the LNG IUS can be inserted.
  • Allergies: Not suitable if you’re allergic to levonorgestrel or any LNG IUS components.
Always share your full medical history with your healthcare professional, including conditions like diabetes, high blood pressure, heart issues, migraines, or blood clotting problems, to make sure the LNG IUS is safe for you.



How the Levonorgestrel Intrauterine System is Inserted

The LNG IUS insertion process is performed by a healthcare professional, typically in a clinic or hospital. These are the steps you can expect:

  • Preparation: Your doctor will conduct a pelvic exam and may screen for STIs or pregnancy. You might take a painkiller like ibuprofen beforehand to reduce cramping.
  • Procedure: A speculum is used to open the vagina, which is cleaned with an antiseptic. The cervix is stabilised, and the uterus is measured for size and shape. IUS’s arms are folded, and it’s placed into the uterus via a tube through the cervical canal. The tube is removed, and the IUS’s strings are trimmed to an appropriate length for later checks.
  • Sensations: You may feel cramping, dizziness, or a slower heart rate during insertion.
IUS starts working immediately if inserted during your menstrual cycle. If placed more than seven days after your period starts, you’ll need backup birth control for a week.


Aftercare and Monitoring

Post-insertion care is important to ensure the IUS remains effective and safe:

  • Follow-up check: About a month after its insertion, your healthcare professional may perform a pelvic exam to confirm its position and check for infections.
  • Self-checks: You may be asked to feel for its strings monthly to check if it’s in place.
  • When to contact your doctor: Reach out to your doctor if you experience heavy or prolonged bleeding, pelvic pain, pain during intercourse, fever, unusual vaginal discharge, severe headaches, yellowing of the skin or eyes, or suspect pregnancy. Also, contact them if you can’t feel the strings, they feel longer, or you feel part of the device itself.





Removal of Levonorgestrel Intrauterine System

IUS removal is a straightforward process, but it must be done by a healthcare professional:

  • The doctor grasps the hormonal IUS’s strings with a gloved hand or forceps and gently pulls. The device’s arms fold upward as it’s removed.
  • You may experience light bleeding or cramping during removal.
  • Rarely, removal may be difficult, potentially requiring special imaging or surgery to locate and extract the device.
Fertility usually returns quickly after removal, allowing you to plan for pregnancy if you wish.


Risks and Side Effects Of Levonorgestrel Intrauterine System

LNG IUS is generally safe, but it carries some risks and side effects:

Common Side Effects

  • Irregular bleeding or spotting, especially in the first three to six months.
  • Stomach or pelvic pain.
  • Headaches or migraines.
  • Vaginal discharge or inflammation (vaginitis).
  • Ovarian cysts, which may cause bloating or pain, but often resolve on their own.
  • Amenorrhoea (absence of periods).
  • Acne or breast soreness.
  • Mood changes.

Serious Risks

  • Uterine perforation: Rarely, the IUS may pierce the wall of the uterus or become embedded in it. The risk of perforation is slightly higher if it is inserted soon after childbirth or while you are breastfeeding.
  • Expulsion: The IUS may come out on its own, increasing pregnancy risk. This is more likely if you’ve never been pregnant, have heavy or long periods, severe menstrual pain, are below the age of 20, or have had an LNG IUS inserted post-delivery.
  • Infections: There’s a small risk of pelvic inflammatory disease or sepsis shortly after its insertion, particularly if bacteria enter during the procedure.
  • Ectopic pregnancy: If you become pregnant while using an LNG IUS, there is a higher chance that the pregnancy will occur outside the uterus, usually in a fallopian tube. This is called an ectopic pregnancy and can be life-threatening if not treated. However, the overall risk of ectopic pregnancy is low because this IUS is highly effective at preventing pregnancy.
  • Severe allergic reactions: Symptoms like swelling, breathing issues, or hives require immediate medical attention.

Levonorgestrel Intrauterine System Price

The cost of an LNG IUS in India ranges between Rs 15,000 and Rs 25,000, depending on the hospital or clinic you choose. It's a good idea to check with your healthcare professional for a complete estimate before proceeding.


Precautions and Guidelines

It’s important to know a few key points when using LNG IUS:

  • Medications: Inform your doctor about all medicines, especially blood thinners, as well as supplements or herbal products.
  • No food or drink interactions: This hormonal IUS isn’t affected by food or alcohol.
  • Backup contraception: Use condoms or any other form of birth control if the IUS is inserted outside your menstrual cycle or if you suspect it’s out of place.
  • STI protection: It doesn’t protect against STIs.
  • Discuss any history of heart problems, stroke, high blood pressure, or immune system issues with your doctor to confirm if it is suitable for you.
Levonorgestrel-releasing intrauterine system is a highly effective, long-term contraceptive option that also helps manage heavy menstrual bleeding and related conditions. However, it’s not suitable for everyone, and careful monitoring is important to address potential risks like expulsion or infection.


FAQs on What is the Levonorgestrel Intrauterine System (IUS)?

  1. How does the levonorgestrel intrauterine system prevent pregnancy?
    It releases a hormone called levonorgestrel that thickens cervical mucus, weakens sperm, thins the uterine lining, and sometimes stops ovulation, all of which help prevent pregnancy.
  2. Who should avoid using the levonorgestrel intrauterine system?
    People who are pregnant, have certain cancers, active infections, uterine abnormalities, liver disease, or allergies to the device should avoid using it.
  3. Does the levonorgestrel intrauterine system protect against sexually transmitted infections (STIs)?
    No, it does not provide any protection against STIs.
Disclaimer: Medically approved by Dr Rubina Shanawaz Z, Senior Consultant, Uro-Gynaecology, Gynaec-Oncology, Robotic Surgery, Fortis Hospital, Cunningham road