A hormonal IUD lasts between 3 and 8 years depending on the brand. The two most widely used models, Mirena and Liletta, are now FDA-approved for up to 8 years. Smaller models with lower hormone doses have shorter lifespans: Kyleena lasts 5 years and Skyla lasts 3 years.
Duration by Brand
All four hormonal IUDs available in the U.S. use the same synthetic hormone (levonorgestrel) but differ in how much they contain and how long they release it effectively.
- Mirena: 8 years. Contains 52 mg of hormone.
- Liletta: 8 years. Also contains 52 mg of hormone.
- Kyleena: 5 years. Contains 19.5 mg of hormone.
- Skyla: 3 years. Contains 13.5 mg of hormone.
Mirena and Liletta are physically larger than Kyleena and Skyla and carry a bigger reservoir of hormone, which is why they last longer. Kyleena and Skyla are the same physical size (28 mm by 30 mm) but Skyla holds less hormone, giving it the shortest lifespan of the four.
How Effective They Are Near the End
A common concern is whether your IUD is still working well in its final year or two. The clinical data on this is reassuring. For Mirena and Liletta, the cumulative failure rate across years 6 through 8 was 0.68%, which is comparable to their failure rate during the first five years. In year 8 specifically, neither Mirena nor Liletta studies reported any pregnancies at all.
The IUD works by slowly releasing hormone into the uterus, thickening cervical mucus and thinning the uterine lining. That release rate does decline over time, but it stays high enough to prevent pregnancy through the full approved duration. By year 8, roughly 34% to 39% of users with Mirena or Liletta still have no periods, a sign the device is actively affecting the uterine lining.
Can You Use It Longer Than Approved?
The 8-year mark for Mirena and Liletta is the limit of what large clinical trials have formally tested. Small studies have followed users out to 10 and even 15 years and suggest the devices may continue working, particularly for people approaching menopause whose natural fertility is already declining. This isn’t a blanket recommendation for everyone, but it’s something worth discussing with your provider if you’re in your mid-40s and your IUD is nearing its expiration.
Both ACOG and the North American Menopause Society recommend continuing contraception until menopause or age 50 to 55. The CDC confirms that patients of any age can safely use hormonal IUDs based on age alone. So if you’re perimenopausal and happy with your IUD, replacement or extended use are both reasonable options.
What Happens When It Expires
Your IUD doesn’t stop working on a single date like a light switch. The hormone tapers gradually. But once you’ve reached the approved duration, the device can no longer be relied on for contraception. If you want to continue using a hormonal IUD, you can have the old one removed and a new one placed in the same visit. There’s no required waiting period between removal and reinsertion.
If you’re done with contraception or want to try getting pregnant, removal is quick. Most people resume their normal menstrual cycle within one to three months, and fertility returns promptly.
Mirena for Heavy Periods
Mirena is also approved to treat heavy menstrual bleeding, not just prevent pregnancy. For this purpose, NHS guidelines recommend it can stay in place for up to 8 years before it needs to be replaced. If you originally got Mirena to manage heavy periods, the same timeline applies. Most people see a significant reduction in bleeding within the first three to six months, and that benefit typically persists for the full duration of the device.