Hormonal IUD
A small device placed in the uterus. Mirena and Kyleena are included.
Your cycle & contraception
Prevent pregnancy, manage difficult periods, or both. Explore the options, compare everyday use and find an approach that fits your health and plans.
Start with a type of contraception below, or compare two methods side by side.
Approaching menopause? HRT does not prevent pregnancy, and hormonal contraception can hide your natural period pattern. Read when contraception can stop and how HRT fits, or return to the menopause overview.
A consultation brings your contraceptive goals and symptoms into the same discussion.
Start with the type of method
Open a guide to explore the method and choose a product. These are options to discuss, not a recommendation for you.
A small device placed in the uterus. Mirena and Kyleena are included.
A device placed in the uterus, without hormones.
A small rod under the skin of the upper arm.
Taken every day. Explore the pill type and your exact brand.
Contraception given at repeat appointments.
A patch worn on the skin, changed on a weekly schedule.
A flexible ring placed in the vagina and used on a schedule.
Used for each act of sex. Also help reduce the risk of STIs.
This guide covers the methods illustrated here. A consultation can also discuss other options, including permanent contraception.
Practical choices
Compare the routines and effects that matter to you.
Perfect and typical use over the first year · general estimates, not an individual prediction. Injectables and IUDs use SA July 2026 class estimates; other methods use their linked references.
Swipe or scroll sideways to see all columns →
| Method | Perfect use | Typical use | Duration or routine | Return of fertility | Explore |
|---|
Same first-year estimates and denominator as the paired comparison. Open a card’s source notes for its population and reference. Rows summarise method families using the displayed product examples; duration and routine are product-specific. This table covers the methods illustrated above, not every contraceptive option.
Some hormonal methods can help with heavy bleeding or period pain. The right approach depends on the cause of your symptoms, your health and whether you also need contraception. A consultation can explore these together.
Read more about heavy or irregular bleeding, painful periods, endometriosis and adenomyosis. If irregular cycles or acne are part of your concerns, see the PCOS guide.
Then compare each method’s bleeding effects and benefits with your own priorities.
Think about what works well, what bothers you and what matters now: bleeding, side effects, daily routine or future pregnancy plans. Compare options, then discuss a starting or switching plan for your circumstances.
For spotting or a changed bleeding pattern, read bleeding while using contraception. If you need ongoing pregnancy prevention, check how to switch without a gap in protection before stopping your current method.
Considering an IUD? Its guide explains insertion, discussing pain relief and aftercare.
Emergency contraception · South Africa
Contact a pharmacist or clinic today. You do not need to know your ovulation day. Tell them about all episodes of unprotected sex and any missed contraception.
Follow the changes
A biological explanation, not a calendar for choosing treatment. Time since sex and cycle stage are separate.
At the selected day
What is in this pack?
Numbering starts with the first active tablet in an established-use sequence. Display colours identify hormone stages; use your actual pack and leaflet for tablet order, starting or switching.
These are formulation differences, not a ranking of suitability or effectiveness. Different hormones cannot be compared by milligram amount alone.
How the body usually responds
OvaryOvulation usually suppressed
Uterine lining
Cervical mucusThicker; sperm passage reduced
Relative hormone patterns · Each hormone has its own illustrative scale. Compare timing, not heights.
Full timeline · tap to choose a day.
FSH supports follicles; the LH surge precedes egg release.
Next cycle → Without pregnancy, hormone levels fall and the next period starts a new cycle.
Separate from tissue thickness
One invented example; marks do not predict your bleeding dates or amounts.
Discharge may become clearer and more slippery before ovulation. Your pattern may differ.
The drawn sperm demonstrate passage through mucus; they are not always present. This illustration does not identify fertile or safe days.
GnRH from the hypothalamus coordinates pituitary FSH and LH. Its rapid pulses are not plotted against a day-scale axis here.
Clinically reviewed by Dr Jan Adlam · 6 October 2026.
Named combined-pill packs use South African professional information from SAHPRA or the local manufacturer. Evra, NuvaRing, Mirena and Kyleena use linked South African PIs; injection intervals and Implanon NXT duration use South African national guidance. POP formulation examples are labelled where a local brand has not been verified. CDC, WHO and FSRH supply additional mechanism, bleeding and effectiveness context. Restart guidance after ulipristal follows CDC 2024; the older local ella PI has different wording.
About the illustrations. Graphs are illustrative shapes, not laboratory data, a pharmacokinetic simulation or a validated pregnancy-risk model. They do not select a suitable method for an individual.
Natural examples place ovulation 14 days before the next cycle. Combined methods use treatment days, with the selected regimen determining the break. Named pills show the documented pack sequence with locked ingredients and regimen. Generic teaching examples are separate and do not identify South African products. The generic 84/7 view shows the full 91-day regimen; its optional natural reference repeats a 28-day example. DMPA and NET-EN display their 12- and 8-week reinjection intervals. Implant views show a 28-day teaching interval within longer use, not a monthly biological cycle. Traditional pills and hormonal IUDs offer explicit ovulatory and non-ovulatory examples.
All pill-omission scenarios leave the response unpredicted from the first omitted tablet to the end of the displayed pack. This is a limit of the illustration, not a duration of additional precautions or a prediction of contraceptive failure. Local product instructions are linked separately. Emergency graphs never assign a post-dose hormone trajectory or period date. A separate follicle illustration can explain a hypothetical delay without shifting the whole cycle. Cyclic combined regimens illustrate a usual withdrawal bleed. Its exact onset, duration and amount are not individual predictions. A separate bleeding strip offers menstrual, withdrawal, spotting and absent-bleeding examples as appropriate. Its marks are invented teaching patterns, never observed probabilities or predicted dates. Cervical mucus changes gradually through a blended transition illustration; its texture is not a microscopic measurement. Ovarian snapshots start with an antral cohort whose development began months earlier. The LH peak precedes release in this illustration; hormone shapes, the lag and stage boundaries are schematic. A functional corpus luteum is shown around the mid-luteal progesterone peak, with regression later if pregnancy does not occur.
Hormone graphs use independent illustrative scales. They show a late-cycle FSH rise, an oestrogen peak before the LH peak, and a mid-luteal progesterone peak. No numerical hormone trajectory is assigned to uncertain responses or suppressed ovarian activity. Grey comparisons are labelled natural examples; an emergency reference ends with the original cycle. Dose steps mark the beginning of a treatment day and use the stage lengths and relative ingredient doses of the referenced pack examples. Drug input is not a blood concentration curve.
The optional date helper counts calendar days from entered period or current treatment-start dates. Three period starts yield two observed intervals; an arithmetic average, rounded to a whole day, can select a 24–38-day illustration. Dates do not confirm ovulation or cycle phase. Counts continue beyond an expected cycle length without an automatic restart. Dates stay in the current tab unless “Remember on this device” is chosen; they are separate from shared or saved teaching views and excluded from printouts.
Endometrial stages distinguish shedding and repair, proliferative growth and secretory differentiation. Glands are pale epithelial-lined tubes; red vessels are separate. The basalis remains through menstruation, above the underlying myometrium. Late-secretory tissue is retained until breakdown rather than drawn as a fixed premenstrual collapse. Hormonal-method images are examples of tissue response, not biopsy or bleeding predictions; cyclic combined regimens illustrate withdrawal bleeding around the planned break. Timing and absent-bleeding patterns vary by formulation; Zoely also highlights absent withdrawal bleeding as a recognised pattern.