Article produced in association with Spital Clinic

Both the copper coil and the Mirena are more than 99 per cent effective as contraceptives — but they work in completely different ways, have opposite effects on periods, and suit very different people.

With the FSRH’s May 2024 licence extension for the Mirena now in effect, this guide covers the five key differences using up-to-date UK evidence, not the older guidance that many sources still repeat.

How Each Device Works

The FSRH March 2023 guideline set out the terminology now used across UK clinical practice: the copper intrauterine device (Cu-IUD) and the levonorgestrel intrauterine system (LNG-IUD).

The copper coil works by releasing copper ions that are toxic to sperm, preventing fertilisation. It contains no hormones at all, making it a strong option for women who cannot or do not want hormonal contraception.

The Mirena — the most widely prescribed 52mg LNG-IUD in the UK — thickens cervical mucus to block sperm, thins the uterine lining, and may suppress ovulation, though most users continue to ovulate normally.

According to Hull University Teaching Hospitals NHS Trust, the hormone levels it produces are lower than those from the combined contraceptive pill — relevant for women advised to avoid higher-dose hormonal methods.

The hormone-free nature of the Cu-IUD is its defining advantage for some; the localised hormonal action of the LNG-IUD is its defining advantage for others.

According to NHS guidance on the copper coil, neither device interacts with medicines or herbal remedies, and both can be fitted in women who have never been pregnant.

The way each device works also determines what it does to periods — often the deciding factor.

Effectiveness and Duration

The NHS confirms both devices prevent pregnancy in more than 99 per cent of users. When it comes to contraceptive effectiveness, there is no meaningful difference between them.

Where they differ significantly is duration. The copper coil lasts up to 10 years, and one fitted in a woman aged 40 or over can remain in place until menopause under FSRH March 2023 guidance.

For the Mirena, the picture changed in May 2024: the FSRH CEU statement on extended LNG-IUD use confirmed that all 52mg LNG-IUDs — including the Mirena, Levosert, and Benilexa — are now licensed for eight years of contraceptive use, up from five under previous guidance.

When the Mirena is used as part of HRT, it protects the uterine lining for up to five years before requiring replacement. Smaller-dose devices such as Kyleena (20mcg) are licensed for five years, and Jaydess for three.

Both are long-acting reversible contraceptives — fertility returns immediately after removal, with no delay or washout period. Both are available without a GP referral through the coil insertion and removal service at Spital Clinic.

What Each Device Does to Periods

The most important practical difference is what each device does to periods — and they go in opposite directions.

The copper coil typically makes periods heavier, longer, and more painful; the NHS notes this may ease after a few months, but heavier bleeding is one of the most common reasons for early removal.

Both devices can cause irregular spotting in the first three to six months after fitting.

The Mirena does the opposite.

According to Hull University Teaching Hospitals NHS Trust, it reduces monthly blood loss by 86 per cent at three months and by 97 per cent at twelve months.

Nine in ten women who use it for heavy periods see a significant reduction; around 20 per cent have no bleeding at all; and 80 per cent report meaningful pain relief.

NHS information on the hormonal coil confirms that periods often become lighter, shorter, and less painful — with many users finding they stop entirely after the initial settling-in period.

For women whose choice of contraception is being shaped by troublesome periods, those statistics make the direction of the decision clear.

For women with already disrupted cycles, it is worth booking a private specialist assessment before deciding — for this group, the choice of coil is as much a treatment decision as a contraceptive one.

Unlike the copper coil, the Mirena is licensed as a first-line treatment for menorrhagia — heavy or prolonged bleeding defined as losing more than 80ml per cycle or periods lasting longer than seven days.

In around half of cases, heavy periods have no identifiable structural cause, making the Mirena’s targeted local action particularly useful: it reduces bleeding at the endometrial level without surgery, general anaesthesia, or high-dose systemic hormones, and offers a non-surgical alternative to procedures such as endometrial ablation.

Side Effects, Risks, and Who Cannot Use Each Device

Both devices carry the same procedural risks. Pelvic infection affects around 1 in 100 women in the first three weeks; expulsion happens in roughly 1 in 20; and uterine perforation occurs in approximately 2 in 1,000 fittings — slightly higher in women breastfeeding within six months of delivery. Ectopic pregnancy, though rare, is a risk if either device fails.

The side-effect profiles diverge beyond those shared risks.

The copper coil carries no hormonal side effects — heavier periods are its main downside. The

Mirena may cause acne, headaches, mood changes, breast tenderness, and ovarian cysts; most resolve without treatment, but they are worth considering for anyone sensitive to progestogen.

The Mirena is also unaffected by vomiting, diarrhoea, or most drug interactions.

Each device has its own contraindications. Neither should be fitted in the presence of an active sexually transmitted infection or unexplained uterine bleeding.

The Mirena is not suitable for women with a history of breast cancer, certain liver conditions, serious cardiovascular disease, or certain uterine abnormalities.

The copper coil, meanwhile, can be used as emergency contraception if fitted within five days of unprotected sex — the only intrauterine option for post-coital protection.

The Fitting Procedure and What to Expect

The fitting procedure is the same for both devices: a 10 to 15 minute clinical appointment, ideally towards the end of a period, though it can happen at any point in the cycle.

The full appointment takes around 30 minutes. Local anaesthetic gel or spray is used to manage discomfort, and the NHS advises taking ibuprofen or paracetamol about an hour beforehand.

No surgery or general anaesthetic is needed. Some cramping and light spotting in the days after fitting is normal and usually settles within a week. Neither device requires you to have had children previously.

Fertility returns immediately after removal of either device — there is no waiting period before trying to conceive.

For most women, the choice between the copper coil and the Mirena comes down to one question: are hormones acceptable or not?

The copper coil suits women who want hormone-free contraception, those who cannot use progestogen, and those who need emergency post-coital protection.

The Mirena suits women who want lighter or absent periods, those managing menorrhagia, and those using it as the progestogen component of HRT.

Both offer equivalent contraceptive effectiveness and full reversibility.

The FSRH’s May 2024 extension of the Mirena’s licence to eight years makes it a stronger long-term option than many comparisons suggest — worth knowing if the information you have found is based on older guidance.

This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published NHS and FSRH standards as at March 2025. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article.

This piece was produced in association with Spital Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

By Con Raso, managing director, Tuned Global

Music and movement are neurologically intertwined. Tempo influences pace, rhythm supports endurance, and familiar tracks can reduce perceived exertion.

Beyond physiology, music creates shared moments. It sets the atmosphere, builds anticipation and turns individual activity into collective experience.

For sports, wellness and fitness brands, this means music selection needs to align with brand values, customer experiences and emotional outcomes.

Well-chosen music increases workout intensity and duration, improves customer retention, strengthens brand recognition, creates community and cultural relevance, and opens new partnership models.

When delivered through properly licensed, data-informed systems, these outcomes become measurable and scalable.

Music also gives brands a way to stay culturally connected to their audience. The question for operators is how to use music strategically and legally.

This is especially important because the way brands approach music has changed significantly.

Early adoption in wellness, fitness and leisure centres often meant plugging in a Spotify playlist and hoping for the best.

Today’s leading sports and fitness innovators are far more sophisticated, curating music experiences that are brand-led, data-informed, tailored to specific audiences and workouts and fully licensed for commercial use.

This shift is being powered by specialist music technology platforms like Tuned Global, which works behind the scenes with brands to manage licensing, catalogue access, analytics and distribution at scale.

Rather than forcing sports brands to become music experts, these platforms allow them to offer legally compliant music in commercial environments, control curation across locations or content formats, and adapt music to different activities and intensities.

Through advanced APIs and centralised cloud infrastructure, operators can manage licensing, catalogue access and music governance at scale, while maintaining full creative control.

They also provide the reporting required by rights holders and integrate music into apps, devices, wearables and connected platforms. The result is music that feels intentional, on-brand and deeply embedded in the experience.

Music in action

Lululemon Studio and Mirror: At-home Fitness and Health

When Lululemon acquired Mirror, it marked a shift towards fully connected, at-home fitness where content, coaching and atmosphere converge.

Music plays a key role in making those workouts feel immersive and motivating, especially without a physical studio or shared space.

Instructors needed access to curated, commercially licensed music delivered consistently across live and on-demand workouts, while remaining compliant with music rights regulations.

Tuned Global provided Lululemon Studio with a branded playlisting app solution that enabled instructors to curate fully licensed music tailored to each workout.

Drawing from a licensed commercial catalogue and supported by usage reporting to rights holders, the system ensured compliance while giving instructors the flexibility to design high-energy, brand-aligned sessions.

The result was a seamless blend of movement, coaching and sound that makes digital workouts feel immersive and premium.

Psycle London: Performance Led Experiences

                     Con Raso

Boutique fitness studio Psycle London has built a loyal following by transforming workouts into performance-led experiences where music is central to the brand.

Each class is choreographed to sound, with instructors designing sessions that build emotional peaks and sustained intensity.

As Psycle expanded its digital and on-demand offering, it needed a way to give more than 70 instructors access to fully licensed commercial music while protecting the business from legal and reputational risk.

Tuned Global delivered a branded playlisting app that enabled Psycle’s instructors to search a cleared commercial catalogue by artist, genre or BPM, preview full tracks and build tailored playlists for classes ranging from high-intensity rides to strength and conditioning.

Behind the scenes, the music is delivered through secure API infrastructure integrated into Psycle’s own platform, with automated reporting to rights holders and support across label and publishing negotiations.

By combining creative flexibility with licensing governance, Psycle were able to scale its music-led experience across studio and digital environments without compromising on brand integrity, compliance or operational control.

Steezy: Movement and Music

Steezy, one of the world’s leading online dance platforms, sits at the intersection of sport, movement and music.

For dancers, music is not background sound. It defines timing, style and expression.

As Steezy scaled internationally, music became both its greatest asset and its biggest operational challenge. Delivering classes built around commercial tracks created both operational complexity and significant licensing risk.

Tuned Global provided the licensed music catalogue delivery infrastructure that enabled Steezy instructors to search a cleared catalogue, curate playlists tailored to specific classes, and prepare sessions using full commercial tracks.

The system ensured that music used across Steezy’s app and desktop platform was properly licensed and reported to rights holders, supporting global expansion without exposing the business or its creators to legal liability.

By combining instructor-friendly tooling with robust licensing governance, Steezy was able to continue growing its international dance community while keeping music at the centre of the experience.

A wider wellness ecosystem

For wellness, sports, fitness and leisure operators considering deeper music integration, a few principles stand out.

First, treat music as a product feature. It should support the outcome you want, whether that is higher intensity, calm recovery, emotional connection or brand recognition.

Second, get licensing right from day one. Using consumer streaming services in commercial environments exposes brands to legal and reputational risk.

For example, In 2019, more than 20 music publishing groups filed a $150 million copyright lawsuit against Peloton, alleging the company used more than 1000 unlicensed songs in its workout videos.

In another example, just last year the Federal Circuit and Family Court of Australia ordered a Sydney gym chain owner and five of his companies to pay more than $235,000 in damages and interest after operating multiple locations without a valid OneMusic licence.

Third, give creators freedom while maintaining brand control. Instructors, coaches and athletes bring personality, so give them tools to curate music safely within brand guidelines.

Last but not least, use data to refine the experience.

Track how music impacts engagement, completion rates and retention, because music is measurable. Finally, think cross-platform.

Your music strategy should work across physical venues, mobile apps, connected devices and on-demand content. Consistency builds trust.

What’s ahead for music as a performance tool

Music in wellness will become even more adaptive. As AI, biofeedback and real-time analytics become more embedded in fitness technology, music will increasingly respond dynamically to heart rate, pace or emotional state.

Early implementations in health and performance environments are already demonstrating how adaptive music can optimise outcomes.

As wearable technology and connected fitness continue to evolve, music will play an increasingly central role in shaping personalised experiences.

The infrastructure choices operators make now will determine how easily they can adopt these capabilities later. Those who invest early in licensed, data-informed music systems will be best placed to innovate without risk.

Music is a performance tool, a brand asset and a powerful lever for engagement. The examples above show that this applies at every scale, from a single boutique studio to a global combat sports brand.

The most successful innovators understand that when music and movement align, something special happens. With the right technology and licensing in place, that can scale.

About Con Raso, Managing Director of Tuned Global

Con Raso is an entrepreneur passionate about innovation, new technologies, and start-ups.

Over the last few decades he has focused on creating innovative mobile and online distribution models within the B2C entertainment market, enabling brands to utilise music as a marketing tool, via unique customer engagement strategies.

Being inherently well-versed in both technology and music, Con ensures our solutions are aesthetically pleasing, engaging and disruptive.

About Tuned Global

Tuned Global is the leading data-driven Cloud Music Platform that empowers businesses to integrate commercial music into their apps or launch complete streaming experiences using advanced APIs, real-time analytics, licensing solutions, music intelligence and customisable white-label apps.

Our turnkey solutions for music, audio, and video, coupled with a broad ecosystem of third-party music tech integrations, make us the most comprehensive platform for powering digital music projects.

We streamline complexities in licensing, rights management, content delivery and music discovery, enabling rapid innovation and bringing new ideas to life.

Since 2011, we’ve supported 40+ companies in 70+ countries — across telecom, fitness, media, aviation, and more — to deliver innovative music experiences faster and more cost-effectively.

For more information, visit www.tunedglobal.com.

To mark International Women’s Day, Women’s HealthX released a new eBook exploring one of the biggest challenges in healthcare today: the sex difference data gap.

Women’s HealthX spoke with leading voices from Mass General Brigham, NYC Health + Hospitals, GSD Health Research and WomanCentered to explore how the healthcare industry can close the sex difference data gap and build a more equitable healthcare system for women.

In this special interview series, they share recommendations for the industry to ensure women are properly represented in research, data, and care.

What you’ll gain from reading this eBook:

• Ways we can work towards closing the sex difference data gap in healthcare research

• The biggest barriers preventing women from accessing equitable care

• The innovations that could transform women’s health in the next decade

• How digital health can expand access to care

• What meaningful allyship looks like in healthcare leadership

• How women can advocate for their health in clinical settings

• The changes experts believe the healthcare industry must make now

Register for the event to download the eBook for free here.

Registration is free for all our end users in pharma and biotech, hospitals, insurers, enterprises and policy makers.