Patients in the USA may choose between copper- and levonorgestrel (LNG)-containing intrauterine contraception (IUC): the CuT380A intrauterine device (IUD), two formulations of the LNG-52 intrauterine system (IUS), the LNG-19.5 IUS, and the LNG-13.5 IUS. IUCs continue to be the most popular reversible method of contraception worldwide. All available devices offer effective, reversible, long-term contraception. The copper and LNG IUCs each manifest a unique profile of benefits and side effects. Patients using the copper IUD generally maintain their menstrual cycles but may experience increased menstrual bleeding. Individuals who use an LNG-IUS experience endometrial suppression, which results in an alteration of bleeding patterns; many users of the LNG-52, LNG-19.5, and LNG-13.5 will become amenorrheic within 1 year (20%, 12%, and 6%, respectively). IUCs are as effective as permanent sterilization but are easily reversible. Clinicians can encourage their use among all patients, including adolescents, nulliparous individuals, and those with more complex medical conditions. The LNG-52 is an effective method for the management of heavy menstrual bleeding. Following IUC removal, fertility returns quickly at rates comparable to the general population.