Objective To determine whether users of the non‐fundal levonorgestrel‐releasing intrauterine system (LNG‐IUS) present with unfavorable bleeding patterns more frequently than fundal LNG‐IUS users. Methods A prospective cohort was conducted from June, 2016 to January, 2018 involving women aged 18–45 years who wished to use the LNG‐IUS as contraception and had no contraindications, endometrial polyps, submucosal myomas, irregular menstrual cycle, or anticoagulant use. Two study groups comprised women using fundal insertion and non‐fundal insertion LNG‐IUS. Bleeding was evaluated using a diary and pictogram chart. Results Of the 92 women who participated in the study, those with non‐fundal LNG‐IUS insertion sustained bleeding at rates greater than 83% (31) in the first 3 months of use, and 58% (14) at 6 months, versus 51% (22) at 3 months and 33% (19) at 6 months in those with fundal insertion (P=0.002 at 3 months; P=0.037 at 6 months). Blood loss in the non‐fundal LNG‐IUS group was higher than in the fundal LNG‐IUS group according to pictograms drawn by participants. Conclusion Women with non‐fundal LNG‐IUS placement had a higher frequency of sustained bleeding and blood loss volume according to self‐reported charts than those with fundal LNG‐IUS placement.