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National Health Service (NHS) funding is a continuing challenge and financial savings are necessary in all areas including sexual and reproductive healthcare (SRH). However, aside from this common focus, the environmental costs of healthcare must be considered, given the scale of the climate emergency and the fact that the NHS has committed to delivering net zero care.1 We implemented an initiative in our service in South East Wales to assess the financial and environmental costs of 52 mg levonorgestrel-containing intrauterine devices (LNG-IUDs) and we encourage others to do the same.