Intrauterine Devices (IUD) and Long Term Contraception.

An intrauterine device is a small contraceptive device that is inserted into the uterus (womb) to prevent pregnancy. In Australia, we have two types:

The Copper IUD – is a small plastic and copper T-shaped device, which constantly releases a small amount of copper into the uterus from its stem. It is designed to stay in place for up to 10 years and is a non-hormonal option. 

The Progesterone IUD –called Mirena, is a small plastic T- shaped device, which slowly releases Progestogen into your uterus from its stem. The Mirena is designed to stay in place for 5 years. 

IUD’s works by:

• Stopping the sperm from fertilising the egg by changing cervical mucous and motility

• Changes the womb’s lining or endometrium making it hard for an egg to attach

IUD’s do not give protection against sexually transmitted infections, so it is important to continue to practise safe sex with IUD contraception. 

Advantages to both Mirena and Copper IUD’s:

• Effective long term contraception

• Fertility returns to normal as soon as they are removed

• Medications do not stop them from working

• Safe to use whilst breastfeeding

• Can easily be removed sooner than expected if needed

• No contraception is 100% effective but both IUD’s are more than 99% effective 

Advantages of the Mirena:

• Menstrual periods may be less painful

• Usually patients will only have a light regular period or no vaginal bleeding at all

Advantages of Copper IUD:

• A good choice if patients don’t want to use hormonal options

Side Effects with a Mirena:

• With initial insertion, some patients have period like cramping which takes a few days to settle

• Spotting or frequent bleeding is common in the first few months following insertion. By 6 months, 95% of users will have a light regular period or no bleeding at all

• Women can experience, headaches, mood changes, tender breasts which need time to settle. It has not been shown to cause weight gain, but may increase hunger. 

• Mirena may not be a good option if you have been treated for breasts cancer or liver disease

Side Effects with Copper IUD:

• Heavier periods

• Spotting or frequent bleeding in the first few months, but this usually settles with time – may not be a good option if you have low iron levels, endometriosis or heavy periods

At An IUD Consultation:

You will have a discussion about the IUD and have your questions answered, from the information you have been given. The procedure takes less than 30 minutes. Similar to a Cervical Screening Test, a speculum will gently, be inserted into the vagina so the cervix can be seen, and the IUD is then inserted into the uterus. You will be given time after the procedure to rest and make sure you feel fine to continue on with your day. Some women require Panadol and water post procedure before leaving the consulting rooms. 

Following the Insertion of an IUD:

• Organise a lift home after your IUD insertion, in case you feel uncomfortable to drive. 

• Avoid sexual intercourse, tampons, swimming and baths for 48 hrs to reduce the risk of infection

• You may need warm pack and Panadol to alleviate period like cramps in the first few days

• Check in if you have any concerns regarding side effects following insertion particularly in the longer term such as deep pain with intercourse, unusual vaginal discharge and lower abdominal pain

• Keep a record of you insertion date, as it shouldn’t stay in longer than recommended