IUDs Overview: Types, Insertion and Replacement Procedures, and After-Care

IUDs are some of the most reliable and effective forms of contraception available. They are gaining in popularity in Australia, and in Europe they are the most popular form of contraception because of the low risk of side effects, the ease of use, and their reliability.

What is an IUD?

IUDs are a Long Acting Reversible Contraceptive (LARC) which are recommended by the WHO, family planning associations, and all doctors who specialise in reproductive health and medicine.

IUDs benefit from being a set-and-forget form of contraception, as they are inside the body and do not need to be regularly maintained or require taking tablets on a regular basis.

There are 2 main types of IUD: hormonal and non-hormonal.

Hormonal IUDs

A hormonal IUD is a small plastic device that has a tiny amount of slow-release progesterone (Levonorgestrel) impregnated in the stem. Once inside the uterus, the hormonal IUD creates an environment which is not conducive for accommodating a pregnancy. It suppresses the lining of the uterus, so a woman’s menstruation (periods) will also become very light or absent. This is of great appeal to some women, although if you like to see a regular period, this may not be a suitable contraceptive for you, as it is likely that it will substantially reduce or remove your regular menstrual cycle.

If you have heavy periods and want reliable contraception, it is the perfect choice.

The hormonal IUD lasts for 5 years, after which time it can easily be replaced. It is very popular for women in their 40s or women who are perimenopausal, as it can also can contribute to hormone replacement for a woman who is struggling with symptoms of menopause.

Non-Hormonal IUDs

The non-hormonal IUD contains a small amount of copper. There are three different designs which can last either 5 years or 10 years. The non-hormonal IUD contains no hormones at all, and so will not reduce menstruation. In fact, one of the risks of a copper IUD is that periods may become heavier, longer, or more painful.

If you prefer a hormone-free option and like to see a regular period — provided that you don’t have very heavy periods already — the copper IUD is a good choice.

Both hormonal and non-hormonal IUDs are more than 99% effective.

IUD Insertion and Replacement

IUD insertion and replacement are usually straightforward but need to be undertaken by a doctor who is specially trained in the procedures. Our doctors at Clinic 66 are very experienced in IUD insertion and replacement, which are our most commonly performed procedures. You will be well placed to come to Clinic 66 for your IUD insertion.

Insertion or replacement may be performed as an awake procedure or under sedation. Sedation requires 2 doctors to care for the patient and consists of a very light, brief anaesthetic which enables you to be comfortable with little recollection of the procedure.

Sedation is available to all patients who attend for IUD insertion or replacement. There are some patients for whom we would certainly recommend sedation, such as women who have never been sexually active, women who have not had a vaginal birth, and women who are perimenopausal. This is because the technicalities of the insertion of the IUD may make it uncomfortable for the patient. If you are unsure whether to have sedation or to be awake, it’s a good idea to book in with one of our doctors and discuss your options.

Risks and Complications of IUD Procedures

IUD procedures (insertion, replacement, and removal) are usually very straightforward. However, as with all medical procedures, there are some small risks and complications. Risks of IUD procedures include pain, infection, perforation, or expulsion of the device. You will be counselled through these issues in detail when you attend for your IUD procedure, where you will be required to sign an informed consent form.

For the insertion, replacement or removal of the IUD, it will be necessary to have an internal examination with one of our specialised doctors, who are very experienced in IUD procedures. We use ultrasound at Clinic 66 to facilitate safe insertion and removal of an IUD.

If you are a patient coming for IUD removal or replacement, and you know that your threads are not visible at the cervix (often called “lost threads”) then you will need to have an ultrasound scan in order to prove that your IUD is still in the uterus before you undergo your IUD procedure.

If you are a woman over the age of 40 and have heavy menstrual bleeding and would like to have a hormonal IUD inserted, you will also need to have an ultrasound scan prior to the IUD procedure. This is so that we may exclude other causes (such as polyps) for your heavy menstrual bleeding prior to the IUD insertion

Women who have uterine abnormalities such as fibroids or bicornuate uterus may not be suitable to have an IUD inserted or replaced at Clinic 66. However, we have specialised gynaecologists in-house to whom we would refer you to for a hysteroscopy.

For any queries around your suitability for an IUD procedure, please make an appointment to see one of our doctors at Clinic 66.

When to Have IUD Procedures

IUD procedures can be done on most days of the week at Clinic 66. We run a surgical list on Tuesdays, Thursdays, Fridays, and Saturdays where IV sedation is available. It is very important that you book in at the right time of your menstrual cycle for IUD insertion as it is essential that we know that you are not pregnant.

This confidence in knowing you are not pregnant can be ascertained by inserting the IUD in days 1 to 7 of your menstrual cycle (preferably not when flow is heavy) or at any time, provided that effective and reliable contraception has been used (e.g. properly taking oral contraceptive pills, abstinence, or use of an implant).

After Your IUD Procedure

We recommend that you do not drive yourself after an IUD procedure even if you have not had an anaesthetic, as it is possible to experience a delayed reaction after an IUD procedure.
Patients who have undergone sedation should not drive for 24 hours post-procedure.

After-care for an IUD is usually straightforward. We recommend a review at around 4 to 6 weeks after an IUD has been inserted or replaced. This can be undertaken at Clinic 66 or with your local doctor, provided that your doctor is familiar with IUDs.

At the 6-week check, we will pass a speculum to ensure that the threads of the IUD are still visible at the cervix, examine you to ensure that there is no sign of infection, and take a history from you regarding any issues (e.g. pain during sexual intercourse or bleeding issues).

If there are concerns at the review visit, we may ask you to undertake a formal ultrasound (we can perform ultrasound in-house but sometimes we need a more sophisticated image).

After an IUD has been inserted, we recommend nothing in the vagina for at least 3 days to reduce the risk of infection. This means no tampons, sexual intercourse, swimming, or sitting in spas.

A normal exercise routine can be reintroduced as soon as possible, although on the day of the IUD procedure, we would recommend rest.

Depending on the timing of insertion, it should be possible to resume normal sexual activity a week after your IUD procedure. Your inserting doctor will discuss this with you on the day.

Provided that the IUD procedure was uncomplicated, you are feeling well, and you have undergone a review which has been deemed as acceptable, there will be no reason for you to see a doctor for your IUD unless there is a problem.

IUD concerns and issues can be discussed at any time with any of the doctors at Clinic 66.

Make an Appointment with Clinic 66

If you would like an IUD or discuss the possibility of one and its suitability for you, or if you have an IUD and you would like to discuss your experience and have a review, please call and make an appointment to see any of our doctors at Clinic 66. No referral required.

Clinic 66
31 Bertram St, Chatswood NSW 2067, Australia
© 2018 Clinic66. All rights reserved.
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