An intrauterine device (IUD) is highly effective contraception (more than 99% effective). There are 2 types of IUD available in Australia- one that is hormone-based and one that is not hormonal and is made of copper and plastic. The copper IUD can also be used for very effective emergency contraception as an alternative to tablets. The main difference between the 2 types of IUD is the effect that they have on your menstrual periods.
We recommend the use of an IUD for most women, even those who have not had children, as they are “set and forget” contraception, have a low incidence of problems and are highly effective. In addition, the contraceptive effect of an IUD is immediately reversible when it is removed. Sounds good? Read on……
You need to have a consultation prior to having your IUD inserted. This can be done with your own doctor, or one of our doctors or clinical nurse specialists. This pre-insertion consultation is important, as the timing of insertion, the type of device and anaesthetic options all need to be discussed.
Do I need to have an IUD insertion procedure with sedation or can I be awake?
The choice is yours. If you have intravenous sedation, you will have a brief, light anaesthetic and have no recollection of the procedure. You will need someone to drive you home, as you can’t drive on the day of a sedation anaesthetic.
Commonly, those who have an IUD insertion (or removal) with sedation are women who:
- Are nervous or tense about being examined or having Pap smears
- Are only recently or never sexually active
- Have had surgery to their cervix, such as a LLETZ procedure
- Have ONLY had elective Caesarean section deliveries (without labouring)
- Are approaching menopause
- Want an IUD removed, but the threads cannot be seen in the cervix
If you DO opt for sedation, then you should:
- NOT eat any food during the 6 hours prior to your appointment
- Drink only water between 6 and 2 hours before your appointment
- Have nothing pass your lips in the 2 hours immediately before your appointment (this means no food or dring and includes smoking, lollies and chewing gum)
An awake IUD insertion procedure takes about 5-10 minutes during which time there may be some discomfort. We advise that you take some simple pain relief (the same as what you would normally take for period pain) about 30 mins before the procedure.
Awake IUD insertion can also be performed using local anaesthetic or a Penthrox inhaler (green whistle). The doctor who will do your insertion procedure will discuss what kind of anaesthesia might be necessary.
What do I need to bring with me?
- 2 or 3 sanitary pads (light flow only)
- Some photo identification- a driver’s licence or passport
- Your Medicare card
- Warm, comfortable clothes and nothing that is too restrictive around the tummy
- A snack, or some food or drink for AFTER the procedure
Are there any reasons why a woman can’t have an IUD inserted?
- If you have a history of breast cancer in the past, we will need a letter from your oncologist and/or breast surgeon to say that you are clear to have a Mirena (hormonal) IUD.
- If a woman has a history of uterine fistula or complex surgery to her uterus, an IUD may not be suitable (a previous Caesarean Section is fine).
- Large fibroids or any other problem (like scarring) which distorts the inside of a woman’s uterus (womb) might make the use of an IUD difficult.
- A pregnancy must be excluded before using an IUD, and that is why we like you to come in for an IUD insertion within 7 days of the start of your menstrual period. In that way, we know that you are not likely to be pregnant. However, if you do not get regular periods, you can still have an IUD inserted but the timing needs to be discussed with one of our doctors or nurses.
Do I need a formal ultrasound scan performed before I come for my IUD insertion?
If you are over 40 years old and you have heavy periods, we need you to have a formal pelvic ultrasound scan, in order to make sure that there are no underlying problems. If needed, we can refer you for a “bulk billed “pelvic ultrasound scan.
Women in their forties who have heavy periods are likely to need to have a Pipelle endometrial biopsy, and there is an additional charge for this procedure (Medicare rebates apply).
If you have had a termination of pregnancy (medical or surgical), and you haven’t yet had a period after the procedure, you should have a pelvic ultrasound . whescan performed, and then send us the report prior to booking in for your IUD insertion. We can provide you with a request form which will be “bulk billed for Medicare card holders.
What if I want my IUD removed?
Removal of an IUD is usually quite straightforward, and can be done in the consulting rooms by a doctor who has experience at removing an IUD.
If the IUD strings are not able to be found in the cervix, and you want to have your IUD removed, we need an ultrasound scan before we attempt to remove the IUD to ensure that the device is still in the uterus (womb).
Please do not have condomless sex one week prior to the insertion OR removal of an IUD (as sperm can hang around, and this can result in an unintended pregnancy).