Intrauterine Devices (IUD's)
Intrauterine Devices (IUDs) provide SAFE, RELIABLE and very EFFECTIVE birth control.
We recommend the use of an Intra-Uterine device (IUD) for most women, as it is a
“set and forget” contraception, has a low incidence of problems and is highly effective.
The contraceptive effect of an IUD is immediately reversible when it is removed, so it's particularly good for women who have not had children yet.
In Australia, the hormonal IUD is subsidised by the government as a treatment for troublesome menstruation and contraception.
They last for 5 years, or 7 years if inserted over the age of 45 years.
Non-hormonal IUDs are not subsidised but are still cost-effective, as they provide long-lasting birth control for 5 or 10 years.
Modern designs make IUDs a great choice for women who want a “fit and forget” form of contraception.
Dr Karen Osborne talks about the Mirena Hormonal IUD and its benefits - particularly for those with heavy periods
If you wish to have your IUD removed before its due date, it is very easy and the contraceptive effects are immediately reversed. So pregnancy could occur as soon as the IUD has been removed.
Most GPs are happy to remove IUDs (provided the threads are visible at the cervix).
What is an IUD?
IUDs are a type of LARC (Long-Acting Reversible Contraception).
Whether you have had children or not, IUDs could be a great option as they are so reliable.
They come in hormonal or non-hormonal (copper) designs.
Hormonal IUDs can also control troublesome menstruation, as well as provide excellent birth control, by reducing blood loss substantially or contributing to a hormonal treatment regime for menopausal women.
Non-hormonal IUDs provide excellent birth control but may cause menstruation to be longer or heavier than usual.
Non-hormonal IUD insertion can also be an alternative to the “morning after pill” provided it’s inserted within 72 hours of the unprotected sexual intercourse (emergency contraception).
The choice of IUD recommended for you will depend on several factors. You will need to have a consult with your normal GP or one of our doctors prior to booking in for an IUD insertion.
Insertion can be done under IV sedation or as an awake procedure.
We recommend that if you’ve not had a vaginal birth in the last 5 years, then consider having IV sedation for the insertion, as it can be quite uncomfortable to have it done as an awake procedure.
If you have heavy periods and want reliable contraception, a hormonal IUD is the perfect choice.
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.
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 contribute to hormone replacement for a woman who is struggling with symptoms of menopause.
Both hormonal and non-hormonal IUDs are more than 99% effective.
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.
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.
Copper IUDs can be inserted as a form of Emergency Contraception instead of pills. The IUD can be kept for future contraception or removed if it doesnt suit you.
In this video, Dr Karen Osborne talks about the benefits of using the non-hormal Copper IUD for emergency contraception vs the morning after pill.
IUD Insertion and Replacement
IUD insertion or replacement is usually straight-forward but must be performed by a doctor who is specially trained in the procedures. We perform this procedure almost every day at Clinic 66, so our doctors are highly experienced.
It can be done as an awake procedure or under sedation, which will require two doctors (one to manage the sedation).
Sedation consists of a very light, brief anaesthetic which enables you to be comfortable with little recollection of the procedure.
We recommend sedation for some women, such as those who have never been sexually active, women who have not had a vaginal birth, and women who are perimenopausal. This is because the insertion of the IUD can be a little uncomfortable.
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.
The best time to have an IUD Procedure
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 the flow is heavy).
It can actually be done 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).
We do recommend that you use a condom for the week prior to a replacement or removal of an IUD, to ensure that no 'rogue' sperm are waiting to produce an unplanned pregnancy!
IUD procedures can be done on most days of the week at Clinic 66, but sedation is only available on Tuesdays, Thursdays, Fridays, and Saturdays.
After Your IUD Procedure (After Care)
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 the procedure.
If you have had sedation, you should not drive for 24 hours post-procedure.
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 we recommend rest on the day of the procedure.
Depending on the timing of insertion, it may be possible to resume normal sexual activity 3 days after your IUD procedure. Your inserting doctor will discuss this with you on the day.
Many women have a review at around 4 to 6 weeks after an IUD has been inserted or replaced. This can be done 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 discuss any issues (e.g. pain during sexual intercourse or bleeding).
If there are concerns at the review visit, we may ask you to have an ultrasound (we can perform ultrasound in-house but sometimes we need a more sophisticated image).
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 for at least five years (unless there is a problem).
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.
We use ultrasound at Clinic 66 to ensure safe and trouble-free insertion and removal of IUDs.
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.
If you are 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 to ensure that your IUD is still in the uterus before you undergo your IUD procedure.
If you are over 40, 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 procedure. This is so that we may exclude other causes (such as polyps) for your heavy menstrual bleeding.
Women who have uterine abnormalities such as fibroids or bicornuate uterus may not be suitable to for an IUD procedure at Clinic 66. However, we do have specialised gynaecologists in-house who can help you with management of these issues as well as IUD insertion eg perform a hysteroscopy if needed.