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.
Great News!!
To save you time, effort, and travel costs, we can now provide contraception consultations including an initial IUD Assessment, over the phone (via Telehealth)
so you don't have to come into
the clinic until we know that
you're suitable.
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 ( face to face or via telehealth) 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 uncomfortable to have it done awake procedure.
Women who have never been sexually active MUST have sedation for IUD insertion.
Hormonal IUDs
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.
Non-Hormonal IUDs
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, you can discuss it with one of our doctors, when you have your pre IUD insertion assessment, and discuss your options.
The best time to have an IUD Procedure
It is 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 when the flow is not too heavy).
However, IUD insertion can be done at any time in your menstrual cycle, 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.
Clinic 66 IUD Booking Procedure
If you would like to book an IUD procedure at Clinic 66 the first step is to contact the customer service team on 02 9411 3411 and to fill out an IUD booking form. Our nurse will then screen the answers to the form and determine if any further information or doctor’s assessment is required before we can safely book your IUD procedure.
Please make sure that the form is filled out accurately as we may be unable to insert your IUD if information is inaccurate or not given.
All patients who are experiencing heavy menstrual bleeding, bleeding in between periods or bleeding after sexual intercourse will need a doctor’s assessment to see if an IUD is suitable and if any pre-IUD investigations are required. If you are visiting your usual GP for a pre IUD consultation, please make sure that they are familiar with our referral requirements. https://www.clinic66.com.au/for-doctors
After Your IUD Procedure (After Care)
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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.
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If you have had sedation, you should not drive for 24 hours post-procedure.
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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.
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A normal exercise routine can be reintroduced as soon as possible, although we recommend rest on the day of the procedure.
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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.
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Many women have a review at around 4 to 6 weeks after an IUD has been inserted or replaced. This can be done with your local doctor, provided that your doctor is familiar with IUDs.
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If you have a 6-week check, ( having a check up is your choice), a doctor 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).
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If you have had an IUD inserted at Clinic 66 and you have problems with pain and/or bleeding within 3 months of the insertion, you should call and speak with a nurse. They will then arrange follow up with the doctor who inserted your IUD . If you feel well and have no problems, it is not necessary to have a check up.
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Provided that the IUD procedure was uncomplicated, you are feeling well, there is no reason for you to see a doctor for your IUD for at least five years.
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If you feel there is a problem you should arrange a clinical review with a doctor who is familiar with IUDs.
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If there are concerns at a review visit, we may ask you to have an external ultrasound scan; (we can perform ultrasound in-house but sometimes we need a more sophisticated image).
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.
We do not recommend the use of menstrual cups in women who have an IUD as there is a risk the IUD could be dislodged or accidentally removed. Occasionally , the use of tampons has also caused an IUD to be dislodged or removed.
Download a printable pdf of our IUD FAQs
Download a printable pdf of the Clinic 66 sedation procedure rules and requirements
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Do I need to have an IUD insertion 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 cervical screening tests 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 and 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 and/ or a Penthrox inhaler (green whistle). Please note that for women who have NEVER been sexually active, we do not offer IUD insertion as an awake procedure ( must be booked under IV sedation) The doctor who performs your insertion procedure will discuss what kind of anaesthesia might be necessary.
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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 If you are travelling from more than 100km away, you should schedule yourself a telehealth consultation with one of our doctors prior to travelling, to ensure that you are suitable for an IUD procedure with us. We do not want to disappoint !
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Are there any reasons why a woman can’t have an IUD inserted?If you have a history of breast cancer, 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 you have a history of uterine fistula or complex surgery to your uterus, an IUD may not be suitable (a previous Caesarean Section is fine). Large fibroids, unusual layout such as bicornuate uterus or any other problem which can distort the inside of your uterus (womb) might make the use of an IUD difficult. We will discuss your options with the report from a formal pelvic ultrasound. If you know you have an unusual uterus, please make an appointment to discuss your options PRIOR to booking in for your procedure. (We dont want you to waste your time by accepting your booking and then us not being able to help you) 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.
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Do I need a pelvic ultrasound before 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 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 and you wish to have an IUD inserted, you should have a pelvic ultrasound performed. Please 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.
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What if I want my IUD removed or replaced?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 dont have unprotected sex for one week prior to the IUD removal or replacement, as sperm can hang around and its possible you could get pregnant once the IUD is removed, even from sperm which have been in the body for a few days.
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Why should I use a condom for the week before my IUD removal or replacement?Please do not have condomless sex one week prior to the replacement OR removal of an IUD (as sperm can hang around, and this can result in an unintended pregnancy).
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Do I need to have a GP consultation before having my IUD inserted?You do need to have a consultation prior to having your IUD inserted, which 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. If you dont want to come into the clinic, you can have a consultation with one of our Telehealth doctors. Please make a booking at clinic66online.com.au