IUD Insertion: What to Expect

As an experienced sexual and reproductive health clinic in Sydney, Clinic 66 provides several reliable and long-acting contraception options, including hormonal and copper IUDs. The IUD is a leading birth control option in Europe, but is sometimes less considered here in Australia. Often, this is due to a combination of misconceptions about how the IUD functions, associated pain, and trepidation about the insertion process.

However, it's worth knowing that the IUD is a licensed and highly effective, long-acting contraceptive. It is often misunderstood, with negative stigma deterring many people from choosing it as an option. Many women fear the impact an IUD might have on their fertility, but in reality, it offers an immediate return to fertility upon removal. In this article, we explore this misconception, alongside many other misunderstood aspects of the IUD.

Let's take a look at what IUDs are available in Australia, how the insertion process works, and what to expect from the procedure.

What is an IUD?

The IUD itself is a small ‘T’ shaped plastic device which is inserted inside the uterus. 

The hormonal IUD works by thickening the mucus in the cervix to stop the sperm from moving into the uterus. This also thins the uterine lining and prevents a fertilised egg from implanting. In some cases, the ovaries may completely stop releasing eggs. 

The copper IUD works by releasing copper ions inside the uterus, creating an environment that sperm can’t survive in or move through effectively.

This disruption of sperm motility and viability means they are far less likely to reach and fertilise an egg in the first place. The copper also changes the fluids in the uterus and fallopian tubes so fertilisation becomes highly unlikely, and it can make the lining of the uterus less receptive to implantation if fertilisation does occur. Because there’s no hormone involved, you’ll continue to ovulate.

All types of IUDs are more than 99% effective at preventing pregnancy. 

For some women, hormonal IUDs can also be used as a hormonal treatment during perimenopause, or to help with endometriosis symptoms like heavy, painful periods.

Types of IUDs Available in Australia

There are three IUDs available in Australia. The Mirena and Kyleena IUDs are a hormonal form of contraception, where the copper IUD is a non-hormonal option. 

The Mirena IUD  

The Mirena IUD is a licensed form of contraception for up to 8 years. It contains 52mg of levonorgestrel (a synthetic hormone), which is a strong enough dose to act as the progesterone element of Hormone Replacement Therapy (HRT). However, if the Mirena IUD is used for HRT, it's only licensed for 5 years and must be replaced at that point. The Mirena is a great option for managing menopause and perimenopause symptoms, while also acting as an effective form of contraception. This is because it:

1. Thins the uterine lining (preventing heavy bleeding and sharp cramping during menstruation)

2. Balances progesterone and oestrogen levels (managing oestrogen fluctuations)

3. Protects the uterine lining (protecting the uterus from oestrogen spikes that can lead to precancerous changes and uterine cancer)

The Mirena IUD is a recommended form of contraception for patients seeking a versatile, set-and-forget option.

The Kyleena IUD

The Kyleena IUD contains only 19.5mg of levonorgestrel and is licensed for five years as a contraceptive option. As it has a lower dose of the synthetic hormone, the Kyleena IUD is slightly smaller than the Mirena IUD. It's not licensed as an HRT option, as it doesn't provide an adequate dose of progesterone to protect the uterus, or to manage perimenopausal symptoms. The Kyleena IUD can reduce the volume and pain of heavy, painful periods, and is usually only recommended for contraception (it's not multipurpose).

The Copper IUD

The copper IUD is the only non-hormonal IUD available in Australia, and can last 5 to 10 years, depending on the device. The copper ions act as a spermicide within the uterus, preventing eggs from being fertilised. In the rare instance that sperm survives, it also restricts the implantation of a fertilised egg within the uterine lining. The copper IUD can only be used as a form of contraception, and isn't multipurpose like the Mirena IUD. It's usually recommended for patients who want a hormone-free contraceptive, and isn't recommended for perimenopausal women, as it can't protect the uterine wall.

Benefits of getting an IUD

The leading benefit of an IUD is that it's more than 99% effective, and offers a set-and-forget form of contraception. Once inserted, patients don't need to think about contraception again until the 5 to 10-year mark, when a replacement is needed. Plus, if your plans change and you want to become pregnant, the IUD can be removed at any time, with fertility returning to normal almost immediately.

Copper IUD	Hormonal IUD (e.g. Mirena™)
Contains no hormones	Contains hormones (levonorgestrel)
Suits people sensitive to hormonal contraception	Often significantly reduces menstrual bleeding and pain
Can also be used as emergency contraception soon after unprotected sex	Can be a first-line choice for conditions like heavy periods or endometriosis
Starts working immediately	Can sometimes stop periods altogether
No need to take a daily pill	Can also be used as a component of Hormone Replacement Therapy (HRT)
Safe to use while breastfeeding	Protects the uterine lining
Fertility returns as soon as the IUD is removed	Suitable for those who can't tolerate oral progesterone

Who is not a good candidate for an IUD?

Whether you're older or younger, have or haven't had children, or are currently breastfeeding, if you want a long-term, reliable form of contraception, you're likely a good candidate for an IUD.

There are a few circumstances where an IUD may not be recommended. Anatomically, if you have an unusually shaped uterus, or a fleshy lump or distortion within the uterus, this can increase the likelihood that the device won't fit properly. Another circumstance where Clinic 66 may not recommend the IUD is if a patient has a hormone-sensitive cancer, or is at high risk of infection (such as with autoimmune diseases). In these cases, patients may need a work-up first to determine their suitability.

Some other instances include:

• If you're currently pregnant

• If you have an STI or pelvic infection

• If you have unexplained vaginal bleeding

• If you have any other uterine abnormalities

Your practitioner at Clinic 66 will always start with a review of your medical history to determine if the IUD is the right contraceptive option for you. If you fall into a category where it may not suit you, our team will talk you through alternative options that can be equally beneficial.

How IUD insertion works

Having an IUD inserted is a straightforward procedure for the majority and usually only takes a few minutes. However, the procedure can cause cramping pains in and around the uterus, as well as discomfort. At Clinic 66, we offer copper, Mirena, and Kyleena IUD insertion with a choice of pain relief options in Sydney. IV twilight sedation may be a good option for those who are nervous about the procedure. This is a form of conscious sedation where you’ll be put into a dream-like state – not fully asleep, with no memory of the procedure afterwards. It involves inserting a small cannula into a vein in your arm, through which our trained professionals deliver anaesthetic directly into your bloodstream.

However, patients may choose to have the IUD inserted while awake, in which case we typically ask you to have pain relief, like Ibuprofen and paracetamol around 45 minutes before your appointment. As long as you are calm and relatively relaxed about medical procedures, most people will tolerate insertion well. It helps to know that any discomfort or pain will only last a few minutes.

We also offer a local anaesthetic gel which can be applied to make the procedure more tolerable, as well as something called the green whistle (penthrox) which can aid in both pain and anxiety relief.

The procedure is similar to a pap smear, or other speculum exams.

1.      You’ll be asked to lie on the examination couch. A speculum (a small duck‑bill‑shaped device) is gently placed into the vagina so the doctor can see your cervix.

2.      The cervix is cleaned with an antiseptic solution to reduce infection risk. Your doctor can use local anaesthetic spray or gel on the cervix to help reduce pain, and options like a Penthrox inhaler (“green whistle”) or light sedation are available based on your comfort and preferences.

3.      A small instrument gently grasps the cervix to keep it stable while other measurements are taken.

4.      A thin instrument is used to measure the length and position of your uterus so the IUD can be placed accurately. This can cause a brief cramp‑like sensation.

5.      The doctor inserts the IUD through the cervix and into the uterus using a thin insertion tube. Once inside, the arms of the IUD open into a T‑shape.

6.      The tiny strings attached to the IUD are trimmed so they sit in your upper vagina. These strings allow you and your clinician to check the IUD’s position later.

What to expect during the procedure?

The actual insertion only takes a few minutes, though the whole appointment including preparation and aftercare can take longer. 

If you’ve had an intravenous twilight sedation, you won't feel or remember the procedure. After waking, you’ll remain in recovery for about 45 minutes. Before leaving, your blood pressure will be checked. If you're feeling all right, you’ll be given the all clear to go home, where you should avoid driving or operating heavy machinery.

Recovery after IUD insertion

Within 24 hours, you should be able to return to most of your normal activities.

Importantly, nothing should go inside the vagina for 48 to 72 hours afterwards. Hormonal IUDs, in particular, can cause bleeding for a couple of days. To manage the bleeding, use only pads or period underwear and avoid tampons or menstrual cups. Additionally, don't have baths or go swimming in the immediate aftermath, as this can increase your risk of infection.

You may experience some crampy, period-type pain for a couple of days afterwards, which can be manageable with Paracetamol or Ibuprofen. Some discomfort is normal, but you should contact your doctor if you experience:

• Persistent pelvic pain that's not improved with pain relief

• Heavy, or prolonged bleeding

• Symptoms of infection, like fever or unusual discharge

• Unexpected bleeding (unrelated to menstruation)

Clinic 66 offers support to all our patients regardless of when they had their IUD insertion. Book a consultation with us if you are worried about your post-procedure symptoms.

Risks and side effects

IUD insertion is generally safe, but like any procedure it carries some risks and possible side effects. During insertion, you can expect cramping or pain, and there may be light bleeding from the vagina. Very occasionally there’s a tiny chance of uterine perforation (a small nick in the uterus) — this is rare and more likely if you’ve recently had a baby. At Clinic 66, we perform an on site pelvic ultrasound after the insertion to check the IUD position before you leave. 

After the procedure, patients can experience spotting or irregular bleeding, especially in the first 3 to 6 months. With the copper IUD in particular, periods may be heavier and more painful at first. There’s also a small risk that the device can move out of place or be expelled, which is why checking the strings once a month helps you make sure it’s still positioned correctly.

Other uncommon but possible issues can include:

• Infection (which is most likely in the first few weeks after insertion if someone has an existing infection)

• Benign ovarian cysts (these will usually resolve on their own)

• Ectopic pregnancy (the change of pregnancy is less than 1% likely, however it is still possible so it’s important to seek immediate medical advice if you suspect you might be pregnant)

Most side effects settle over time, and your clinician at Clinic 66 will talk you through what to expect, how to monitor for issues, and when to see a doctor.

Cost of IUD insertion

At Clinic 66, we strive to make sexual health and contraceptive health services accessible while providing an uncompromisingly high standard of care. 

Factors like type of IUD, sedation options and Medicare access influence the final cost of your IUD insertion in Sydney. The below gives an overview of what you can expect to pay at Clinic 66.

Procedure	With Medicare (Approx)	Medicare Rebate	Your Out‑of‑Pocket (OOP)	With Concession Card (Approx)
IV IUD – Mirena/Kyleena	$990	$442	$548	$388
IV IUD – Copper	$990	$431	$463	n/a
IV Sterilisation (STOPS)	$1,200	$509	$691	n/a
MTOPS procedure	$580	$172	$408	$269
IV VAS (IV sedation & anaesthesia)	$1,350	$544	$806	n/a
Awake VAS (sedation/analgesia without IV)	$1,150	$362	$788	n/a
Awake IUD – Mirena/Kyleena	$715	$319	$396	$279
Awake IUD – Copper	$660	$311	$349	n/a

IUD vs other birth control options

Feature	IUD (Intrauterine Device)	Implant	Combined Pill / Vaginal Ring	Injection (Depo‑Provera)
How it works	Device placed in uterus; hormonal IUD releases progestogen & thickens mucus; copper IUD creates hostile environment for sperm.	Flexible rod under skin releases progestogen to prevent ovulation.	Daily pill or ring with hormones (oestrogen + progestogen) to stop ovulation and thicken mucus.	Hormone injection every ~12 weeks prevents ovulation and thickens mucus.
Typical effectiveness	> 99% (very low pregnancy risk) with both copper and hormonal types.	> 99% with typical use.	~93% typical use; up to ~99% with perfect use.*	~96% typical use.
Duration / maintenance	Long‑acting: 5–10 years (varies by type).	Long‑acting: up to ~3 years.	Short‑acting: must be taken daily (pill) or replaced monthly (ring).	Medium: needs repeat visit ~every 12 weeks.
Hormonal vs non‑hormonal	Copper IUD is non‑hormonal; hormonal IUD uses progestogen.	Hormonal (progestogen).	Hormonal (oestrogen + progestogen).	Hormonal (progestogen).
User involvement	Very low after insertion (set‑and‑forget).	Very low after insertion.	High — requires daily or scheduled action.	Moderate — regular appointment every 3 months.
Reversibility	Fertility returns quickly after removal.	Fertility returns after removal.	Fertility returns after stopping.	Fertility may take a few months after stopping.
Other benefits / considerations	Lifelong once in place; minimal user error; copper option for non‑hormonal preference.	Highly effective and long‑acting with low user error.	Can help regulate cycles & reduce period symptoms; requires adherence.	May reduce period pain & bleeding for some.

Where to get an IUD in Sydney

We understand that some people find dealing with their sexual health and contraception confronting. But we can comfortably say, at Clinic 66 there’s nothing we haven’t seen before.

If you’re considering your birth control options and want to know more about the IUDs available to you and your options for insertion, we can help.

To save you time, effort, and travel costs, Clinic 66 can now provide contraception consultations including an initial IUD assessment via a telehealth video consultation. This means you won’t have to come into the clinic until we know that you're suitable. If you do have any physical symptoms post-insertion, such as abnormal bleeding (bleeding in between your periods or after sex), we also provide in-clinic IUD assessment appointments for examination. Book with our sexual and reproductive specialists for all your contraceptive needs.