Intrauterine Contraceptive Devices (Iuds)

Intrauterine contraceptive devices (IUDs)

An intrauterine contraceptive Hormonal IUD Copper IUD device (IUD) is one of the “fit and forget” long acting Street names IUD, Mirena, T IUD, Copper T reversible contraceptive Medical Hormonal IUD, Mirena (brand) Load 375, TT380 methods (LARCs). It is a small names device which is fitted inside Effectiveness 99.8% 99.2% the uterus, where it can remain for lengthy periods to prevent It lasts 5 years, unless you have it Copper Load 375 is effective pregnancy. removed earlier for 5 years. TT380 Standard is effective for 10 years. This is sometimes called a ‘Copper T’. TT380 Short is effective for 5 years.

Fertility Fertility returns when it is Fertility returns when it is removed removed

Who can use Females of any age from Females of any age from it? menarche to menopause menarche to menopause Hormones Contains progestogen Does not contain hormones Visibility Very discreet. Very discreet STIs No protection No protection Side effects During the first 3-5 months The frequency of periods Hormonal IUD - bleeding after insertion, bleeding will be the same as that patterns patterns are unpredictable. experienced prior to insertion ® Mirena is the brand name for the Irregular light bleeding is but blood loss may increase in IUD which releases a progestogen common. amount and number of days (similar to the hormone bleeding. progesterone, which is naturally After 12 months approximately produced by the female body). It 65% of women will have Some women may experience is T-shaped, made of plastic and only very light bleeding or no more painful periods. steadily releases small amounts of periods at all. the progestogen directly into the Mirena can be used to treat uterus. excessively heavy menstrual bleeding. Side effects Allow 6 months to adjust to There are no hormonal side - hormonal hormones effects as copper IUDs do not release hormones. Only a small amount of progestogen passes into the bloodstream and hormonal side effects are extremely rare. If they occur they are generally mild and improve with time. Research has found no difference in the rate of symptoms such as headache, Copper IUD acne, mood change and weight gain between users of copper Copper IUDs are made of plastic IUDs and hormonal IUDs and copper. There are 3 types of Cost For current costs, check For current costs, check copper IUDs currently available in at the time of making an at the time of making an Australia. appointment. appointment.

©True Relationships & Reproductive Health www.true.org.au V 5 4/18 What is an IUD What are the possible risks of using Ectopic pregnancy is a serious an IUD? condition and can lead to reduced IUDs are inserted into the uterus. Once fertility. inserted they are not felt by the woman Possible risks associated with the or her partner. All IUDs available in insertion procedure include: To reduce complications, in the rare Australia have fine nylon threads event of a pregnancy occurring with Abdominal pain attached to the lower end of them so an IUD in place, it is important to see that when fitted, the threads extend Following insertion, some women a doctor as soon as possible if you through the cervix (neck of the womb) notice abdominal cramping pain for up have any reason to suspect you are into the upper vagina. These threads to a few weeks. pregnant, e.g. if there is a change in allow the woman to check that the your usual bleeding pattern; if a period Perforation IUD is still in place and allow for easy is missed; is lighter than usual or you removal by a health practitioner. This is a rare but serious complication have unusual abdominal or pelvic pain. where the IUD passes through the How do IUDs work? Is an IUD suitable for all women? wall of the uterus into the pelvic area, IUDs work by: usually at the time of, or shortly after, Most women can safely use an IUD. insertion. This may occur in about • changing the lining of the uterus Your doctor will review the suitability of 1 per 500 insertions. This requires making it unsuitable for a pregnancy the method with you prior to insertion. surgery under a general anaesthetic to • thickening the mucus of the cervix, remove the IUD. The risk of perforation In assessing your suitability, preventing sperm entering the uterus is further increased when the IUD is consideration is given to a number of inserted in a woman who is breast important factors: How effective is an IUD? feeding (six times increased risk) and • current menstrual and bleeding Both types of IUDs are highly effective. is within 36 weeks postpartum (three patterns times increased risk). The copper IUDs are at least 99% • unexplained vaginal bleeding (this effective. This means that, on average, Expulsion should be investigated before using if 100 women use an IUD for 1 year, Sometimes the IUD may be partially an IUD) it is possible that 1 of them could or completely pushed out of the become pregnant. • a recent history of a sexually uterus. It occurs in about 5 per 100 transmitted infection or PID Mirena® is approximately 99.8% insertions and is most common in the effective. This means that, on average, first few months following insertion. It • uterine or cervical abnormalities if 1000 women use Mirena® for 1 is important to regularly check for the • any history of breast, cervical or year, it is possible that 2 of them could threads, to detect if this has occurred, uterine cancer become pregnant. as the IUD won’t work effectively if not fully within the uterus. The doctor will also review: What are the advantages of using an IUD as a method of contraception? Pelvic inflammatory disease (PID) • previous pregnancies • long acting This is a rare complication of IUD • whether you need to have a Cervical insertion, most likely to occur in the Screening test and other tests for • reversible with rapid return to usual first few weeks following the insertion infection prior to insertion fertility when removed procedure. It occurs in less than 1 per • any allergies including copper allergy • highly effective 300 insertions. PID may in some cases lead to infertility. • the timing of insertion and pain relief • relatively inexpensive needs for the insertion procedure Possible risks associated with What are the disadvantages of ongoing use of an IUD: What do I need to know about using an IUD as a method of having an IUD insertion? contraception? Miscarriage Prior to insertion, an assessment of • insertion and removal of the device If a pregnancy occurs in the your medical history and suitability can only be done by a trained Health uterus there is an increased risk of for this method will happen. This Practitioner miscarriage. If the IUD is then left assessment enables you to ask any in place, there is an increased risk • insertion into the uterus requires a questions you may have and be certain of miscarriage with infection in later procedure which some women may that it is the most suitable method stages of pregnancy or premature find quite uncomfortable for you. A pelvic examination will be birth. performed, a Cervical ScreeningTest, • possible changes in periods/bleeding Ectopic pregnancy if due, and other tests to check for patterns infection, may also be required. If a pregnancy does occur with an • does not protect against sexually IUD in place there is a small chance Insertion of an IUD involves a transmitted infections (STIs) the pregnancy will develop in the procedure. Some women find Fallopian tube. However, because the insertion quite uncomfortable. This IUDs do not protect against IUD prevents most pregnancies, it is can be managed with the use of STIs. an uncommon complication and less local anaesthetic into the cervix but common than amongst women who occasionally requires a sedative or To make sure you are protected are not using any contraception. general anaesthetic. against pregnancy and STIs The device should be inserted by a use a condom for every sexual medical practitioner trained in the encounter. procedure.

©True Relationships & Reproductive Health www.true.org.au V 5 4/18 What do I need to know about the However, if you have a copper IUD What are the main differences ongoing use of an IUD? inserted after the age of 40 or a between copper and hormonal hormonal IUD inserted after the age IUDs? You will be given details of follow up of 45, this expiry date can often be at the time of the insertion. Generally, While there are many similarities, there extended and the same device left you are asked to attend for a follow are some differences between copper in for a longer period of time. This up visit after insertion and/or any time and hormonal IUDs. is because you have a lower risk of concerns exist. falling pregnant in your late 40s and Making a choice about which IUD is You should contact your doctor if: 50s. Please discuss further with your most suitable for you will be based on medical practitioner. your own preferences, requirements • you feel you may be pregnant. If and medical issues. using a copper IUD you should It is important to keep a record of the contact a doctor if you miss a period. date that replacement is due and to Can the IUD be used as emergency arrange for replacement no later than contraception? • you experience pelvic pain or this date. tenderness, fever or chills, offensive In some circumstances a copper IUD discharge or deep pain with The IUD can easily be removed at any can be inserted up to 5 days after intercourse time. As fertility can return immediately unprotected sex to prevent pregnancy after removal, it is important to occurring. It can be left in place to • you cannot feel the string or feel the consider alternative methods of provide ongoing contraception or string has lengthened contraception, before the IUD is removed after a normal period. • you (or your partner) can feel the removed, if trying to avoid pregnancy. Where is the IUD available? hard stem of the IUD The IUD is available from True clinics, The IUD needs to be replaced with gynaecologists as well as some a new device every 5 or 10 years general practitioners (GPs). depending on which device is inserted.

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