Intra-uterine devices (IUD)

An intra-uterine device (IUD) is placed inside the uterus to prevent pregnancy. At SHine SA two types of IUD are used:

• copper IUDs (Multiload and Copper T) made of plastic and copper
• a hormonal IUD (Mirena) made of plastic that releases small amounts of progestogen into the womb

How do IUDs work?

Copper IUDs affect sperm movement and prevent the implantation of the egg.

Hormonal IUDs change the lining of the womb and make it difficult for a fertilised egg to implant. Progestogen also thickens the mucus at the neck of the womb, blocking the sperm.

What are the good things about IUDs?

It's a very effective, reliable method of contraception (98-99%) which is easily reversible. IUDs are also effective for a long time. Copper T is effective for 10 years and Multiload and Mirena are effective for 5 years. They are cheap if used for the full period of time (i.e. 5-10 years).

Who should not use IUDs?

IUDs may not be suitable for women:

• who have had a recent sexually transmitted infection
• who have a history of pelvic inflammatory disease
• with abnormal vaginal bleeding
• with abnormal Pap smears 

A copper IUD may not be your first choice of contraception if you have:

• painful or long periods
• anaemia (low blood iron)
• an allergy to copper (which is uncommon)

Occasionally there are abnormalities of the uterus which make IUDs difficult to insert. Sometimes IUDs can also be difficult to insert if you have not had a child.

What are the side effects?

The side effects and complications with all IUDs include:

• a small risk of developing pelvic infection in the first 3 weeks following insertion (this should be treated promptly by a doctor)
• a small risk of perforation of the womb during insertion
• a small risk of migration of the device sometime after insertion
• very occasionally the IUD may come out during a period
• a very small risk of ectopic pregnancy
• increased vaginal discharge

Women using copper IUDs may have:

• heavier and/or more painful periods, which may settle after the first 3 months

Women using hormonal IUDs may have:

• irregular bleeding and/or spotting for the first 3-5 months
• no periods at all by 12 months
• hormonal side effects (uncommon) such as weight gain, acne, headache and breast tenderness

How can I get an IUD?

You will need to see a health care professional to discuss whether this is the best method of contraception for you. If you decide to use an IUD you will need to have a test for infections. You also need a current smear test. If these tests are normal you can make an appointment to get an IUD.

When can an IUD be inserted?

Copper IUDs should be inserted during the first 12 days of your cycle, where day one is the first day of bleeding.

Hormonal IUDs should be inserted during the first 7 days of your cycle, where day one is the first day of bleeding.

If you are using other methods of contraception and are changing to an IUD you need to discuss with your doctor when the IUD should be inserted.

To decrease cramping, one hour before insertion take 2 aspirin or another medicine used for period pain, such as Nurofen, Ponstan or Naprogesic.

When does the IUD start working?

If the IUD is inserted as recommended above the contraceptive effect will start immediately.

When can an IUD be used after childbirth?

An IUD can be inserted from 8 weeks after childbirth (or 12 weeks if birth is by caesarean section).

What do I do after my IUD has been put in?

To reduce the risk of infection do not have sexual intercourse or use tampons for 48 hours.

If cramps occur take medicine used for period pain to reduce pain and reduce the risk of expulsion of the IUD.

You should check your IUD after your first period and if you have severe or unusual pain. To check that your IUD is still in place insert two fingers into your vagina to locate the string.

Contact your doctor or SHine SA clinic if you:

• cannot feel the string
• feel the string has lengthened
• can feel the hard stem of the IUD

Use another form of contraception (e.g. a condom) until you have had a check-up by a doctor.

Also contact your doctor or SHine SA clinic if you have any of the following symptoms:

• a fever or you're feeling unwell, weak or tired
• persistent or excessive cramps or back pain
• unusual pelvic pain or tenderness
• unusual vaginal discharge or odour
• pain during sexual intercourse

With a copper IUD if your period is more than a week overdue see your doctor or SHine SA clinic for a pregnancy test.

You will need to have a check-up by 6 weeks or if you have any concerns.

When can the IUD be removed?

An IUD can be removed at any time but preferably in the first 5 days of your cycle.

When will I be fertile again?

The contraceptive effect of both types of IUD stop as soon as the IUD is removed.

And remember...

The IUD will not protect you against sexually transmitted infections (STIs). Practise safer sex. Condoms reduce the risk of STIs.

Remember to have regular two-yearly smear tests and consult your doctor promptly if you have symptoms of pelvic pain or infection.

Women who have copper IUDs inserted should not have microwave/shortwave treatment to the abdomen or lower back.

This information is available to download in leaflet format as Intra-uterine device (IUD).