Intrauterine devices (IUDs) are a popular form of contraception in Melbourne. They are long-lasting, affordable, effective, and safe.

Assisted by a practice nurse, a GP with specialised training can perform an IUD insertion in a well-equipped, private treatment room.

Most patients find it a relatively quick and easy procedure.

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ON THIS PAGE

• Types of IUDs: Hormonal vs Copper
• What does an IUD insertion cost?
• Who can have an IUD inserted?
• What to expect during and after your insertion appointment
• Side effects
• Will I gain weight with an IUD?
• How easily are they removed?
• Getting started
• About Dr Jeanne North

Apart from IUDs being up to 99.9% effective in preventing pregnancy and lasting up to 10 years, people enjoy the following benefits:

• Periods are generally lighter and less painful (hormonal IUDs only)
• Safe for breastfeeding
• Unaffected by medications
• Once inserted, you only need to check the string each month
• An entirely reversible form of contraception
• Your normal fertility returns immediately once the IUD is removed.

IUDs can also be used as emergency contraception if inserted within five days after unprotected sex. However, the success rate in preventing pregnancy drops significantly.

Mirena vs Kyleena vs Copper IUDs

In Australia, the two main IUD types are hormonal (Mirena and Kyleena) and copper. Both types come in a small T-shaped frame made of flexible plastic.

Hormonal IUDs

Hormonal IUDs contain levonorgestrel – the same synthetic progestogen as what’s in the pill and the ‘morning after’ pill.

Both Mirena and Kyleena types slowly release levonorgestrel, causing cervical mucus to thicken and preventing sperm from getting through.

The hormone also thins your uterus lining, making it unable to sustain a fertilised egg, and can prevent or delay your ovaries from releasing eggs.

Mirena is 99.9% effective in preventing pregnancy and lasts up to five years or seven years if inserted after you turn 45.

People who have heavy periods or are approaching perimenopause prefer Mirena as the higher hormone dose can help with menstrual control and menopausal symptoms.

Kyleena is 99.7% effective and must be replaced every five years, regardless of age.

Kyleena is a smaller than Mirena. It’s preferred by younger people, those with small uteruses, or people who have never given birth.

Copper IUDs

Copper IUDs don’t contain hormones.

They’re 99.5% effective in preventing pregnancy and work in the following ways:

• The fine copper wire wrapped around the T-frame is toxic to sperm and eggs.
• The device can change the lining of your uterus.
• They slow your eggs’ travel time to your uterus, which delays the chance of eggs and sperm meeting.

Depending on the brand, copper IUDs can last five to ten years.

What Does an IUD Insertion Cost?

If you have a Medicare card, the out-of-pocket fee for a 45-minute IUD insertion appointment at the clinic is $204.

You’ll also need a pre-insertion appointment to assess your eligibility and a follow-up appointment six weeks after the procedure to check the IUD’s strings. We charge for both at our usual appointment fees.

At your first consult, I’ll give you a prescription to pick up the device at your local pharmacy to bring to your insertion appointment. Under the Pharmaceutical Benefits Scheme (PBS), a Mirena or Kyleena costs around $30 ($7 for Health Care Card holders).

You don’t need a prescription for copper devices. These cost $70 – $120.

Patients without Medicare can speak to our friendly receptionists about consult fees. Hormonal devices outside of the PBS cost around $170.

We charge our usual appointment fees to remove an IUD.

Who Can and Can Not Have an IUD Inserted?

Most people can!

However, I don’t recommend considering a hormonal IUD if you:

• have undiagnosed vaginal bleeding or pelvic inflammation (we’ll investigate this before proceeding);
• have an unusually shaped uterus, or
• are being treated for breast cancer or severe liver disease.

Copper IUDs may not be suitable if you have iron deficiency, as they will likely make your periods heavier.

What to Expect During and After Your Insertion Appointment

If we both agree that an IUD is appropriate for you, you’ll need to use a reliable form of contraception or abstain from sexual intercourse four weeks before your insertion appointment.

During your insertion appointment, I’ll take the device that you collected from the pharmacy and take a urine sample for a quick pregnancy test. I’ll also take some swabs for sexually transmitted diseases (STIs) and, if it’s due, conduct a cervical screening test.

You’ll be in our clinic’s private treatment room for around 45 minutes. However, some people may need longer to recover, so please allow 90 minutes.

Is an IUD Insertion Painful?

It’s common to experience mild cramping during the insertion, which generally doesn’t last long.

Taking Panadol and anti-inflammatory tablets (e.g. Nurofen, Voltaren, or Ponstan) an hour or so before your appointment is a good idea.

Our assisting practice nurse will ask for any music requests to help you relax during your appointment.

When you’re comfortable, I’ll apply some gentle local anaesthetic spray to your cervix before carefully inserting the IUD.

After Your IUD Insertion

You may feel a bit woozy afterwards, so having someone drive you home is a good idea.

To reduce any risk of infection, you’re best not to take a bath, have penetrative sex, or insert anything into your vagina for seven days after the procedure, including tampons.

We’ll see you again in six weeks to see how it’s all going and check the IUD strings are where they should be.

Are There Any Side Effects or Disadvantages?

Patients generally report very few side effects after having a hormonal IUD inserted.

Most minor complications are short-lived and can include the following:

• Mild cramps lasting up to a week after your IUD insertion. Usually, nothing a heat pack and a couple of Panadol or Nurofen can’t fix.
• Irregular bleeding may occur between periods, usually settling in 4-6 months.
• You may notice a change in vaginal mucous (discharge) in the first few weeks.
• In rare cases, the IUD can fall out within the first three months.
• Mild hormonal reactions such as headaches, mood swings, and tender breasts.

Copper IUDs tend to cause heavier and more painful periods.

IUDs don’t protect against STIs. As we all know, condoms are your go-to for safe sex.

Do IUDs Cause Weight Gain?

Copper IUDs don’t contribute to weight gain in the least.

With hormonal IUDs, weight gain is quite rare. The good news is that water retention and bloating (not body fat) are typically to blame – a possible side effect of levonorgestrel.

Any unlikely water retention should dissipate three months post-insertion.

How Easily are IUDs Removed?

In almost all cases, IUDs are incredibly easy for a doctor to remove – generally much easier than insertion.

All it takes is a 15-minute appointment. The procedure may be mildly uncomfortable, yet it shouldn’t be painful.

Your normal fertility level will immediately return after having an IUD removed, or you can have a new device inserted.

How to Get Started

The best way to get started is to make an appointment for an initial chat. We’ll focus on what you want and expect from this type of contraception.

In the lead-up, it’s a great idea to speak with friends and family who’ve had an IUD inserted and hear their experiences.

We’ll consider your lifestyle factors and medical and gynaecological history and order any tests necessary to determine your IUD eligibility.

If it’s not for you, we can arrange another time to discuss alternative contraception options that may better suit you.

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Dr Jeanne North is a local GP at Doctors of South Melbourne.

She has specialised training in IUD insertions and a special interest in minor surgical procedures.

You can make an appointment online with Jeanne or call us on (03) 8579 6838.