Hormonal IUD
A hormonal intrauterine device (IUD) is a small, T-shaped plastic device that is inserted into the uterus to provide long-term contraception. It releases a low dose of a synthetic hormone called progestin, which is similar to the hormone progesterone that is naturally produced by the ovaries. The most common type of hormonal IUDs are Mirena and Kyleena.
The progestin in a hormonal IUD thickens the cervical mucus, which makes it difficult for sperm to enter the uterus and fertilize an egg. It also thins the lining of the uterus, which makes it less likely for an egg to implant in the uterus if fertilisation does occur. Hormonal IUDs are over 99% effective at preventing pregnancy when used correctly. More information about hormonal IUDs as contraception found here
In addition to preventing pregnancy, hormonal IUDs may also have other benefits, such as reducing menstrual bleeding, cramping and preventing the progression and recurrence of endometriosis. For this purpose, the Mirena is typically recommended, which has a higher dose of progestin than the Kyleena. While the Mirena is not specifically designed to stop your period, many women may experience changes in their menstrual bleeding patterns when using this form of birth control. A common side effect of the Mirena is a decrease in menstrual bleeding or even the absence of periods in some cases.
Here is what you can expect during IUD insertion:
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You will be asked to sit on the examination chair, with a drape covering the lower half of your body
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A speculum is used to gently open the vagina and visualise the cervix.
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The doctor will clean the cervix with an antiseptic solution and pass a slim plastic tube containing the IUD through the cervix into your uterus
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Once the IUD is properly positioned, the tube will be removed, leaving the IUD in place, and the strings of the IUD will be trimmed to the appropriate length.
*Inserting a hormonal IUD under ultrasound guidance is a technique used by some healthcare providers to ensure correct placement of the device within the uterus. It can also help to reduce discomfort during insertion.
Do I need pain relief?
The experience of IUD insertion can vary from person to person, but some people report feeling mild to moderate discomfort during the procedure. However, most people are able to tolerate the discomfort, which usually lasts only a few seconds.
We recommend taking an over the counter analgesic such as ibuprofen or paracetemol 30 minutes before your procedure. You may also be given the option of having Penthrox (aka. "the green whistle"), a short-acting analgesic which is inhaled during the insertion to reduce pain.
What to expect after IUD insertion
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Cramping: It is normal to experience mild to moderate cramping for a few days after the insertion. Ibuprofen can be taken to reduce discomfort.
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Spotting and bleeding: You may experience light spotting or bleeding for a few days after the insertion. This is normal and should subside within a week or so.
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Changes in menstrual bleeding: The hormonal IUD can cause changes in your menstrual bleeding pattern, such as lighter periods, irregular bleeding, or no periods at all. These changes can occur gradually over time and may take a few months to stabilise.
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Other side effects: Some women may experience other side effects, such as headaches, breast tenderness, nausea, or mood changes. These side effects are usually mild and should subside within a few weeks.
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Follow-up appointment: We recommend making a followup appointment to confirm placement of the IUD approximately 6 weeks post insertion. This can be arranged through our rooms or with your GP.
Risks
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Expulsion: In rare cases, the IUD can become dislodged or expelled from the uterus.
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Perforation: In rare cases, the IUD can perforate the wall of the uterus during insertion.
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Ectopic pregnancy: While hormonal IUDs are highly effective at preventing pregnancy, they do not provide protection against ectopic pregnancy, where a pregnancy occurs outside of the uterus
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Infection: There is a small risk of developing an infection after IUD insertion. Symptoms of infection may include fever, chills, abdominal pain, and foul-smelling discharge.
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Other side effects: Some women may experience other side effects, such as headaches, breast tenderness, nausea, or mood changes. These side effects are usually mild and should subside within a few weeks. Please contact our rooms if these symptoms persist.
Instructions for your procedure:
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Consult with Anju / Practice Nurse regarding IUD insertion, receive prescription for IUD and pathology request for urine test. Book IUD insertion appointment
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Attend urine test approximately 1 week before IUD insertion
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Collect Mirena/Kyleena from your local pharmacy in the days before the appointment +/- Penthrox
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Do not empty the bladder in the hour before your appointment -aim for a moderately full bladder
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Take ibuprofen/paracetemol 30 minutes prior to your appointment
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Attend appointment (if you are considering having Penthrox, please bring a support person to drive you home after the procedure)
Instructions after your procedure:
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Do not use tampons or have penetrative sex for 72 hours post insertion
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Use barrier contraception (condoms) until next period
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Appointment to confirm placement in approximately 6 weeks
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Call the rooms if strong pain or concerns following insertion
Information regarding cost of IUD insertion