INTRAUTERINE CONTRACEPTION
Superior Contraception and/or Menstrual Regulation
IUD CLINIC
WHAT IS AN IUD?
An intrauterine device (IUD) is an effective and low cost form of long-acting reversible contraception. Depending on the IUD chosen, it may offer benefits such as reduction in menstrual flow, cycle length and cramping. An IUD is a small, soft T-shaped device with a nylon string attached, which is inserted into the uterus by a healthcare provider. IUDs are among the most reliable and convenient forms of contraception for women of all ages, from teens to breastfeeding mothers and women transitioning into menopause.
There are two types of IUDs available: hormonal and the non-hormonal copper IUD, and they are 99.8% effective in preventing pregnancy for up to 3-10 years. An IUD can be removed at any time, and fertility returns rapidly.
Together, we determine your IUD type based on your menstruation pattern, health history and personal preference.
MORE THAN BIRTH CONTROL
Hormonal IUDs can help prevent heavy and irregular periods in women of all ages. All IUDs decrease your risk of endometrial cancer.
HORMONAL IUD: MIRENA / KYLEENA
The Mirena or Kyleena IUDs are polyethylene T-shaped devices with a progestin (levonorgestrel) hormone contained within the stem.
How Does It Prevent Pregnancy?
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The medication is slowly released over time. It prevents pregnancy by altering the endometrium, changing the cervical mucus to prevent the passage of sperm, and possibly inhibiting ovulation.
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Its failure rate is 0.09/100 patients Years (WY), the lowest of all contraceptive methods, and ectopic pregnancy rate is 0.02/100 WY.
Menstrual Regulation
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One of the side effects of the levonorgestrel is thinning of the endometrial lining over time. For the first three months, most patients will have irregular, nuisance spotting while the endometrial lining is being thinned out.
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At one year, 15-50% of patients are amenorrheic (do not have a period). The majority of other patients experience light bleeding every few months. Due to the effect of progesterone on the endometrium, patients who do continue to have periods have significantly decreased blood loss and less cramping than without the IUD.
Risks & Side Effects
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Perforation (1/1000), infection (1/100) primarily in the first three weeks after insertion, expulsion (2-10%), and failure/pregnancy (0.2%). If a patient becomes pregnant with any IUD in place, the risk of the pregnancy being in an ectopic location is 15-20%.
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Pain or dysmenorrhea, typically primarily in the first three months after insertion. This is often treated satisfactorily with Ibuprofen.
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There are few hormonal side effects due to the low circulating concentration of levonorgestrel. The most common ones are breast tenderness, acne, and headache, which tend to be most noticeable in the first two to three months of use. Most patients are not bothered by these side effects. Rarely, women will experience mood changes; if these occur you should speak with you health care provider.
Cost & Duration of Use
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Mirena provides contraception for 8 years, and Kyleena provides contraception for 5 years. Talk to your provider to decide when you should change your IUD.
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The Mirena or Kyleena IUD cost is approximately $450.00. Almost all drug plans cover the Mirena or Kyleena IUDs.
COPPER IUD/IUB
Copper IUDs are hornone-free intrauterine devices which as soon as they are placed starts releasing small amounts of copper to provide continuous birth control.
Traditional plastic and copper T-shaped devices such as the Mona Lisa®, Liberte® or Flexi-T® come in multiple sizes, selected depending on the desired duration of contraception, the size of a woman's uterus and/or if she has had pregnancies in the past.
The Ballerine® IUB is an titanium and nickel filament with copper beads, assumes a spherical shape once inserted into the uterine cavity; it conforms to the shape of the uterus and minimizes risk of damage and irritation. It prevents pregnancy for 5 years.
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How Does It Prevent Pregnancy?
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The copper IUD prevents pregnancy by changing the environment of the endometrial cavity and altering sperm function. There are no hormones involved.
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The copper IUD can be used as emergency contraception when used within 7 days after unprotected sex.
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It is a very reliable method of contraception, with a failure rate of 1.26 per 100 patients-years (WY) and an ectopic pregnancy rate of 0.25 per 100 WY.
Menstrual Bleeding
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Its presence will not alter the timing of your menstrual cycles, but may make your period slightly heavier and more crampy, especially within the first 3-4 months. Ibuprofen (Advil or Motrin) can help to control this.
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Side effects include increased bleeding or spotting, especially in the first three months after insertion. Bleeding averages 13 days in the first month and decreases to 6 days per month at one year.
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Up to 6% of patients will experience heavier more painful periods with the copper IUD. If you already have painful/crampy periods this is not the best option for you.
Risks & Side Effects
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Perforation (1/1000), infection (1/100) primarily in the first three weeks after insertion, expulsion (2-10%), and failure/pregnancy (0.6%). If a patient becomes pregnant with any IUD in place, the risk of the pregnancy being in an ectopic location is 15-20%.
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Pain or dysmenorrhea, typically primarily in the first three months after insertion. This is often treated satisfactorily with Ibuprofen.
Cost & Duration of Use
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It is good for 3-10 years.
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Copper IUDs are very inexpensive, approximately $115.00 - $170 plus dispensing fee from the pharmacy. However, they are not always covered under drug plans.
RESOURCES: IS AN IUD RIGHT FOR YOU?
IUD Fact Sheet - Options for Sexual Health BC
Everything You Need to Know about IUDs - Ariana Tobin
What to Expect During an IUD Insertion - Dawn Stacey PhD
IUD INSERTION APPOINTMENTS
WE AIM TO BOOK NON-URGENT IUD INSERTIONS WITHIN 4-6 WEEKS
All emergency contraception IUD insertions need to be booked within 5-7 days from the day of your unprotected sex. Please bring this to our attention when you book your appointment and we will do our best to accommodate you.
Placing an IUD only takes a few minutes, but you will need extra time in our clinic for the following:
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IUD counselling and answering any questions you may have;
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Urine pregnancy test to confirm that you are not pregnant;
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Time to allow local anesthetic (lidocaine jelly applied to the cervix) to take effect;
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Post-placement rest for up to 15 minutes.
PAIN MANAGEMENT
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​An IUD can be inserted at any time during your cycle in the setting of a negative pregnancy test.
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If you haven’t been pregnant before, we often recommend scheduling your insertion during or just after your period to make the process smoother.
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To ensure your comfort, we use a local anesthetic (freezing) to numb the cervix during the procedure. If additional support is needed, we also offer oral or inhaled analgesia in select cases to help manage any discomfort; these prescriptions will need to be arranged in advance of the procedure.
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Pain is subjective, so while some patients may experience only a mild pinch or cramping similar to menstrual discomfort, others may feel more intense sensations. If you're sensitive to procedures, it's advisable to arrange for a ride home afterward.