Island Sexual Health Society Be informed, not surprised!

Intrauterine device (IUD)

2011 March 30

The IUD is a small, flexible plastic device that is inserted into the uterus to prevent pregnancy for up to 5 years. In Canada there are two types: the copper IUD and the Mirena IUD (with hormones).

IUDs are very effective in reducing the risk of pregnancy but they do not offer any protection against sexually transmitted infections

How do I get an IUD at ISHS?

Make an appointment at any of our clinics in Greater Victoria to begin the process of getting an IUD. More than one appointment is necessary.

Pre-insertion orientation and screening

Before getting an IUD, you will have an orientation session with one of our educators to go over the risks, benefits and alternate methods of birth control available. During this visit an education checklist must be signed indicating which type of IUD you choose.

Secondly, you must see a doctor to determine whether you can safely use an IUD, and be screened for infections (chlamydia, gonorrhea, bacterial vaginosis, trichomoniasis, yeast). The test results take approximately 1 week to come back from the lab.

Mirena IUD:
As of February 28, 2011, we are no longer carrying Mirena IUDs for purchase through our clinics because as, a non-profit, we simply cannot afford to stock the amount that we insert each month! All clients wanting a Mirena IUD will be given an outside prescription to purchase the Mirena and bring it along to their insertion appointment. If you cancel your insertion appointment less than 48 hours before the insertion, a $50 cancellation fee will be due before you can re-book your insertion.

Copper IUD:
If you are purchasing your Copper IUD through us, we now require full payment at the time of booking. The Copper IUD is $70 (plus taxes). We accept Cash, Visa, and Debit. If you have to cancel your appointment prior to the insertion, the payment will be refunded in full if a miniumum of 48 hours cancellation notice is given. If cancellation is not made a minimum of 48 hours before the appointment time, a $50.00 administration fee will be deducted. Payment made by cash will be refunded by ISHS cheque and will require 5 working days to process.

If you are bringing your own IUD:

. If you cancel your insert appointment less than 48 hours before your insertion, a $50 cancellation fee will be due before you can re-book your insertion.

IUD insertion

An IUD can be inserted at anytime during the menstrual cycle once pregnancy or the possibility of pregnancy can be excluded.

For women who have recently given birth, IUD insertion is offered after 8 weeks post-partum.

The insertion appointment lasts about 40-60 minutes while the actual insertion takes about 10 minutes. You may wish to take 400 mg of ibuprofen prior to your appointment. Please eat a light meal 90 minutes prior to your appointment.

Please bring someone to accompany or drive you home as some women may experience cramping or dizziness after insertion.

After insertion it is normal to experience some cramping and light bleeding. If this feels more uncomfortable than during a menstrual period, contact the clinic.

Please ensure you receive a copy of the aftercare instructions as you will have to check your IUD strings regularly to ensure proper placement.

You should use abstain or use a back up method of contraception for 7 days after insertion.

A follow-up appointment is not necessary provided you are able to feel the strings and are having no problems. If you cannot feel the strings, you should use a back up method until you can be examined by a physician.

How IUDs work

The presence of the IUD (a foreign body) in the uterus affects sperm movement to prevent fertilization. The main way that an IUD works is to prevent fertilization.

An IUD is about 99% effective at preventing pregnancy.

Copper IUD

The copper IUD has a T-shaped plastic frame wrapped in copper wire. The copper causes added changes in the uterus and can directly inhibit sperm motility, to prevent pregnancy. Ovulation is not affected. Among typical couples who use the Copper IUD, 1-2% will experience an accidental pregnancy in the first year.

Mirena IUD

The Mirena IUD has a T-shaped plastic frame containing a hormone that is released slowly over 5 years. The hormone (levonorgestrol) causes changes in the uterus and the cervical mucus which prevent pregnancy. Ovulation may be inhibited in some women. Among typical couples who use the Mirena IUD, one in 1,000 wil experience an accidental pregnancy in the first year.

The Mirena is reported to have the lowest failure rate of any birth control method and appears to be as effective as a tubal ligation

IUD benefits and risks

Advantages of the IUD include:

  •  continuous protection for 5 years
  • 98%+ effectiveness for the copper and 99.9% for the Mirena
  •  reversibility
  •  low cost
  •  Some evidence suggests that copper containing devices reduce the risk of endometrial cancer.
  •  Mirena may reduce menstrual flow and cramping. Some evidence suggests that the Mirena may help manage uterine fibroids.

Disadvantages of the IUD include:

  • potential for increased menstrual cramping and blood flow with copper devices and irregular spotting for a few months after the insertion of a Mirena.
  • Hormonal side effects with Mirena use are uncommon. The amount of levonogestrel that transfers into the bloodstream is only 5-10% of the birth control pill. Possible side effects include depression, acne, headache, and breast tenderness.
  • Up to 6% of IUD users will discontinue IUD use within 5 years due to pain. Pain may be a response to the presence of the IUD, infection or malposition of the IUD.

Risks of the IUD include:

  • Uterine perforation: There is a 1 in 1000 risk of uterine perforation at the time of insertion.
  • Infection: There is a 1 in 100 risk (1%) of pelvic infection in the 20 days following insertion but the tisk is the same as a non-IUD user thereafter. Exposure to STIs are responsible for pelvic infection occurring after the first month of use. It is important to remember that the IUD does not protect against STIs. PID may lead to future infertility.
  • Expulsion: There is a 1 in 20 (5%) risk of the IUD being expelled, usually in the first year of use.