Contraception - intrauterine devices (IUD)

What is an intrauterine device (IUD)?

An intrauterine device (IUD) is a small contraceptive device that is put into the uterus (womb) to prevent pregnancy. The 2 types available in Australia are the:

copper IUD (also called the non-hormonal copper IUD)

hormonal IUD (Mirena™ and Kyleena™).

Kyleena is a lower dose version of Mirena and has been available in Australia since 2020.

The copper IUD is designed to stay in place for up to 10 years and the hormonal IUDs (Mirena™ and Kyleena™) for 5 years. Both can easily be removed sooner, if needed.

the contraceptive implant

, IUDs are known as long-acting reversible contraception (or LARC) because they work over a number of years.

Copper IUD

The copper IUD is a small, T-shaped, plastic and copper device. It constantly releases a small amount of copper into the uterus.

The copper IUD can also be used for

emergency contraception

instead of the emergency contraceptive pill (‘morning after pill’) if it’s within 5 days of

unprotected sex

Hormonal IUD

The hormonal IUDs are small, T-shaped, plastic devices (sold as Mirena™ and Kyleena™ in Australia). They slowly releases a hormone (progestogen) into your

uterus

. Progestogen is like the hormone produced by the ovaries.

Effectiveness of IUDs

Both copper and hormonal IUDs are more than 99% effective at preventing

pregnancy

IUD insertion

Sexual Health Victoria’s Medical Director Dr Kathy McNamee provides some advice on preparing and managing pain from an IUD insertion.

Your doctor or nurse practitioner will write you a script and you can get the IUD from a pharmacy. Sometimes you can buy a copper IUD from the clinic providing the IUD insertion. The IUD is inserted inside your uterus by a trained doctor or nurse.

The IUD has a fine nylon thread attached to it which comes out through the cervix (opening to the uterus). If you feel high up inside your vagina, you can check that the thread is there and know the IUD is still in place. Because it is high up in the vagina, the thread cannot be seen.

It’s good idea to make a record of the date when you had the IUD inserted. You will need to make sure it is taken out before it expires (5 or 10 years, depending on the type, after being inserted).

Cost of IUDs

The hormonal IUD prescription is covered by the

Pharmaceutical Benefits Scheme

in Australia. It costs around $7 if you are a

Health Care Card

holder

External Link

and around $43 if you are not.

The copper IUD is not covered by a Health Care Card. The cost in pharmacies can be around $70 to $120. There may also be an insertion cost from the health professional.

The overall cost of the procedure will vary depending on whether you attend a private or public provider. If you don’t have a

Medicare card

private health

insurance

External Link

, it will be more expensive.

Advantages of IUDs

Advantages of copper or hormonal IUDs include:

They are more than 99% effective in preventing

pregnancy

They last for a long time – Mirena™ and Kyleena™ can last for 5 years, and the copper IUD can last for 10 years.

They are safe to use if you are

breastfeeding

No medications stop them from working.

They provide another

contraceptive choice

if you have difficulty taking the hormone oestrogen. (The

combined pill

and the

vaginal ring

contain both oestrogen and progestogen.) The hormonal IUD only contains progestogen and the copper IUD has no hormones.

Once put in, you don’t need to do anything more apart from checking the thread each month after

your period

to ensure it has not moved out of the correct position.

The device can be taken out at any time by an appropriately trained doctor or nurse.

Your chance of

getting pregnant

will go back to normal as soon as the copper or hormonal IUD has been taken out.

Advantages of the hormonal IUD include:

Most users have

no vaginal bleeding

at all, or a light regular period.

Periods may be less painful

Advantages of the copper IUD include:

It is a choice for those who do not want to use hormonal contraception.

It is a very effective method of

emergency contraception

IUD possible side effects

Possible side effects include:

When first inserted, some may experience period-type cramping that usually settles after a few days.

Sometimes the IUD can come out. This is more common in the first 3 months of it being inserted.

Your period will change. Spotting or frequent bleeding is common in the first 3 to 6 months. By 6 months around 90-95% of people may have a light regular period or no bleeding at all (this is not harmful to the body).

You may experience tender breasts,

headaches

, skin changes and mood changes. These side effects nearly always settle with time. The hormonal IUD has not been shown to cause weight gain.

Copper IUD possible side effects

Possible side effects from the copper IUD include:

Spotting or frequent bleeding

in the first 3 months. This nearly always settles with time and your regular bleeding pattern will return.

Heavier periods

IUD and potential health risks

In about 1 in 500 people, a small hole in the wall of the uterus (womb) may be created while the IUD is being inserted. The IUD can move through the hole and sit in the wrong place. If this happens,

keyhole surgery (known as a laparoscopy)

is required to have the IUD removed.

Around 1 in 300, may get an infection when the IUD is first inserted. This can be successfully treated with antibiotics.

It is very unlikely to get pregnant when using an IUD. If you do get pregnant with an IUD in place, there is a higher chance of

ectopic

pregnancy

External Link

. This means that the pregnancy may settle in the

fallopian tubes (pathway of the egg to uterus)

. If this happens, seek urgent medical assistance.

When an IUD is not suitable

An IUD might not be a good option for you if you have:

uterus

that is not the usual shape

a current

pelvic infection

The hormonal IUD might not be a good option for you if you have:

been treated for

breast cancer

severe

liver disease

The copper IUD might not be a good option for you if you have:

heavy periods

low iron levels

endometriosis

Pregnancy when using an IUD

If you become pregnant while using an IUD, see a doctor or nurse as soon as possible and have the IUD removed. The doctor or nurse will also need to rule out a pregnancy in your fallopian tubes (

ectopic pregnancy

If the IUD is removed, you can choose to continue or terminate the pregnancy (have an

abortion

If the IUD is not removed and you continue with the pregnancy, there is a higher risk of

miscarriage

delivering the baby early

(premature labour).

Using an IUD after the birth of a baby

You can have an IUD inserted within 2 days after

giving birth

If it’s not inserted straight after birth, then you need to wait at least 4 weeks.

IUDs are safe to use if you are

breastfeeding

Conceiving a baby and IUDs

If you

want to become pregnant

, an IUD can be removed at any time by a doctor or a nurse.

Your fertility

will quickly return.

Other types of contraception

There are many

contraceptive methods available in Australia

. When choosing the method of contraception that best suits your needs, it can help to talk to a doctor or nurse about your options. Different methods may suit you at different times in your life.

A doctor or nurse can give you information about:

the benefits and risks of using various methods of contraception

how well each method works

the possible risks and side effects

how easy it is to use

how much it costs

how each method meets your current and future needs.

Other methods include the

contraceptive implant or injection

, the

vaginal ring

or the combined oral

contraceptive pill

IUDs do not protect you from STIs

Neither type of IUD gives protection from

sexually transmissible infections (STIs)

. It’s important to

practise safer sex

, as well as to prevent an

unintended pregnancy

The best way to lessen the risk of

STIs

is to use barrier methods (such as

external

internal condoms

) for

oral

, vaginal and anal sex with all new sexual partners. Condoms can be used with IUDs.

Information in community languages

The following information is available from

Health Translations

Contraception - intrauterine devices (IUD)

Contraception - intrauterine devices (IUD)

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