Dr Louisa Gilles

When considering your contraceptive needs or managing problematic menstrual bleeding it is good to have some options. An IUD is a great addition to the choices women can make.

What is an IUD?

Small contraceptive devices that are inserted into the uterus by a qualified health professional.

There are 2 types of (progestogen) hormonal devices: Mirena and Kyleena. Mirenas have been in use for over 35 years. Kyleena is like Mirena’s little sister. It is physically smaller (so sometimes easier or less painful to insert) and contains less hormone so there is a lower chance of experiencing hormonal side effects for women that are sensitive to this.

There are also a range of non-hormonal devices (copper IUDs).

What are the benefits of an IUD insertion?

While no method of contraception is 100% effective, the failure rate of an IUD is lower compared to using pills, condoms, or timing methods. The effectiveness is not influenced by remembering to do something every day or an intercurrent illness.

They are long acting – Mirenas last 8 years for contraception, Kyleenas 5 years, and Coppers either 5 or 10 years. Due to this longevity, they can also be very cost-effective. They can be suitable for women or teens at various life stages including before having a pregnancy, postpartum, during breastfeeding, and in the perimenopause or post-menopausal stage.

There are benefits outside of contraception too.

A Mirena can be extremely useful for controlling heavy and/or painful periods.

It can be used as part of menopausal hormone therapy in combination with other hormones.

A copper IUD is the most effective emergency contraceptive option (compared to “morning after pills”) if inserted within 5 days of unprotected sex.

Does it hurt to have an IUD inserted?

This is a concern that many women have, and many have shared “horror stories” online. While it is usually uncomfortable, most women tolerate having this procedure well. Many find it mildly - to moderately painful, often only for a very short period of time (a few seconds).

A lot can be done to minimise the pain – including a supportive environment where the woman is in control and knows what to expect, use of local analgesia and pain killers, use of penthrox (the green whistle) or diazepam for those with more concerns about the procedure.

Less commonly a woman may choose to have a referral to a gynaecologist to have the procedure performed under sedation or general anaesthetic.