Hormone Releasing Intrauterine Device IUD
WHAT IS A HORMONE RELEASING IUD?
The hormone-releasing IUD is a small plastic device which is inserted into the uterus (womb) by a doctor and is used to prevent pregnancy. It contains a hormone called levonorgestrel in its stem. Levonorgestrel is a type of progestogen. A very small amount of this hormone is released continuously over 5 years.
HOW DOES IT WORK?
The hormone-releasing IUD works mainly by preventing fertilisation. It does this by thickening the mucus in the cervix to prevent sperm penetration; interfering with sperm movement, and thinning the lining of the uterus.
HOW EFFECTIVE IS IT?
The hormone-releasing IUD is 99.8% effective at preventing pregnancy.
HOW LONG DOES IT LAST?
It is effective for 5 years.
WHAT ARE THE ADVANTAGES OF A HORMONE RELEASING IUD?
- It is a highly effective contraceptive (99.8%).
- It does not require any day to day action.
- It is long-acting.
- The effect is rapidly reversible after removal.
- It is a very cost-effective method over time.
- It can be used by breastfeeding women.
- It decreases menstrual bleeding and pain(many women experience very light periods or no periods).
WHAT ARE THE DISADVANTAGES?
- It must be inserted and removed by a doctor.
- As with any procedure, there is always a small risk of complications.
- The insertion procedure can be uncomfortable.
- IUDs provide no protection against sexually transmissible infections(STIs).
- You may experience light bleeding and spotting for 3 to 6 months after insertion.
- Your periods may be irregular.
- Some women may have factors in the shape of their uterus that prevent IUD insertion, and this may not be apparent until insertion is attempted.
WHAT ARE THE POSSIBLE PROBLEMS WHICH MAY OCCUR WITH A HORMONERELEASING IUD?
- There is a small risk of pregnancy occurring with an IUD (less than 1 in 100). If pregnancy does occur there is a slightly increased risk of it occurring in the fallopian tube.
- Infection: There is a small risk of infection at the time of insertion(about 1 in 500).
- Expulsion: In about 5% of cases the uterus will expel the device. Women need to check that the IUD is still in place by feeling for the IUD string after each period. If the string is not present this may indicate that the IUD has moved or been expelled.
- Perforation: This is a rare event (approximately 2 in 1000 insertions)which occurs when the IUD passes through the wall of the uterus into the pelvic area. This will require surgery under a general anaesthetic to remove the IUD.
HOW IS AN IUD REMOVED?
Removal of an IUD is done by a doctor. It is a relatively quick and straightforward procedure.
WHO DO I GO TO FOR IUD INSERTION?
IUDs are only inserted by doctors who have done IUD training. The clinic at SHFPACT provides IUD insertion services. Some GPs and most gynaecologists also provide this service.
WHAT HAPPENS IN THE IUD INSERTION PROCESS AT SHFPACT?
INITIAL CONSULTATION APPOINTMENT
- There will be an initial consultation with a doctor to determine if a hormone-releasing IUD is a suitable option for you. The method and insertion procedure will be explained, a Cervical Screening Test will be offered if it is due, and swabs may also be collected if required. It is best to ask any questions or raise concerns at this point.
- A prescription for the IUD will then be given to you. You will need to go the chemist and have this filled then you need to bring the IUD with you to the clinic on the day of insertion.
- The hormone-releasing IUD needs to be inserted on day 1 to 7 of your menstrual cycle (day one being the first day of your period) or at any time if you are currently using the oral contraceptive pill or another reliable method of contraception.
- Following your initial consultation, you will need to make an appointment for the insertion.
- You will be encouraged to arrange to be driven home and to rest up after the procedure and for the remainder of the day (you may need to organise care for young children, time off work etc.). You will probably be fine to return to normal activities the following day.
- Most women will be at the clinic for an hour to an hour and a half. If parking please ensure you have left enough time.
- The doctor will run through the procedure and make sure the process is clear.
- An uncomplicated insertion procedure takes about 15 mins. You will be asked to stay at the clinic for a minimum of 20 minutes following the procedure. If you are not feeling well you will be asked to remain until the staff caring for you feel that you are well enough to leave.
- There may be cramping and/or bleeding in the first few days afterwards.
- Spotting may occur for up to 3 to 6 months after insertion.
- We advise that nothing should enter the vagina for 3 days afterwards in order to reduce the risk of infection: no tampons, no sex, no baths, no swimming or douches (showering is ok).
- You will need to return for a check-up in 4- 6 weeks. At this appointment, the doctor or nurse will do a speculum examination to check the strings are visible, and an internal exam to check for pain or infection.
- You should contact the doctor if:
- You suspect you might be pregnant.
- You experience excessive pelvic pain or tenderness, fever or chills, offensive vaginal discharge, or deep pain with intercourse.
- You can’t feel the string or can feel the plastic of the device.
HORMONE RELEASING IUD BROCHURE PDF
References: Contraception: An Australian clinical practice handbook 4th Edition. Contraception: Intrauterine Devices/ Family Planning QLD. Hormone Releasing IUD (Mirena) Fact sheet, Family Planning NSW. Guillebaud, J & MacGregor, A. 2013. Contraception: Your questions answered. 6th Edition. Churchill Livingstone. Last updated Jan 2019.