Intrauterine device (IUD)
Both copper (left) and hormone (right) IUDs are very effective. Make an appointment to find out more or to get an IUD.
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 do not protect against sexually transmitted infections.
Make an appointment to see a doctor about getting an IUD.
IUDs in detail
How to get an IUD
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.
When you book your insertion appointment, a $50.00 deposit will be taken. This fee will be deducated from your final bill on the day of insertion. If you have to cancel you appointment prior to the insertion, the deposit will be refunded if a minimum of 24 hours notice is given. If notice is given after the 24 hours then the refund will be forfeited.
IUD insertion
An IUD can be inserted at anytime during the menstrual cycle once pregnancy or the possibility of pregnancy can be excluded. It is important to continue using your current birth control method until your follow up appointment.
In 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 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, however, if fertilization does occur, IUDs appear to have additional effects, including preventing implantation.
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.
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.
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
- 99% effectiveness
- 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: rate of 1 per 1000 insertions (rare). All perforations occur or are initiated at the time of IUD insertion. Risk factors for perforation include IUD insertion early after delivery of a baby, an inexperienced inserter or a uterus that doesn’t move around easily.
- Infection: a rate of 1 in 100 risk for pelvic infection exists for about 1 month following the insertion of an IUD. Exposure to STIs are responsible for pelvic infection (PID) occurring after the first month of use. It is important to remember that the IUD does not protect against STIs. A long-term mutually monogamous relationship is best for a woman with an IUD as multiple partners will greatly increase the risk of STIs and PID. PID may lead to future infertility.
- Expulsion: Most common in the first year of use (2-10% of users). The 5 year cumulative rate for the copper IUD is 6.7% and for the Mirena is 5.8%. Risk factors for expulsion include insertion early after delivery of a baby, insertion in a woman who has never had a baby and previous expulsion. A woman who has previously expelled an IUD has a 30% chance of expelling a subsequent IUD.
- Failure: If a woman becomes pregnant with an IUD in place, the presence of an ectopic (also known as tubal) pregnancy must be excluded. IUDs do not increase the risk of an ectopic pregnancy. If the woman chooses to continue the pregnancy, the risk of miscarriage is increased as long as the IUD remains in place.