THE WELL. Intrauterine Contraceptive Devices WOMAN CENTRE



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THE WELL WOMAN CENTRE Intrauterine Contraceptive Devices

INTRAUTERINE CONTRACEPTIVE DEVICES How does the Mirena work? How effective is the Mirena? What are the advantages of the Mirena? What are the disadvantages of the Mirena? How does the copper coil work? How effective is the copper coil? What are the advantages of the copper coil? What are the disadvantages of the copper coil? This Section Applies To Both Mirena And The Copper Coil. How is an IUD fitted? After it s fitted do I have to do anything? What if I change my mind? What if I get pregnant while using an IUD? I want to have a baby. Will I be able to get pregnant when the IUD is removed? THE WELL WOMAN CENTRE 2

INTRAUTERINE CONTRACEPTIVE DEVICES There are two types of intrauterine device (IUD) used in Well Woman Centres for long term contraception. a device containing progesterone called Mirena, and a device containing copper, the Copper T 380. Both are small T shaped devices that must be inserted into your womb by a trained doctor. Once in place, the IUD is effective for 5 years in the case of Mirena, and 10 years in the case of the Copper T 380. How does the Mirena work? It thickens the mucus in your cervix so it helps to stop sperm reaching an egg. In some women it stops the ovaries releasing an egg (ovulation), but most women who use the Mirena still ovulate. It makes the lining of the womb thinner so implantation cannot happen. How effective is the Mirena? The Mirena is very safe less than 1 in 100 women will get pregnant during the time the coil is in place. What are the advantages of the Mirena? It works as soon as it is put in. It lasts for 5 years. After you have used the Mirena for about 3 months your periods usually become lighter and shorter, so the Mirena can be useful if you normally have heavy painful periods. THE WELL WOMAN CENTRE 3

The Mirena usually reduces or eliminates period pain. What are the disadvantages of the Mirena? Most women have slight bleeding between periods for the first 3 months or so. Temporary side effects such as headaches, acne and breast tenderness are possible. These usually settle down within a few weeks. Infection may be introduced into your womb when the coil is being put in. The womb can push the Mirena out. This is rare but if it does occur it is most likely to happen within a few weeks of it being put in. The Mirena may go through the wall of the womb as it is being inserted. This is very unlikely when the Mirena is fitted by an experienced doctor. How does the copper coil work? It thickens the mucus in your cervix so it provides a barrier to sperm moving. It sets up a reaction in the lining of your womb so that an egg is less likely to implant. How effective is the copper coil? The copper coil is slightly less effective than Mirena. However, the failure rate is still lower than when using contraceptive pills because pills may be forgotten or not absorbed due to a stomach upset. What are the advantages of the copper coil? It works as soon as it is put in. THE WELL WOMAN CENTRE 4

It lasts for 10 years What are the disadvantages of the copper coil? It can make your periods heavier than normal. Infection may be introduced into your womb at the time the coil is being put in. The womb can push the coil out. This is rare but if it does occur it is most likely to happen within a few weeks of being put in. The coil may go through the wall of the womb as it is being inserted. This is very unlikely when the coil is fitted by an experienced doctor. This Section Applies To Both Mirena And The Copper Coil. How is an IUD fitted? Whether you have a Mirena or a copper coil fitted, the device must be put in by a specially trained doctor. The device is fitted sometime during the first 5 days of your cycle. This is because this is the time when the neck of your womb (cervix) is softest and so the device is easiest to fit. You may also be asked to insert 2 tablets (containing a hormone called misoprostol) into your vagina 3 hours before the device is fitted because these will also help soften your cervix. Fitting an IUD can be uncomfortable so it is a good idea to take a painkiller beforehand. You may get a period type pain for a few days afterwards. Talk to the doctor about taking pain relief to help with this. During insertion, the threads of the coil are normally cut so that about an inch of thread is visible at your cervix. After it s fitted do I have to do anything? You should come back for a check-up about 6 weeks after the IUD is fitted when we can check that the threads are still visible, which means that the device is in place. After the six THE WELL WOMAN CENTRE 5

weeks check, if everything is normal then you should plan to have a check up once a year. If you get any unusual bleeding in the meantime, please make an appointment to see a one of our doctors. In some women who have the Mirena fitted, periods may stop completely. This is normal and is not a cause for concern. What if I change my mind? A trained doctor can take out the IUD at any time. If you are planning to have the IUD taken out, you should ether abstain from sex or use a condom for the week before the coil is taken out. This is because sperm can live for several days and there is a possibility of you getting pregnant if the coil is taken out within a few days of sexual intercourse. What if I get pregnant while using an IUD? It is not common with the copper coil and rare with the Mirena. If you get pregnant and the coil threads are easily seen, then the doctor will remove the device. However if the threads are not visible, then it is better just to leave the IUD in place. There is no increased risk that it will cause a baby to have any problems after delivery. I want to have a baby. Will I be able to get pregnant when the IUD is removed? Neither device has an effect on your ovarian function so you would return to normal fertility when the device is removed. Updated July 2009 THE WELL WOMAN CENTRE 6