By Dr. Tamsin Franklin.
Intrauterine Devices (IUDs) provide reliable contraception for women of all ages who wish to prevent pregnancy. A device sits inside your uterus, and a small string made of nylon is cut 2 cm from your cervix to allow removal. IUDs can also help manage endometriosis pain and reduce menstrual loss to help manage iron deficiency. Once removed, your fertility returns.
There are two types of IUD on the market, one which has progesterone and one which is made of copper and has no progesterone.
IUDs affect the way sperm moves and survives in the uterus, stopping these cells from reaching and fertilising the ovum (egg). IUDs can also change the lining of the uterus to stop a fertilised ovum from sticking. The hormonal IUD can make the fluid at the opening to the uterus thicker, stopping sperm from getting through. It can also affect ovulation by changing the hormones that cause an ovum to be released each month.
The progesterone-coated IUD (brand name “Mirena” or “Kyleena” – I’ll use “Mirena” only in the rest of this post) reduces menstrual flow so is a great choice for women who want reversible long-term contraception with something that will allow maintenance of normal iron levels. Great for vegans and vegetarians, people who travel a lot, those who love sport, and women who don’t love bleeding every month.
The Mirena is also the best choice for perimenopausal women who struggle with the shortened menstrual cycle and erratic bleeding. It will continue through to the menopause where if you wish to manage flashing, it can be combined with the oestrogen patch to give low risk hormone supplementation.
The copper IUD is good if you absolutely don’t want any hormonal management. You will find your periods are heavier, and it is slightly more awkward to insert, but otherwise it is a great choice.
Contraindications to an IUD are actually few. If you have had breast cancer in the last 5 years, you should not have a Mirena. Having a family history or a past history is not actually a contraindication. None of the IUDs contain oestrogen, which is the main risk for clotting and breast cancer.
Considering the differences between the copper and progesterone (Mirena) IUDs in more detail;
- Differences in menstruation: After a Mirena IUD has been put in, you may have three to five months of frequent and irregular bleeding between periods. After this time, your periods may be shorter, lighter, and less painful. About 50 percent of women stop bleeding altogether. After a copper IUD has been put in, you may have a few weeks of irregular bleeding between periods. After this time, your periods may be heavier and more painful.
- Differences in side effects: A Mirena IUD may cause headaches, acne, breast tenderness and an increase in appetite in the first few months. A copper IUD has no hormonal side effects.
- Differences in cost: The Mirena IUD device is covered by a health care card in Australia, and costs less than $50. The copper IUD is not covered by a health care card, and may cost over $100 outside a public hospital setting.
The insertion process is explained in this video that I produced.
Check it out. If you are interested, please make an appointment to come and talk about it. All of the female doctors at Turn The Corner can discuss the pros and cons of having an IUD, and can remove them. We have three doctors currently that are qualified to insert them; Dr Michelle, Dr Shumaila, and myself.