Contraception - intrauterine devices (IUD)

Summary
Intrauterine devices (IUDs) are small contraceptive devices that are inserted into the
uterus (womb) to prevent pregnancy.
The 2 types available are the copper IUD and the hormonal IUD (sold as Mirena™ or
Kyleena™).
Both are among the most effective methods of contraception and can stay in place for 5
to 10 years, depending on the type.
IUDs (both copper and hormonal) do not give protection from sexually transmissible
infections (STIs). The best way to reduce the risk of STIs is to use barrier protection such as
condoms with all new sexual partners.

What is an intrauterine device (IUD)?

An intrauterine device (IUD) is a small contraceptive device that is put into the
uterus (womb) to prevent pregnancy. The 2 types available in Australia are the:
copper IUD (also called the non-hormonal copper IUD)
hormonal IUD (Mirena™ and Kyleena™).
Kyleena is a lower dose version of Mirena and has been available in Australia
since 2020.
The copper IUD is designed to stay in place for up to 10 years and the
hormonal IUDs (Mirena™ and Kyleena™) for 5 years. Both can easily be
removed sooner, if needed.
Like the contraceptive implant
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-implants>
, IUDs are known as long-acting reversible contraception (or LARC) because
they work over a number of years.
Copper IUD
The copper IUD is a small, T-shaped, plastic and copper device. It constantly
releases a small amount of copper into the uterus.
The copper IUD can also be used for emergency contraception
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-emergency-
contraception>
instead of the emergency contraceptive pill (‘morning after pill’) if it's within 5
days of unprotected sex
<http://www.betterhealth.vic.gov.au/health/healthyliving/safe-sex>
.
Hormonal IUD
The hormonal IUDs are small, T-shaped, plastic devices (sold as Mirena™ and
Kyleena™ in Australia). They slowly releases a hormone (progestogen) into
your uterus
<http://www.betterhealth.vic.gov.au/conditionsandtreatments/fertility-reproductive-
system-female>
. Progestogen is like the hormone produced by the ovaries.
Effectiveness of IUDs
Both copper and hormonal IUDs are more than 99% effective at preventing
pregnancy
<http://www.betterhealth.vic.gov.au/healthyliving/pregnancy>
.
IUD insertion
Sexual Health Victoria's Medical Director Dr Kathy McNamee provides some advice on
preparing and managing pain from an IUD insertion.
Your doctor or nurse practitioner will write you a script and you can get the
IUD from a pharmacy. Sometimes you can buy a copper IUD from the clinic
providing the IUD insertion. The IUD is inserted inside your uterus by a trained
doctor or nurse.
The IUD has a fine nylon thread attached to it which comes out through the
cervix (opening to the uterus). If you feel high up inside your vagina, you can
check that the thread is there and know the IUD is still in place. Because it is
high up in the vagina, the thread cannot be seen.
It’s good idea to make a record of the date when you had the IUD inserted. You
will need to make sure it is taken out before it expires (5 or 10 years, depending
on the type, after being inserted).
Cost of IUDs
The hormonal IUD prescription is covered by the Pharmaceutical Benefits
Scheme
<http://www.betterhealth.vic.gov.au/health/serviceprofiles/pbs-service>
in Australia. It costs around $7 if you are a Health Care Card holder
<https://www.servicesaustralia.gov.au/health-care-card>
and around $43 if you are not.
The copper IUD is not covered by a Health Care Card. The cost in pharmacies
can be around $70 to $120. There may also be an insertion cost from the
health professional.
The overall cost of the procedure will vary depending on whether you attend a
private or public provider. If you don't have a Medicare card
<http://www.betterhealth.vic.gov.au/health/servicesandsupport/understanding-
medicare>
or private health insurance
<https://www.privatehealth.gov.au/>
, it will be more expensive.
Advantages of IUDs
Advantages of copper or hormonal IUDs include:
They are more than 99% effective in preventing pregnancy
<http://www.betterhealth.vic.gov.au/healthyliving/pregnancy>
.
They last for a long time – Mirena™ and Kyleena™ can last for 5 years, and the
copper IUD can last for 10 years.
They are safe to use if you are breastfeeding
<http://www.betterhealth.vic.gov.au/health/healthyliving/breastfeeding>
.
No medications stop them from working.
 They provide another contraceptive choice
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-choices>
if you have difficulty taking the hormone oestrogen. (The combined pill
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-the-pill>
and the vaginal ring
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-vaginal-ring>
contain both oestrogen and progestogen.) The hormonal IUD only contains
progestogen and the copper IUD has no hormones.
Once put in, you don’t need to do anything more apart from checking the
thread each month after your period
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstrual-cycle>
to ensure it has not moved out of the correct position.
The device can be taken out at any time by an appropriately trained doctor or
nurse.
Your chance of getting pregnant
<http://www.betterhealth.vic.gov.au/health/healthyliving/Conceiving-a-baby>
will go back to normal as soon as the copper or hormonal IUD has been taken
out.
Advantages of the hormonal IUD include:
Most users have no vaginal bleeding
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstruation-
amenorrhoea>
at all, or a light regular period.
Periods may be less painful
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstruation-
pain-dysmenorrhoea>
.
Advantages of the copper IUD include:
It is a choice for those who do not want to use hormonal contraception.
It is a very effective method of emergency contraception
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-emergency-
contraception>
.
IUD possible side effects
Possible side effects include:
When first inserted, some may experience period-type cramping that usually
settles after a few days.
 Sometimes the IUD can come out. This is more common in the first 3 months
of it being inserted.
Your period will change. Spotting or frequent bleeding is common in the first 3
to 6 months. By 6 months around 90-95% of people may have a light regular
period or no bleeding at all (this is not harmful to the body).
You may experience tender breasts, headaches
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/headache>
, skin changes and mood changes. These side effects nearly always settle with
time. The hormonal IUD has not been shown to cause weight gain.
Copper IUD possible side effects
Possible side effects from the copper IUD include:
Spotting or frequent bleeding
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/vaginal-
bleeding-irregular>
in the first 3 months. This nearly always settles with time and your regular
bleeding pattern will return.
Heavier periods
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/heavy-periods>
.
IUD and potential health risks
In about 1 in 500 people, a small hole in the wall of the uterus (womb) may be
created while the IUD is being inserted. The IUD can move through the hole
and sit in the wrong place. If this happens, keyhole surgery (known as a
laparoscopy)
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/laparoscopy>
is required to have the IUD removed.
Around 1 in 300, may get an infection when the IUD is first inserted. This can be
successfully treated with antibiotics.
It is very unlikely to get pregnant when using an IUD. If you do get pregnant
with an IUD in place, there is a higher chance of ectopic pregnancy
<https://www.betterhealth.vic.gov.au/health/HealthyLiving/ectopic-pregnancy>
. This means that the pregnancy may settle in the fallopian tubes (pathway of
the egg to uterus)
<http://www.betterhealth.vic.gov.au/conditionsandtreatments/fertility-reproductive-
system-female>
. If this happens, seek urgent medical assistance.
When an IUD is not suitable
An IUD might not be a good option for you if you have:
a uterus
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/retroverted-
uterus>
that is not the usual shape
a current pelvic infection
<http://www.betterhealth.vic.gov.au/health/healthyliving/pelvic-inflammatory-disease-
pid>
.
The hormonal IUD might not be a good option for you if you have:
been treated for breast cancer
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/breast-cancer>
severe liver disease
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cirrhosis-of-the-
liver>
.
The copper IUD might not be a good option for you if you have:
heavy periods
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/heavy-periods>
low iron levels
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/iron>
endometriosis
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/endometriosis>
.
Pregnancy when using an IUD
If you become pregnant while using an IUD, see a doctor or nurse as soon as
possible and have the IUD removed. The doctor or nurse will also need to rule
out a pregnancy in your fallopian tubes (ectopic pregnancy
<http://www.betterhealth.vic.gov.au/health/healthyliving/ectopic-pregnancy>
).
If the IUD is removed, you can choose to continue or terminate the pregnancy
(have an abortion
<http://www.betterhealth.vic.gov.au/health/healthyliving/abortion-in-victoria>
).
If the IUD is not removed and you continue with the pregnancy, there is a
higher risk of miscarriage
<http://www.betterhealth.vic.gov.au/health/healthyliving/miscarriage>
or delivering the baby early
<http://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-premature-
labour>
(premature labour).
Using an IUD after the birth of a baby
You can have an IUD inserted within 2 days after giving birth
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-after-giving-
birth>
.
If it’s not inserted straight after birth, then you need to wait at least 4 weeks.
IUDs are safe to use if you are breastfeeding
<http://www.betterhealth.vic.gov.au/health/healthyliving/breastfeeding>
.
Conceiving a baby and IUDs
If you want to become pregnant
<http://www.betterhealth.vic.gov.au/health/healthyliving/Conceiving-a-baby>
, an IUD can be removed at any time by a doctor or a nurse. Your fertility
<http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/infertility-in-
women>
will quickly return.
Other types of contraception
There are many contraceptive methods available in Australia
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-choices>
. When choosing the method of contraception that best suits your needs, it can
help to talk to a doctor or nurse about your options. Different methods may
suit you at different times in your life.
A doctor or nurse can give you information about:
the benefits and risks of using various methods of contraception
how well each method works
 the possible risks and side effects
how easy it is to use
how much it costs
how each method meets your current and future needs.
Other methods include the contraceptive implant or injection
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-implants>
, the vaginal ring
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-vaginal-ring>
or the combined oral contraceptive pill
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-the-pill>
.
IUDs do not protect you from STIs
Neither type of IUD gives protection from sexually transmissible infections
(STIs)
<http://www.betterhealth.vic.gov.au/conditionsandtreatments/sexually-transmissible-
infections>
. It’s important to practise safer sex
<http://www.betterhealth.vic.gov.au/health/healthyliving/safe-sex>
, as well as to prevent an unintended pregnancy
<http://www.betterhealth.vic.gov.au/health/servicesandsupport/pregnancy-unplanned>
.
The best way to lessen the risk of STIs
<http://www.betterhealth.vic.gov.au/conditionsandtreatments/sexually-transmissible-
infections>
is to use barrier methods (such as external
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-condoms-for-
men>
or internal condoms
<http://www.betterhealth.vic.gov.au/health/healthyliving/contraception-condoms-for-
women>
) for oral
<http://www.betterhealth.vic.gov.au/health/healthyliving/Oral-sex>
, vaginal and anal sex with all new sexual partners. Condoms can be used with
IUDs.
Information in community languages
The following information is available from Health Translations Directory
<https://www.healthtranslations.vic.gov.au/>
:
The hormone-releasing IUD (PDF)
<https://www.healthtranslations.vic.gov.au/resources/the-hormone-releasing-iud>
by Family Planning NSW
Arabic
Assyrian
Burmese
Chinese (simplified)
Dinka
Farsi (Persian)
Khmer (Cambodian)
Korean
Lao
Serbian (Cyrillic)
Swahili
Thai
Turkish
Vietnamese
The copper IUD (PDF)
<https://www.healthtranslations.vic.gov.au/resources/the-copper-iud-bilingual>
by Family Planning NSW
Arabic
Assyrian
Burmese
Chinese (simplified)
 Dinka
Farsi (Persian)
Khmer (Cambodian)
Korean
Lao
Serbian (Cyrillic)
Swahili
Thai
Turkish
Vietnamese
Long acting reversible contraception - LARC (PDF)
<https://www.healthtranslations.vic.gov.au/resources/long-acting-reversible-
contraception-larc-methods>
by Royal Women's Hospital, Victoria
English
Karen
Nuer
Oromo
Somali
Tigrinya
Where to get help
Your GP (doctor)
<http://www.betterhealth.vic.gov.au/health/serviceprofiles/General-practitioner-
services>
Your school nurse or welfare coordinator. Some secondary schools provide
access to an adolescent health trained GP on site
Your local community health service
Your pharmacist (including after hours Victorian Supercare Pharmacies
<http://www.betterhealth.vic.gov.au/health/servicesandsupport/victorian-supercare-
pharmacies>
)
Many community health services and some public hospitals have clinics
including family planning, sexual health and women’s health
Private clinics offering abortion also offer contraceptive services
1800 My Options
<https://www.1800myoptions.org.au>
– Victoria’s sexual and reproductive health information and phone line
service Tel. 1800 My Options (1800 696 784
)
Sexual Health Victoria (SHV)
<https://shvic.org.au/our-reproductive-and-sexual-health-clinics>
– book an appointment online
<https://shvic.org.au/our-reproductive-and-sexual-health-clinics/book-an-
appointment-online>
or call Melbourne CBD Clinic: (03) 9660 4700
, Box Hill Clinic: (03) 9257 0100
or (free call): 1800 013 952
(Monday to Friday 9 am – 5 pm). These services are youth friendly
Melbourne Sexual Health Centre
<https://www.mshc.org.au/>
(Monday to Friday 8:30 am – 5 pm) Tel. (03) 9341 6200
or 1800 032 017
or National Relay Service (for people with a hearing impairment) (03) 9341
6200
Thorne Harbour Health (formerly Victorian AIDS Council)
<https://thorneharbour.org/>
Tel. (03) 9865 6700
or 1800 134 840
(toll free)
The Centre Clinic
<https://thorneharbour.org/services/centre-clinic/>
, St Kilda Tel. (03) 9525 5866
Equinox Gender Diverse Health Centre
<https://equinox.org.au/>
(Monday to Friday 9 am – 5 pm) Tel. (03) 9416 2889
or email: [email protected]
<mailto: [email protected]>
PRONTO!
<http://pronto.org.au/>
 Clinic for men who have sex with men. Book online or Tel. Tel. (03) 9416 2889
Ballarat Community Health Sexual Health Clinic
<https://bchc.org.au/service/sexual-health-clinic/>
– book online or Tel. (03) 5338 4541
Bendigo Community Health Sexual Health Clinic
<https://www.bchs.com.au/sexual-health-clinic>
– book online Tel. (03) 5406 1200
or (03) 5448 1600
Gateway Health Sexual and Reproductive Health – Clinic 35
<https://www.gatewayhealth.org.au/services/gp-clinics/sexual-and-reproductive-
health-clinic-35/>
, Wodonga (Monday to Friday 9 am – 5 pm) Tel. (02) 6022 8888
and Wangaratta Tel. (03) 5723 2000
or email: [email protected]
<mailto:[email protected]>
Sunraysia Community Health Services,
<https://schs.com.au/>
Mildura (Monday to Friday 8:30 am – 5 pm) Tel. (03) 5022 5444
or email to: [email protected]
<mailto:[email protected]>
Barwon Health Sexual Health Clinic
<https://www.barwonhealth.org.au/index.php>
(no GP referral, walk-in service Tuesdays 2 pm – 6:30 pm) Tel. (03) 5226 7489
Victorian Aboriginal Health Service
<https://www.vahs.org.au/>
Fitzroy: Tel. (03) 9419 3000
and Preston Tel. (03) 9403 3300
(Monday to Friday 10 am – 4 pm) and after-hours locum service Tel. 132 660
or Epping: Tel. (03) 8592 3920
(Monday to Thursday 9 am-5 pm, Friday 9 am-4 pm)

References
Contraception
<https://www.tg.org.au>
, Therapeutic Guidelines Limited, Australia
FSRH guideline: Contraception after pregnancy
<https://www.fsrh.org/standards-and-guidance/fsrh-guidelines-and-
statements/contraception-for-specific-populations/contraception-after-pregnancy/>
, Faculty of Sexual and Reproductive Healthcare, UK
 Contraception options
<https://shvic.org.au/for-you/contraception>
, Sexual Health Victoria, Australia
Hormonal IUD
<https://www.fpnsw.org.au/factsheets/individuals/contraception/hormonal-iud>
, Family Planning NSW
Copper IUD
<https://www.fpnsw.org.au/factsheets/individuals/contraception/copper-iud>
, Family Planning NSW
Levonorgestrel (Kyleena) for contraception
<https://www.nps.org.au/radar/articles/levonorgestrel-kyleena-for-contraception>
, NPS MedicineWise
Kyleena. Australian approved product information. Bayer Australia Ltd.
Gemzell-Danielsson K, Apter D, Dermout S, Faustmann T, Rosen K, Schmelter T,
et al. Evaluation of a new, low-dose levonorgestrel intrauterine contraceptive
system over 5 years of use
<https://pubmed.ncbi.nlm.nih.gov/30583885/>
. Eur J Obstet Gynecol Reprod Biol. 2017;210:22-8. Pubmed

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