Insertion of Intrauterine Device – what to expect

What are Intrauterine devices (IUDs)

IUDs are small devices that are put into the uterus (womb).
Reasons for IUD insertion are:
• contraception
• to treat and manage abnormal uterine bleeding including postmenopausal bleeding
• to reduce pain associated with periods
• to protect the uterine lining during hormone therapy
Hormonal IUDs (Mirena or Kyleena) and non-hormonal IUDs (Copper) are available. Both types are very effective and can stay in place for five years for hormonal IUDs, and to ten years for copper devices.

How to prepare for the appointment for IUD insertion?

Please bring your IUD to the appointment (pre purchased from the pharmacy – there will be a cost to you in obtaining the device). The box for the IUD is long as it includes the inserter for the IUD.

Do not worry if you have your period on the day you are booked for the insertion, it can sometimes make the IUD insertion easier.

Please make sure you have had something to eat and enough water to drink before you come for your appointment.

We recommend that you take some pain relief about 1 hour before your appointment. Please take 1g paracetamol (2x 500mg tablets) and 400mg ibuprofen (2x 200mg tablets). If you are unable to take these medications, then discuss this with your GP prior to your appointment.

Allow at least two hours for your appointment time. You may need to take the rest of the day off work. We can provide you with a medical certificate.

What to expect during the insertion of an IUD in our clinic?

It is important that you are not pregnant at the time of your IUD insertion. Please take reliable contraception leading up to your appointment. We will ask you to provide a urine sample on the day to perform a pregnancy test.

The IUD insertion occurs in a gynaecological examination chair with your feet in stirrups. A speculum (duck-bill-shaped device) will be inserted into the vagina.
Sometimes we may recommend taking vaginal or cervical swabs at the time of your IUD insertion and we can perform your cervical screening test if it is due.

We will clean your cervix with an antiseptic solution that can be a little cold. We may use metal instruments to help with the insertion of the IUD and to measure the size of your uterus prior to insertion.

A sterile plastic insertion tube is passed through your cervix in order to place the IUD into the uterus. This may cause some discomfort and cramping pain.

The thread of the IUD is cut a couple of centimeters from your cervix and will curl up at the top of your vagina.

We will give you a pad to wear after the procedure as there is often some spotting right after the insertion of the IUD.

In some women, it is not physically possible to insert an IUD without a general anaesthetic. We may not know this until the day of insertion. If this is the case, we will organise an insertion under a general anaesthetic on a different day.

What to expect after the insertion of an IUD?

It is possible to have some cramping pain similar to period cramps after the insertion in the days following it. If this pain does not respond to pain relief such as paracetamol and ibuprofen, we ask you to seek advice from your GP, or present to the emergency department.

Prolonged spotting in the first 90 days after the insertion of an IUD is not uncommon (22% experience this). Rarely this can last up to 6 months.

After placement of your IUD, we ask you to perform a monthly thread check to ensure it is still in your uterus. If you are unable to feel the threads, please contact your GP to check if the IUD is correctly positioned.