IUD insertion information for clinicians
This page has information and resources for clinicians inserting IUDs.
1) Indications and contraindications for IUD insertion
IUD Indications and contraindications
2) Helping your patient choose an IUD.
For post-coital contraception, copper IUDs are 99.9% effective within 7 days; LNG-IUS (Mirena) are not effective.
For treating menorrhagia, LNG-IUS are more effective than oral contraceptives; copper IUDs increase bleeding.
For women who have had hormonal side effects with oral contraceptives, such mood changes, decreased libido and weight gain, there is less chance that they will get these side effects from LNG-IUS. About 5% of women have their LNG-IUSs removed for these reasons, but about 30% of women who had these side effects with other hormonal contraception also get them with LNG-IUSs.
Some women are eager to have their periods disappear and others find it disturbing and prefer to feel their natural cycles. With copper IUDS, one can expect 20-50% more bleeding and cramping.
Bayer sells three different levo-norgestrel releasing IUDs: Mirena, Kyleena and Jaydess. Mirena is licenced both for contraception and menorrhagia and about 70% of women will lose their periods. Kyleena and Jaydess are smaller and have less hormone than Mirena. Jaydess is licenced for 3 years while Mirena and Kyleena are licenced for 5 years.
There are 3 companies selling copper IUDs in Canada: TriMedic sells FlexiT 300, 300+ and 380+, MediSafe sells Liberté UT and TT short and regular and PACE sells MonaLisa 5, 10 and N. FlexiT has 300 or 380 mg of copper, is licensed for 5 years, comes in two sizes, regular for nullips and plus for multips and costs about $90. Liberté UT380 has 380 mg of copper, is licensed for 5 years, comes in two sizes, short for nullips and standard for multips and costs about $75. Liberté TT380 has 380 mg of copper, comes in two sizes, the short for nullips is licensed for 5 years and the regular for multips is licensed for 10 years and costs about $75. MonaLisa 10 is licensed for 10 years, MonaLisa 5 for 5 years and MonaLisa N for 3 years.
The insertion techniques vary and you may find one easier than another.
3) Equipment for IUD insertions and where to order it
5) Technique d’insertion DIU (French)
Insertion of Liberte TT-380 – FRENCH
Insertion of Liberte UT380 – FRENCH
6) Tips for managing difficult IUD insertions in nulliparous women, acutely retroflexed uteri, obese women and anxious women.
7) Local anesthesia
8) What about strings?
9) Managing complications
MEDICAL DIRECTOR: DR ELLEN WIEBE