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

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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.

Average amount of hormone (levonorgestrel) released:
Mirena 14 mcg/day
Kyleena 9 mcg/day
Jaydess 6 mcg/day

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.

Choosing an IUD


3) Equipment for IUD insertions and where to order it

131101 IUD equipment

4) Insertion techniques for Liberte, FlexiT, NovaT, MonaLisa and Mirena IUDs

Insertion Liberte UT380  Http://youtu.be/IUET8H6I_I4

Insertion of Liberte TT 380 Http://youtu.be/NoUuv-0oxg4

Insertion of FlexiT

Mirena Insertion

Insertion of Jaydess

Insertion of MonaLisa 5

Insertion of MonaLisa 10

Insertion of MonaLisa N

151011 Insertion of SMB

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.

Difficult insertions

7) Local anesthesia

Local anesthesia

8) What about strings?

What about strings

9) Managing complications

Managing complications

10) Additional Resources

IUC teaching App: IUC Expert





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Fax : 604-873-8304
Email: willowwomensclinic@yahoo.ca