IUD Information / FemCaps / Diaphragms

There are two kinds of IUDs in Canada – copper and progesterone. They all last for years and are put into the uterus by the doctor. IUDs work well and couples like them because they prevent pregnancy without needing to do something every time you have sex (like condoms) or having to take a pill everyday.  They are excellent for women who cannot take hormones because of side effects or because they have a high risk of blood clots.

Insertion:  The doctor checks the size and position of your uterus. She puts a speculum into your vagina so she can see your cervix and check for infection. She usually uses freezing with a local anesthetic. Most women feel a pinching feeling and then a sharp cramping pain which lasts a few minutes when the IUD is inserted. Taking ibuprofen an hour before helps the cramps. The best time to put in an IUD is during or just after a period but they can be put in any time as long as we know you are not pregnant. We can prescribe and insert an IUD on the same visit.

Risks: There are no increased risks of infection except the first few weeks after getting it in. That is why we check for infection and give antibiotics to anyone who is high risk for infection (for example, a woman with many sexual partners). There are no long term effects on fertility. There is about 5% chance per year of the IUD being rejected or falling out. This is why it is a good idea to check for the string by putting your finger inside your vagina or by getting a doctor to check. There is about a 1/1000 chance of the IUD perforating the uterus or getting into the wrong place and needing minor surgery to remove it. Perforations heal and do not cause any problems later with having babies.

Which IUD should you choose?

Copper IUD - $75  (5 or 10 year) Many women choose copper IUDs because they are less expensive and have no hormones. They are very effective with about 1 in 100 women getting pregnant in a year. They usually make the periods heavier, longer and more painful by about 20-50%. There are no effects from a copper IUD outside the uterus: no weight gain, mood changes, nausea, sore breasts, etc. A woman with heavy, painful periods should choose a Mirena or Jaydess if she can afford it.  The copper IUD is also very effective as emergency contraception.

Mirena – $400 (5 years) – Most health benefit plans will pay for the Mirena so it may be the cheapest choice. Mirenas work better; only 1/1000 women per year will get pregnant and the periods will be lighter and easier. The amount of hormone in a Mirena is much less than birth control pills, patches or shots so there are very few hormone side effects. Only about 5% of women will notice any hormone side effects such as weight gain, mood changes or acne. Most women get some spotting in the first month or two after their Mirena has been inserted.

Jaydess – $325 (3 years) – These are smaller and have less hormone than Mirena (14 vs 20 mcg levonorgestrel). They are new in Canada and may not yet be covered by insurance, but should be first choice for women who just want contraception and do not have very heavy painful periods.

IUDs for emergency contraception

Copper IUDs are over 99% effective as an emergency contraceptive up to 7 days after unprotected sex. PlanB (2 pills) is 60% effective and works best before 72 hours (3 days).

Cost of Insertion: If you have a BC Care Card there is no charge for the insertion. If you do not have a BC Care Card the cost is $230.00.

IUB study: IUBs (intra-uterine balls) are not currently available. See the IUB study page for more information.

For an appointment to have an IUD inserted, please complete the IUD booking form or call 604-709-5611. Please fill out/have your BC Care Card # with you as we will need this to book the appointment.

For more information check :www.mirena.ca, http://www.cmaj.ca/cgi/content/full/169/6/585

 

FEMCAPS:

What is a FemCap? It is a soft silicone cup to use each time you have sex. Spermicide jelly is placed inside and the cap is placed in the vagina to hold the spermicide next to the cervix.

How does it work? The cap is a physical barrier to the sperm and the spermicide stops the sperm chemically.

How effective is it? About 5% of women will become pregnant in one year of correct use.

How do I get a FemCap? You will need to be fitted for a FemCap and taught how to put it in your vagina correctly.

What does it cost? Your medical plan pays for the fitting by the doctor and the FemCap costs $90 if you buy it at Willow Clinic. If you do not have a BC Care Card the cost of the fitting is $125.00.

Advantages: no hormones, no latex, controlled by the woman

Disadvantages: must be used every time you have sex, not as effective as birth control pills or IUDs.

For more information, see:http://www.femcap.com/

For an appointment to get a cap fitted, call 604-709-5611.

DIAPHRAGMS:

What is a diaphragm? It is a soft silicone cup to use each time you have sex. Spermicide jelly is placed inside and the cup is placed in the vagina to hold the spermicide next to the cervix.

How does it work? The cup is a physical barrier to the sperm and the spermicide stops the sperm chemically.

How effective is it? About 5% of women will become pregnant in one year of correct use.

How do I get a diaphragm? You will need to be fitted for a diaphragm and taught how to put it in your vagina correctly.

What does it cost? Your BC Care Card pays for the fitting by the doctor and the diaphragm costs about $50 at the drug store. If you do not have a BC Care Card the cost for the fitting will be 125.00

Advantages: no hormones, no latex, controlled by the woman

Disadvantages: must be used every time you have sex, not as effective as birth control pills or IUDs.

For more information, see: http://en.wikipedia.org/wiki/Diaphragm_(contraceptive)

For an appointment to get a diaphragm fitted, call 604-709-5611.

Fun facts about IUDs

THE CAMEL CONNECTION

The first intrauterine devices (IUDs) were used by the Arabs.  They would put pebbles in their camel’s uterus to prevent her from getting pregnant on long trips across the desert or to market.

EARLY IUDs:

In 1909, Richter used silkworm gut.  In the same year, Grafenberg used silkworm gut and silver wire.  IUDs used in the 1960’s had names like the Lippes Loop, the Margulies Spiral, of the Saf-T-Coil.

TODAY’S IUDs:

The style of IUD we use today has been common in North America for about 50 years.

The tail-less steel ring is used in China by about 45 million women.

Worldwide, there are nearly 160 million IUD users, most of them (over 100 million) in China.  IUD use varies in developed countries, from as low as 1% in the Netherlands and the USA to about 30% in Scandinavia.

WHO INVENTED THE MODERN IUD?

Ernst Grafenberg invented and marketed the first IUD in 1928.  He was a Jewish German opthalmologist-turned-OBGYN.  When the Nazis assumed power in Germany, Grafenburg, was forced to resign from his hospital.  He refused to leave Germany, believing that since his practice included wives of high Nazi officials, he would be safe.  He was wrong.  He was arrested in 1937.  Three years later, Margaret Sanger (an early advocate of birth control) ransomed him from Nazi prison. He went to the U.S. and opened a practice in New York City.

DID YOU KNOW…

Grafenberg was also famous for his studies of the G-Spot (Grafenberg Spot), a pleasure zone inside the vaginal.

WHY WOMEN CHOOSE THE IUD

Actual comments from Willow Clinic patients:

“Because of family history, I don’t want to take any estrogens.”

“I just want to feel secure about everything and not have to think about it.”

“It was better than having to take a pill or inserting something and having to take it out.”

“Less hassle.”

“…I never felt like I had any other options because all the other, like the patch and depo provera, all have these crazy side-effects that I was terrified of, and I know condoms always break.”

“I wish everybody knew about it, because they’re [IUDs] so wonderful.”

MEDICAL DIRECTOR: DR ELLEN WIEBE


Suite 1013 – 750 West Broadway Vancouver BC V5Z 1H9
Ph. : 604-709-5611
Fax : 604-873-8304
Email: willowwomensclinic@yahoo.ca