Contraception - intrauterine devices (IUD)

An intrauterine device (IUD) is a small contraceptive device that’s inserted into the uterus (womb) to prevent pregnancy. The two types available are the copper IUD and the hormonal (Mirena) IUD. The hormonal IUD contains progestogen, which is a synthetic version of the natural hormone progesterone. Both types are very effective forms of contraception and can stay in place for at least five years.

IUDs affect the way sperm move and survive in the uterus, preventing them from reaching and fertilising the egg. They can also cause changes to the lining of the uterus so a fertilised egg can’t develop. The hormonal IUD can thicken the mucus made by the cervix (entrance to the womb), preventing sperm from getting through. It can also affect ovulation by altering the hormones that cause an egg to be released each month.

Different methods of contraception may suit you at different times in your life. Talk with your doctor or health care provider about the risks, benefits and alternatives.

The copper IUD

The copper IUD is a small plastic device with copper wire wrapped around it and a fine nylon string attached to the end. When the IUD is in place, the string comes out through the cervix into the top of the vagina. This piece of string lets you check that the IUD is still in place and makes it easy for a doctor to remove it. You can’t feel the string unless you put your finger deep inside your vagina.

The hormonal (Mirena) IUD

The hormonal (Mirena) IUD is a small plastic ‘T-shaped’ device that contains progestogen. This is a synthetic version of the natural hormone progesterone. The device has a coating (membrane) that controls the release of the progestogen into the uterus. Like the copper IUD, it has a fine nylon string attached to the end to make checking and removing it easier. The hormonal IUD is available in Australia under the brand name Mirena.

Advantages

Advantages of using copper or hormonal IUDs include the following:

• They are more than 99 per cent effective in preventing a pregnancy.
• They last between five and ten years.
• They can be removed at any time by your doctor, with a quick return to fertility.
• You can forget about them once they’re inserted (except to check the strings).

Disadvantages

Disadvantages of using copper or hormonal IUDs include the following:

• They must be inserted by a doctor trained in the technique.
• You may have additional costs and difficulty accessing the service.
• There is a small risk of infection at the time of insertion.
• There may be an increased risk of pelvic inflammatory disease (PID) – infection of the pelvic organs including the fallopian tubes – if you are at risk of sexually transmissible infections (STIs).
• There is a small risk of perforation – the IUD tearing the wall of the uterus when it’s inserted.
• There may be complications with unintended pregnancies.
• They don’t protect against STIs.
• They can fall out.

Differences between copper and hormonal IUDs

There are a number of differences between copper and hormonal IUDs.

Menstruation

• Hormonal – after a hormonal IUD is inserted, you may have three to five months of frequent irregular spot bleeding. After this, you will generally get short, light, painless periods. About 20 per cent of women stop bleeding completely.
• Copper­ – after a copper IUD is inserted, you may have a few weeks of irregular spot bleeding. After that, your periods may be heavier and sometimes more painful.

Cost

• Hormonal – a hormonal IUD is covered by a health care card in Australia. It costs around $5 if you are a card holder and around $33 if you don’t have a card.
• Copper – a copper IUD is not covered by a health care card and may cost around $100 outside a public hospital setting.

Side effects

• Hormonal – a hormonal IUD may cause headaches, acne, breast tenderness and an increase in appetite. These symptoms usually settle after the first few months of use.
• Copper – a copper IUD has no hormonal side effects.

Medical conditions

• Hormonal – a hormonal IUD should not be used if you have had breast cancer in the last five years.
• Copper – a copper IUD will not have any known impact on existing medical conditions.

Other types of contraception
There are a number of contraceptive choices available in Australia. Talk to your doctor or health care provider about your options. The method of contraception you choose will depend on your general health, lifestyle and relationships. It’s important to weigh up the benefits and disadvantages of each method and think about your current and future needs.

Protect against STIs

Hormonal and copper IUDs don’t protect against sexually transmissible infections so it is important to practice safe sex. The best way to reduce the risk of STIs is to use barrier protection such as condoms and dams (a thin piece of latex placed over anus or vagina during oral sex) with all new sexual partners. Condoms can be used with IUDs when having oral, vaginal and anal sex to help prevent the spread of infections.

Where to get help

• Your doctor
• Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100 or the Action Centre (for young people under 25) Tel. 1800 013 952 or (03) 9660 4700
• The Women’s Health Information Centre (WHIC) Tel. (03) 8345 3045
• Melbourne Sexual Health Centre Tel. (03) 9347 0244 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
• Your local community health centre
• A pharmacist

Things to remember

• Intrauterine devices (IUDs) are small contraceptive devices that are inserted into the uterus (womb) to prevent a pregnancy.
• The two types available are the copper IUD and the hormonal (Mirena) IUD.
• Hormonal and copper IUDs are very effective forms of contraception and can stay in place for five to eight years.
• IUDs don’t protect against sexually transmissible infections (STIs) – the best way to reduce the risk of STIs is to use barrier protection such as condoms and dams with all new sexual partners.

You might also be interested in:

• Contraception - choices.
  
• Contraception - condoms for women.
  
• Contraception - diaphragms.
  
• Contraception - emergency contraception.
  
• Contraception - implants and injections.
  
• Contraception - the Billings method.
  
• Contraception - the pill.
  
• Contraception - tubal ligation.
  

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Family Planning Victoria

Fact sheet currently being reviewed.
Last reviewed: July 2011

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An intrauterine device (IUD) is a small contraceptive device that’s inserted into the uterus (womb) to prevent a pregnancy. The two types available are the copper IUD and the hormonal (Mirena) IUD. Both types are very effective forms of contraception and can stay in place for at least five years.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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