Intrauterine Device

I believe in IUD's so much, I wanted to have a separate page for them.

Again, one of my favorites.  I am not sure who came up with this idea, but it sure is a good one. The idea is that if you place this small plastic thing inside the uterus, you can prevent pregnancy for as long as it is there. IUDs came a long way since they were first used. In Canada, we currently have two type of IUDs. Both share the general rule: you decide on it, have it inserted in our office in under 10 minutes, and then nearly totally forget about it for the next five years. You will still get it checked once a year, but we can do this at the same time as we are doing your Pap test. So, it is one visit for both checks, once a year. Do note that the new guidelines for Pap tests is to have them done every three years, though.

Now, the difference between the two is simple.

One has copper on it to increase its efficacy in preventing pregnancy. But this may be associated with increased menstrual bleeding. So, if your periods are light, 2-3 days long, this is a good option. But if you are used to say 7 days of bleeding or really heavy bleeding, you may not want to use a copper IUD.
There are a few brands and different sizes. They are also slightly differently priced but may range from the 150-180 dollars or so. If your drug plan covers the birth control pill, chances are it will cover IUDs.

The other variety has a special progestin hormone, and this is what makes it different. The hormone is secreted locally inside the uterus, and almost nothing reaches your blood stream. This hormone will act on your uterus and increase the efficacy of the IUD in preventing pregnancy. The good side effect is that these changes in the uterus might make your periods much lighter, or even make them disappear altogether. Again, some women see this as a huge advantage.
Homronal IUD's come in 2 brand names:
Jaydess: appropriate for women who want to prevent pregnancy for 3 years, or so, and who prefer to have a period every month. It is a bit smaller than the other one and is very suitable to women who never had children before. Jaydess is not available any more. If you have it, it is safe to use. But when it is time to renew it, you will probably need to get a kyleena.
Kyleena: has gradually been replacing Jaydess. It is a five year small IUD, geared to women who had not been pregnant before, so Mirena would be too large for them. And yet again, you can still have a monthly period on it. 
Mirena: Is the older of the two. It has a bit more hormone, so it stays for up to 5 years. It will also, more likely than not, prevent your period. This is medically acceptable. Actually, it is a very useful tool. We use this Mirena to prevent heavy periods even in women who already had their tubes tied.

If you had at least one vaginal delivery, insertion of an IUD is as simple as having a pap test taken. You may be a little bit crampy for a day or so. If you had no previous pregnancies, we may recommend that you use some local pills that will open up your cervix a little bit. We will discuss this with you in the office when you come for the IUD.  
Read the Mirena Pamphlet.
Just click on the Icons:
In case you ever wondered, this is how big (or small) the IUD's are.
How do I get an IUD inserted?

Your family physician will refer you to us for a consult about birth control and IUDs (you can get this referral from a walk in clinic if you have no family physician). You will come to the office, we talk about the different methods for prevention of pregnancy (basically things that are on this page). If you think that an IUD is suitable for you, we will do a pelvic exam and some routine swabs. This is to makes sure that there are no other issues.

The swabs are routine, for Chlamydia and Gonorrhea, and more so for something called BV. BV is not a 'real' infection. It is just a change in the balance in the bacteria that normally live in the vagina. Your best protection against infections is this natural balance. If anything, we may recommend that you take an antibiotic for 7 days and then come back for the IUD insertion. We will give you a prescription for an IUD, and you will need to fill it and bring it to the following appointment. Do note that the MIRENA comes in a relatively large package. It contains the IUD, and its introducer in a large sterile container. The IUD itself is about the size of plastic pen cover, only flat.

On the following visit, you come with the IUD, and if the swabs are negative, we put it in. As I said, it takes about 20 minutes. It is basically the same as a Pap test, only it might be a bit crampy. This is caused by the IUD inside the uterus, but should not last more than a day or two. You may also have some spotting for 1-2 days after insertion.

It works from the moment it is in. We do recommend, however, that you wait for 1-2 days before you are sexually active, at least until the bleeding has stopped.

We do not recommend you use an IUD if you have multiple sexual partners (within a three month period).  It is also not recommended if you are allergic to copper, have had an ectopic pregnancy, have active pelvic inflammatory disease (PID) or active cervical infections, or have irregular vaginal bleeding.  It is also not recommended if you may be pregnant. Women with an irregularly shaped uterus may not use an IUD.
Back to preventing pregnancy page