An intrauterine device, also known as intrauterine contraceptive device or coil, is a small, often T-shaped birth control device that is inserted into a woman’s uterus to prevent pregnancy. IUD’s are one form of long-acting reversible birth control.

Copper-T IUD

Copper-T is an intrauterine device (IUD) that can provide long-term birth control (contraception). It’s sometimes referred to as a non-hormonal IUD option.

The Copper-T device is a T-shaped plastic frame that’s inserted into the uterus. Copper wire coiled around the device produces an inflammatory reaction that is toxic to sperm and eggs (ova), preventing pregnancy.  It can prevent pregnancy for up to 10 years after insertion.

Copper-T offers effective, long-term contraception. It can be used in premenopausal women of all ages, including teenagers.

Among various benefits:

  • Eliminates the need to interrupt sex for contraception
  • Can remain in place for up to 10 years
  • Can be removed at any time
  • Can be used while breast-feeding
  • Doesn’t carry the risk of side effects, such as blood clots, related to hormonal birth control methods

Copper-T isn’t appropriate for everyone. Your gynaecologist may discourage use of the Copper-T if you:

  • Have uterine abnormalities — such as large fibroids — that interfere with the placement or retention of the Copper-T.
  • Have a pelvic infection, such as pelvic inflammatory disease.
  • Have uterine or cervical cancer.
  • Have unexplained vaginal bleeding.
  • Are allergic to any component of the Copper-T
  • Have a disorder that causes too much copper to accumulate in your liver, brain and other vital organs (Wilson’s disease).

Risks

Less than 1 percent of women who use the Copper-T will get pregnant in the first year of typical use.

If you do conceive while using the Copper-T, you’re at high risk of an ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube. But because the Copper-T prevents most pregnancies, the overall risk of having an ectopic pregnancy is lower than it is for sexually active women who don’t use contraception.

The Copper-T doesn’t offer protection from sexually transmitted infections (STIs).

Side effects associated with the Copper-T include:

  • Bleeding between periods
  • Cramps
  • Severe menstrual pain and heavy bleeding

It’s also possible to expel the Copper-T from your uterus. You might not feel the expulsion if it occurs.

You may be more likely to expel the Copper-T if you:

  • Have never been pregnant
  • Have heavy or prolonged periods
  • Have severe menstrual pain
  • Previously expelled an IUD
  • Are younger than age 25
  • Had the IUD inserted immediately after childbirth

How you prepare

The Copper-T can be inserted anytime during a normal menstrual cycle. If you just had a baby, your gynaecologist might recommend waiting about eight weeks after delivery before inserting the Copper-T.

Before inserting the Copper-T, your gynaecologist will evaluate your overall health and do a pelvic exam. You may have a pregnancy test to confirm you’re not pregnant, and you may be screened for STIs.

Taking a non-steroidal anti-inflammatory drug, such as ibuprofen, one to two hours before the procedure can help reduce cramping.

WHAT YOU CAN EXPECT

Copper-T placement

Copper-T is typically inserted in a gynaecologist’s office.

During the procedure

Your gynaecologist will insert a speculum into your vagina and clean your vagina and cervix with an antiseptic solution. A special instrument might be used to gently align your cervical canal and uterine cavity. Next, your gynaecologist will fold down Copper-T’s horizontal arms and place the device inside an applicator tube.

The tube is inserted into your cervical canal and the Copper-T is carefully placed in your uterus. When the applicator tube is removed, the Copper-T will remain in place. Your gynaecologist will trim the Copper-T strings so that they don’t protrude too far into the vagina and may record the length of the strings.

During the Copper-T insertion, you may experience dizziness, fainting, nausea, low blood pressure or a slower than normal heart rate. Your gynaecologist will likely suggest that you stay lying down for a few minutes to allow these side effects to pass.

Rarely, it’s possible for the IUD to perforate the uterine wall or cervix. If this complication occurs, your gynaecologist will discuss the appropriate management.

After the procedure

About a month after the Copper-T is inserted, your health care provider may re-examine you to make sure the device hasn’t moved and to check for signs and symptoms of infection.

While you’re using Copper-T, contact your gynaecologist immediately if you have:

  • Signs or symptoms of pregnancy
  • Unusually heavy vaginal bleeding
  • Foul vaginal discharge
  • Worsening pelvic pain
  • Severe abdominal pain or tenderness
  • Unexplained fever
  • Possible exposure to an STI

It’s also important to contact your gynaecologist immediately if you think your Copper-T is no longer in place. Call your doctor if:

  • You have breakthrough bleeding or bleeding after sex
  • Sex is painful for you or your partner
  • The strings are missing or suddenly seem longer
  • You feel part of the device at your cervix or in your vagina

Your gynaecologist will check the location of the Copper-T and remove it if necessary.

Removal

The Copper-T is usually removed in a gynaecologist’s office. Your provider will likely use forceps to grasp the device’s strings and gently pull. The device’s arms will fold upward as it’s withdrawn from the uterus.

Light bleeding and cramping are common during removal. Rarely, removal can be more complicated.

Mirena

Mirena is a hormonal intrauterine device (IUD) that can provide long-term birth control (contraception).

The device is a T-shaped plastic frame that’s inserted into the uterus, where it releases a type of the hormone progestin. To prevent pregnancy, the Mirena:

  • Thickens mucus in the cervix to stop sperm from reaching or fertilizing an egg
  • Thins the lining of the uterus and partially suppresses ovulation

Mirena prevents pregnancy for up to five years after insertion.

Why it’s done

Mirena offers effective, long-term contraception. It can be used in premenopausal women of all ages, including teenagers.

Among various benefits, the Mirena:

  • Eliminates the need to interrupt sex for contraception
  • Doesn’t require partner participation
  • Can remain in place for up to five years
  • Can be removed at any time, followed by a quick return to your normal fertility
  • Can be used while breast-feeding — although your gynaecologist will likely recommend waiting six to eight weeks after childbirth because earlier placement increases the risk of injuring the uterus during placement
  • Doesn’t carry the risk of side effects related to birth control methods containing oestrogen

Mirena can decrease menstrual bleeding after three or more months of use. About 20 percent of women stop having periods after one year of using Mirena.

Mirena can also decrease:

  • Severe menstrual pain and pain related to the abnormal growth of uterine-lining tissue outside the uterus (endometriosis)
  • The risk of pelvic infection
  • The risk of endometrial cancer

Because of these non-contraceptive benefits, Mirena is often prescribed for women with:

  • Heavy menstrual bleeding
  • Cramping or pain with periods
  • Endometriosis
  • Abnormal growth of the lining of the uterus (endometrial hyperplasia)
  • Abnormal growth of uterine-lining tissue into the muscular wall of the uterus (adenomyosis)
  • Anemia
  • Fibroids

Mirena isn’t appropriate for everyone. Your gynaecologist may discourage use of Mirena if you have:

  • Breast cancer, or have had it
  • Uterine or cervical cancer
  • Liver disease
  • Uterine abnormalities, such as fibroids, that interfere with the placement or retention of Mirena
  • A pelvic infection or current pelvic inflammatory disease
  • Unexplained vaginal bleeding

Tell your gynaecologist if you:

  • Take any medications, including non-prescription and herbal products
  • Have diabetes or high blood pressure
  • Have a heart condition or have had a heart attack
  • Have migraines
  • Have blood-clotting problems or have had a stroke
  • Recently gave birth or are breast-feeding

Risks

Less than 1 percent of women who use Mirena will get pregnant in a year of typical use.

If you do conceive while using Mirena, you’re at higher risk of an ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube. However, because Mirena prevents most pregnancies, women who use it are at lower risk of having an ectopic pregnancy than are other sexually active women who are not using contraception.

Mirena is generally safe. But it’s important to remember that:

  • Mirena doesn’t protect against STIs.
  • Rarely, insertion of Mirena causes perforation of the uterus. The risk of perforation might be higher when inserted during the postpartum period.

Side effects associated with Mirena include:

  • Headache
  • Acne
  • Breast tenderness
  • Irregular bleeding, which can improve after six months of use
  • Mood changes
  • Cramping or pelvic pain

It’s also possible to expel Mirena from your uterus. You may be more likely to expel Mirena if you:

  • Have never been pregnant
  • Have heavy or prolonged periods
  • Have severe menstrual pain
  • Previously expelled an IUD
  • Are younger than age 20
  • Had Mirena inserted immediately after childbirth

Your gynaecologist may recommend removal of Mirena if you develop:

  • A pelvic infection
  • Inflammation of the endometrium (endometritis)
  • Endometrial or cervical cancer
  • Pelvic pain or pain during sex
  • Very severe migraine
  • A significant increase in blood pressure, or have a stroke or heart attack
  • Possible exposure to an STI

How you prepare

Your gynaecologist will evaluate your overall health and do a pelvic exam before inserting Mirena. You may be screened for STIs.

Mirena can be inserted:

  • Anytime during your menstrual cycle if you’re not pregnant. You might need to take a pregnancy test to confirm you’re not pregnant.
  • Immediately after a pregnancy termination.
  • Immediately after delivering a baby vaginally or by caesarean section — although insertion immediately after vaginal delivery increases the risk of expelling Mirena.

If you have Mirena inserted more than seven days after the start of your period, be sure to use backup contraception for one week.

Taking a non-steroidal anti-inflammatory medication, such as ibuprofen, one to two hours before the procedure can help reduce cramping.

WHAT CAN YOU EXPECT

Mirena placement

Mirena is typically inserted in a gynaecologist’s office.

During the procedure

Your gynaecologist will insert a speculum into your vagina and clean your vagina and cervix with an antiseptic solution. Special instruments might be used to gently align your cervical canal and uterine cavity and to measure the depth of your uterine cavity.

Next, your gynaecologist will fold Mirena’s horizontal arms and place the device inside an applicator tube. The tube is inserted into your cervical canal, and Mirena is carefully placed in your uterus. When the applicator tube is removed, Mirena will remain in place.

Your gynaecologist will trim Mirena’s strings so that they don’t protrude too far into the vagina, and may record the length of the strings.

During Mirena insertion, you may experience cramping, dizziness, fainting or a slower than normal heart rate.

After the procedure

Once a month, check to feel that Mirena’s strings are protruding from your cervix. Be careful not to pull on the strings.

About a month after Mirena is inserted, your gynaecologist may re-examine you to make sure Mirena hasn’t moved and to check for signs and symptoms of infection.

While you’re using Mirena, contact your gynaecologist immediately if you:

  • Think you may be pregnant
  • Have unusually heavy, persistent vaginal bleeding
  • Have abdominal pain or pain during sex
  • Have an unexplained fever
  • Have unusual or foul-smelling vaginal discharge, lesions or sores
  • Develop very severe headaches or migraines
  • Have yellowing of the skin or eyes
  • Were exposed to an STI
  • Can no longer feel the IUD strings, or they suddenly seem longer

It’s also important to contact your gynaecologist immediately if you think Mirena is no longer in place. Your provider will check the location of Mirena and, if it’s displaced, remove it if necessary.

Removal

Mirena can remain in place for up to five years. To remove Mirena, your gynaecologist will likely use forceps to grasp the device’s strings and gently pull. The device’s arms will fold upward as it’s withdrawn from the uterus.

Light bleeding and cramping is common during removal. Rarely, removal can be more complicated.

Kyleena – IUD

Kyleena is used for the prevention of pregnancy (contraception) for up to 5 years.  Kyleena is a T-shaped intrauterine delivery system (IUS), which after placement inside the womb, slowly releases a small amount of the hormone levonorgestrel (LNG).  The T-shaped frame of Kyleena is just 28mm x 30mm.  There are fine threads attached which are used by your gynaecologist to remove Kyleena.

How does Kyleena work?

Kyleena works by thickening the cervical mucus which inhibits passage of the sperm through the cervical canal.  This prevents the sperm and egg from coming into contact and prevents fertilisation.  Kyleena also reduces the monthly growth of the lining of the womb.

Important aspects of Kyleena:

  • Releases only a low dose of hormone
  • Does not contain oestrogen
  • Does not affect the normal function of your ovaries

 

How is Kyleena inserted, and how long does it take?

The insertion procedure should take no longer than a few minutes.  Your gynaecologist will first perform a pelvic examination.  A thin flexible tube containing Kyleena will then be inserted into your womb.  Once Kyleena is in the correct position, your gynaecologist will withdraw the insertion tube leaving Kyleena in place.  You may experience some pain and / or dizziness during placement.  If you would like pain relief before Kyleena is in inserted, please speak to your gynaecologist about preventive pain relieving treatment.

After insertion, you may feel some pain similar to menstrual cramps.  However, this usually disappears within a few days.  If you experience severe pain or heavy bleeding after Kyleena is inserted or if pain / bleeding persists for more than a few weeks, please make an appointment to see your gynaecologist.

 When should Kyleena be inserted?

Kyleena should be placed within 7 days from the start of your monthly period.  You will be protected from pregnancy immediately.

About a month after Kyleena is inserted, your gynaecologist may re-examine you to make sure Mirena hasn’t moved and to check for signs and symptoms of infection.

What to expect?

Kyleena is likely to affect your menstrual cycle.  It can change your menstrual periods so that you experience spotting (a small amount of bleeding), shorter or longer periods, lighter or heavier bleeding, or no bleeding at all.

You may have bleeding and spotting between menstrual periods, especially during the first 3-6 months.   Sometimes the bleeding is heavier than usual at first.

Overall, you are likely to experience a gradual reduction in the amount and number of days of bleeding each month.  Some women eventually find that periods stop altogether.

What are the side effects associated with Kyleena?

Very common (may affect more than 1 in 10 people):

  • Headache
  • Abdominal / pelvic pain
  • Acne / Seborrhoea (“greasy skin”)
  • Bleeding changes including increased and decreased menstrual bleeding, spotting, oligomenorrhoea (infrequent periods), and amenorrhea (absence of bleeding)
  • Ovarian cyst
  • Vulvovaginitis (inflammation of the external genital organs or vagina)

Common (may affect up to 1 in 10 people):

  • Depressed mood / depression
  • Migraine
  • Nausea (feeling sick)
  • Alopecia (hair loss)
  • Upper genital tract infection
  • Dysmenorrhea (painful menstruation)
  • Breast pain / discomfort
  • Device expulsion (complete and partial)
  • Genital discharge

Uncommon (may affect up to 1 in 100 people):

  • Hirsutism (excessive body hair)

Rare (may affect up to 1 in 1000 people):

  • Uterine perforation

IUB™ Ballerine®

What is the IUB™?

The IUB™ Ballerine® is a birth control method that requires no hormones and is effective for up to 5 years. The IUB™ Ballerine® works along the same principle as other intrauterine devices and prevents pregnancy locally – within the uterus. The contraceptive effect comes mainly from the copper.

The IUB™ Ballerine® consists of a special shape memory alloy, which has been successfully used in medicine for a long time, e.g. in implants and stents. Several copper pearls are strung on a uterus friendly frame, coated with polymer.

How does it work?

The IUB™ is inserted into the uterus and works by releasing small amounts of copper which:

  • Interfere with the process of fertilization
  • Limits sperm mobility
  • Prevents sperm from fertilizing the egg
  • Prevents the egg from attaching in the uterus

The amount of copper released from the copper pearls is minimal – the average quantity of copper ingested with a normal diet is much higher than the quantity inserted to the body through the copper pearls.

Why should I consider using an IUB™?

  • You’re rather forgetful in taking the pill every single day
  • You have an aversion to taking the pill – medically
  • You’re trying to avoid ingesting more hormones than needed
  • You want a hormone free, reversible pregnancy protection
  • Your main criteria is high effectiveness
  • It does not affect the libido and bone metabolism
  • It has no influence on the ovulation
  • It does not cause weight increase

Once the flexible IUB™ Ballerine® frame is released from the insertion tube in the uterus it remembers its 3-dimensional past and coils into a round and smooth shape without sharp edges and corners.

Attached to one end of the frame are two removal strings that serve to remove the IUB™ Ballerine®.

The use of the shape memory alloy Nitinol as carrier material in an intrauterine contraception device is unique. For many years this alloy has been successfully used in medical implants.

The IUB™ Ballerine® lasts for up to 5 years.

Since the IUB™ Ballerine® is one third to a half of the size of traditional intrauterine devices, it can be inserted almost painlessly without local anaesthesia.

Once the IUB™ Ballerine® is placed in the uterus it forms a 3-dimensional spherical shape.

The IUB™ Ballerine® is available in 3 different sizes ranging from 12 mm to 18 mm in diameter. Your doctor will advise you which size is most suitable for you. 

What you can Expect:

The hormone free IUB™ is placed in your uterus during your gynaecologist consultation. Your gynaecologist will first examine you to find the position of your uterus. After measuring your uterus, the IUB™ can be carefully inserted with a tube containing the IUB™ copper pearls.  If women have not been pregnant yet, it can happen that the cervix needs to be stretched a little bit before inserting the IUB™ copper pearls. The tube is removed, leaving the IUB™ inside your uterus where it finds its ideal position and becomes active immediately.

The correct position of the IUB™ can be checked with ultrasound examination. Two threads extend into your vagina. The best time for the placement is the last days of your menstruation where the cervix is open wide enough and the possibility of a pregnancy is the lowest. 4-12 weeks after the placement a check-up examination should be done. After that a yearly check-up with your gynaecologist is recommended.

The placement of the IUB™ can be painful when the cervix is very tight. In this case a local anaesthetic or the use of medicine that relax the muscles of the cervix are recommended. Immediately after the insertion menstruational complaints can occur. No grounds for worry – the uterus needs time to adapt to the new situation. The pain usually subsides quickly. Should the pain continue, please consult your gynaecologist immediately to clarify the situation.

After placement of the IUB™ heavier, longer periods and spotting between periods can occur – most of these side effects diminish after 2-3 months. After your uterus gets used to the IUB™ copper pearls these side effects occur less frequently. Very occasionally the placement can cause a short fainting, like it can happen when giving blood – without any further serious complications.

Rarely, the IUB™ goes through the wall of the uterus, especially during placement. This is called perforation. If the IUB™ perforates the uterus, it should be removed. Surgery may be needed. If the IUB™ perforates the uterus, you are not protected from pregnancy. The IUB™ may partially or completely fall out of the uterus. This is called expulsion.

Women who have never been pregnant may be more likely to expel the IUB™ than women who have been pregnant before. If you can feel the threads outside of your vagina visit your gynaecologist for a check-up.

You should not use the IUB™ if you:

  • might be pregnant
  • have an abnormally shaped uterus
  • have a pelvic infection called pelvic inflammatory disease (PID) or have current behaviour that puts you at high risk of PID (e.g. frequently changing sex partners)
  • have had an infection in your uterus after a pregnancy or abortion in the past 3 months
  • have cancer of the uterus or cervix
  • have unexplained vaginal bleeding
  • have an infection in your cervix
  • have Wilson’s disease (a disorder in how the body handles copper)
  • are allergic to any material that is used in the IUB™
  • already have an intrauterine contraceptive in your uterus

To make sure the IUB™ is placed correctly it is best advised to avoid sexual intercourse or the use of vaginal tampons or menstrual cups 5 days after placement.

Contact your gynaecologist if you:

  • think you are pregnant
  • have pelvic pain or you or your partner feel pain during sexual intercourse
  • have unusual vaginal discharge or genital sores
  • have unexplained fever
  • might be exposed to sexually transmitted diseases (STDs)
  • cannot feel the IUB™’s threads or can feel the threads are much longer
  • can feel any other part of the IUB™ besides the threads
  • become HIV positive or your partner becomes HIV positive
  • have severe or prolonged vaginal bleeding
  • miss a menstrual period

The IUB™ copper pearls do not protect against HIV infection (AIDS) and other sexually transmitted diseases. It is recommended to use a condom when changing sex partners frequently.

4–12 weeks after placement a check-up by your gynaecologist is recommended.

The IUB™ should be removed after 5 years. It can be replaced with a new IUB™.