Contraceptive Device Information Intrauterine Device (IUD)

An Intrauterine Device (or IUD) is a long-acting reversible contraceptive, or LARC for short. LARCs are a popular option for many women, as they don’t have to remember a pill every day and can be a safer option for some women.

In Australia, there are 2 main types of IUDs available for use: hormonal (sold as Mirena and Kyleena) and non-hormonal (Copper IUD, or Cu-IUD).

The IUD is a small plastic and/or metal device inserted into the womb, or uterus, to prevent a pregnancy.

Hormonal IUD

These are a T-shaped device made of plastic inserted into the womb. The hormonal IUD works by slowly releasing the hormone progestogen into the uterus, which both lightens periods and reduces the chance of pregnancy. In some women, this type of IUD can also prevent ovulation (the release of the egg from the ovaries) which further reduces the chance of a pregnancy. Mirena and Kyleena have the same hormone, but Kyleena is a smaller and lower dose option which may be more appropriate for some women.

Copper IUD

These are non-hormonal devices, made of plastic and copper. The copper is released slowly into the uterus and acts as a spermicide to prevent a pregnancy. 

How effective are they and how long do they last?

IUDs are over 99% effective at preventing a pregnancy, only 1 in 100 women will get pregnant each year. In comparison, the combined oral contraceptive pill is also 99% effective with perfect use, but is closer to 93% with typical use. The hormonal IUD can last for up to 5 years as a contraceptive and the Copper IUD lasts for up to 5 or 10 years depending on the type. 

Advantages 

• IUDs are long acting, meaning they last for 5 – 10 years depending on the type of IUD used 
• They are reversible, so once removed your fertility should quickly return to what is normal for you. 

• They can be used whilst breast feeding. 
• They rarely interact with other medications. 
• It is a great alternative contraception if you are having difficulty with other methods e.g. remembering to take the pill. 
• The Copper IUD doesn’t contain any hormones, which makes it a good option for women needing contraception but reluctant to take hormones for various reasons. 
• The Mirena can be used to reduce heavy and/or painful periods. Many women report very little or no periods after a few months of insertion. 

• Both IUDs are generally safe for women who cannot take oestrogen containing contraceptives, due to underlying health conditions or other medication.  
• Although they can be a little more expensive upfront, they will often be cheaper in the longer term.  

Disadvantages 

• Both types will need to be inserted by a trained clinician. 
• Most women will notice a change in their bleeding pattern (period) especially the initial 3-6 months after insertion. 

• There may be cramping pain during insertion which usually settles after a few days. 
• Some women may experience hormonal side effects with the hormonal IUDs, such as breast tenderness, headaches or mood changes. These usually settle within a few weeks however sometimes women may opt to remove the IUD.  
• The IUD does not offer protection against sexually transmitted infections. 
• Despite these disadvantages, most women find any side effects settle and find the benefits outweigh the side effects.  

How is an IUD inserted?

IUD is inserted in the uterus with a local anaesthetic spray. The procedure itself takes about 15 minutes but you will be in the clinic for an hour or so. This will be discussed in further detail at your pre-insertion consultation.

I am interested in an IUD – what do I do next?

A pre-IUD insertion appointment with Dr Dasha Simmonds will be required.
There are 2 types of pre-insertion appointments. The first is a 15-minute consultation, which is appropriate for people who are quite sure they want an IUD, or are discussing an IUD replacement.

The second appointment type is a 30-minute appointment. This allows extra time to explore an IUD as an option, as well as consider whether other contraceptives would be better suited to you. This gives more time for questions and exploration.

During pre-insertion consultations you will be asked questions with regards to your medical, gynaecological and sexual health, and tests may be required. This is to allow your doctor to assess your suitability for the IUD and plan accordingly.

Following this you will be advised when is the best time to make the appointment for the insertion of the IUD.

This initial appointment is not a commitment to having an IUD. During this discussion it may become clear that you would be better suited to a different contraceptive option, which can be discussed/prescribed instead.

How much does it cost to have an IUD inserted?

The initial consultation will cost the standard costs for the appointment – either a standard appointment or long consultation. The Medicare rebate is time based, and will therefore match the general consult fees. This can also be a telehealth consultation, and is one of the few that does not require that you have seen the doctor in the last 12 months to receive your rebate.

At this initial consultation, you will be provided with a prescription for the IUD.

If you have a Medicare card, the Mirena and Kyleena are the cost of a PBS (Pharmaceutical Benefits Scheme – meaning the Government subsides the cost of certain medication to make it more accessible) script, which is now around the $30 mark (or under $10. If you do not have Medicare subsiding the cost, they are around the $220+ and $170+ mark respectively, but will vary pharmacy to pharmacy. Some overseas health insurances may match the PBS subsidy.

Copper IUDs cost around $80-100. Some private health insurance companies may subsidise the costs of non-PBS medication.

Insertion Appointment fees:

IUD insertions have a consistent out of pocket cost of $200 for Medicare card holders.  The upfront fee and rebate may change depending on Medicare requirements. 

A follow up appointment at 6 weeks is recommended, to ensure you have an opportunity to discuss side effects or concerns, and check the placement. This is a standard 15 minute consultation.

Considering the IUD can last from 5-10 years, this becomes a very cost-effective option quite quickly.

This may be cheaper if you have reached your Medicare Safety Net (Hyperlink the link below in the text of Medicare Safety Net).

https://www.servicesaustralia.gov.au/how-medicare-safety-nets-and-thresholds-work?context=22001

Removal of IUD’s.

If you would like an IUD to be removed, this can be performed in a standard consult.

However, if you are removing your IUD as you are considering trying for a pregnancy, or if you wish to discuss an alternative form of contraception, we recommend a long appointment (30 minutes) to have time to address things thoroughly.

There is no additional fee for IUD removal as part of an IUD replacement.