What is an IUD?
An IUD is an intrauterine device that is a form of long acting reversible contraception.
Why choose an IUD instead of other methods?
It is a set and forget system that doesn’t require daily administration.
It is more cost effective in the long term than the oral contraceptive pill or condoms.
It is one of the most effective forms of contraception. The chances of falling pregnant in a year with an IUD is less than 5 in 1000 as compared to 9 in 100 with typical use of the oral contraceptive pill.
Hormonal IUDs release the least amount of hormones as compared to other hormonal contraceptive methods. Non hormonal IUDs do not release any hormones at all.
IUDs do not interact with other medications and can be taken while breastfeeding.
When desiring to conceive, the return of fertility is rapid upon removal.
What are some of the disadvantages of choosing the IUD?
IUDs require insertion by specially trained doctors, therefore it is less accessible than other methods. The procedure can cause abdominal cramping and discomfort.
Here is an excellent video by Sexual Health Victoria on how much pain to expect with the procedure.
What types of IUDs are available?
There are broadly two categories, hormonal and non hormonal IUDs.
Hormonal IUDs available in Australia include the Mirena and Kyleena, both of which release a minuscule amount of progestogen.
Non hormonal IUDs are more commonly known as Copper IUDs, which as the name implies, releases copper. The two most commonly available are the Load375 and TT380.
What are the pros and cons of a hormonal vs non hormonal IUD?
Here is a table comparing the differences between the two categories.
| Hormonal (Mirena & Kyleena) | Non Hormonal (Copper) | |
| Indications | Contraception Mirena only: Heavy menstrual bleeding Progestogen arm of Menopause Hormone Therapy Treatment of endometrial hyperplasia | Contraception Emergency Contraception |
| Duration | Kyleena: 5 years Mirena: 6 years for contraception (recently endorsed by FPAA) Up to 10 years for contraception if inserted after age 45. 5 years for other indications | Load 375, TT380 Short: 5 years TT380 Standard: 10 years |
| Efficacy | 99.7% to 99.9% | 99.5% |
| Bleeding patterns | Chance of having no menses Irregular menses Up to 80% lighter bleeding with Mirena | Initially irregular with intermenstrual bleeding, eventually regular. Slightly prolonged. Up to 50% heavier bleeding |
| Side effects | Initially abdominal cramps and irregular bleeding which improve with time. Small chances of hormonal side effects which improve with time. | Initially abdominal cramps and irregular bleeding which improves with time. No hormonal side effects |
If you would like further reading, here is an excellent resource by Sexual Health Victoria on the hormonal IUD, and the non hormonal copper IUD.
What is the difference between the Mirena and Kyleena?
The Kyleena releases a smaller amount of progestogen, 19.5mg of levonorgestrel, than the Mirena which releases 52mg of levonogestrel. The Kyleena is a slightly smaller device than the Mirena, and therefore has been found to be less painful to insert, particularly for women who have never had a vaginal birth before. The bleeding patterns with the Kyleena and Mirena are quite similar. However, the Kyleena is not recommended for women who have heavy menstrual bleeding and cannot be used as the progestogen arm of Menopause Hormone Therapy.
For an in depth comparison, click here.
Want to know more?
To find out more or which IUD is best suited to your personal circumstances, please book an appointment to discuss further. It takes approximately 30mins to exclude contraindications, discuss bleeding patterns, side effects, risks, the nature of the procedure and instructions on how to prepare for the procedure.